scholarly journals Serum Calcium Levels in Preterm and Term Neonates on Phototherapy

2014 ◽  
Vol 34 (1) ◽  
pp. 24-28 ◽  
Author(s):  
S Arora ◽  
GS Narang ◽  
G Singh
Keyword(s):  
Serum Calcium ◽  
Magnesium Deficiency ◽  
Tertiary Care ◽  
Preterm Neonates ◽  
Care Hospital ◽  
Term Neonates ◽  
Neonatal Icu ◽  
Appropriate For Gestational Age ◽  
Preterm Group ◽  
Double Surface

Introduction: In addition to known causes of hypocalcemia like, prematurity, Intrauterine growth retardation (IUGR), asphyxia, sepsis, infants of diabetic mothers (IDM), high phosphate formula, Magnesium deficiency, effect of phototherapy on serum calcium levels has caught attention of researchers from time to time. The objectives of this study were to evaluate serum calcium levels in relation to duration of phototherapy, single surface Vs double surface phototherapy in term and preterm neonates. Materials and Methods: This study was done in a neonatal ICU of a tertiary care hospital. Hundred preterm and term neonates > 72 hrs of age with weight appropriate for gestational age were selected. Serum calcium levels were measured at the onset and after 24 hrs and 48 hrs of phototherapy and results were analyzed in both the groups. Results: Hypocalcemia was more frequently observed in term group as compared to preterm group. Hypocalcemia occurred more frequently after 48 hrs of continuous phototherapy in both groups. Hypocalcemia was more common under DSPT as compared to SSPT in both groups. Conclusion: Hypocalcemia is a significant problem in neonates subjected to phototherapy. DOI: http://dx.doi.org/10.3126/jnps.v34i1.9165 J Nepal Paediatr Soc 2014;34(1):24-28

scholarly journals Morbidity profile and immediate outcome of late preterm neonates compared to term neonates in a rural tertiary care hospital of Gujarat

2017 ◽  
Vol 4 (4) ◽  
pp. 1329 ◽  
Author(s):  
Manish Rasania ◽  
Prasad Muley
Keyword(s):  
Preterm Infants ◽  
Tertiary Care ◽  
Preterm Births ◽  
Full Term ◽  
Late Preterm ◽  
Preterm Neonates ◽  
Care Hospital ◽  
Term Infants ◽  
Term Neonates ◽  
Late Preterm Infants

Background: Late premature infants are born near term, but are immature. As a consequence, late preterm infants are at higher risk than term infants to develop morbidities. Although late preterm infants are the largest subgroup of preterm infants, there is a very limited data available on problems regarding late preterm infants in rural India.Methods: This is a retrospective cohort study using previously collected data from neonates born at Dhiraj Hospital and neonates who were born outside but admitted at SNCU of Dhiraj Hospital, Piparia, Vadodara district, Gujarat, India between January 2015 to December 2015.Results: 168 late preterm infants and 1025 term infants were included in this study. The need for SNCU admission is significantly higher in late preterm compared to full term (41.07% vs 2.04%). Morbidities were higher in late preterm neonates compared to full term neonates. Sepsis (4.76% vs 1.07%), TTN (10.11% vs 2.04%), hyperbilirubinemia (19.04% vs 9.36%), RDS (1.78% vs 0.09%), hypoglycemia (1.78% vs 0.29%), PDA (1.78% vs 0.58%), risk of major congenital malformation (2.38% vs 0.58%). Need for respiratory support was 5.95% in late preterm vs 2.04% in full term neonates. Immediate neonatal outcome in terms of death and DAMA (non-salvageable) cases was poor in late preterm neonates compared to full term neonates (1.19% vs 0.78%).Conclusions: Late preterm neonates are at higher risk of morbidities and mortalities. They require special care. Judicious obstetric decisions are required to prevent late preterm births. 

scholarly journals Morbidity and Mortality Outcome in Late Preterm Neonates at a Tertiary Care Hospital

2016 ◽  
Vol 12 (1) ◽  
pp. 44-47
Author(s):  
Tahsinul Amin ◽  
Ayesha Najma Nur
Keyword(s):  
Preterm Infants ◽  
Tertiary Care ◽  
Late Preterm ◽  
Morbidity And Mortality ◽  
Respiratory Morbidity ◽  
Preterm Neonates ◽  
Care Hospital ◽  
Term Neonates ◽  
Late Preterm Infants ◽  
Significant Difference

Introduction: The morbidity and mortality in late preterm neonates is higher than term neonates. The main reason is the relative physical and neurologic immaturity, though there is no significant difference in the weight or the size of the two groups. Objective: The study was conducted to compare the early neonatal morbidity and mortality (within first 7 days of life) in late preterm infants (34–36 6/7 weeks) with those in term neonates (37–41 6/7 weeks). Materials and Methods: This was a prospective study conducted from 01 January 2015 to 30 June 2015 in the department of Neonatology at a tertiary hospital. Results: Total 100 neonates were included in the study; fifty neonates in each group. Late preterm infants had significantly higher morbidity due to any cause, e.g. respiratory morbidity (p<0.05), jaundice (p<0.05), hypoglycemia (p<0.05), sepsis (p<0.05) and perinatal asphyxia (p<0.05). Early neonatal mortality in late preterm neonates was significantly higher than term neonates (p<0.05). Conclusion: Late preterm neonates are at high risk for morbidity and mortality as compared to term neonates. Journal of Armed Forces Medical College Bangladesh Vol.12(1) 2016: 44-47

scholarly journals PHOTOTHERAPY

2015 ◽  
Vol 22 (12) ◽  
pp. 1541-1545
Author(s):  
Sadida Bahawal ◽  
Umm-Ul- Baneen Naqvi ◽  
Mehboob Alam Siddiqui ◽  
Dr.Shakil Ahmad ◽  
Imran Sarwar
Keyword(s):  
Serum Calcium ◽  
Tertiary Care ◽  
Full Term ◽  
Preterm Neonates ◽  
P Value ◽  
Inclusion Criteria ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Term Neonates ◽  
Paediatric Unit

Hyperbilirubinemia is the most common abnormal physical finding in first fewweeks of lif and its most common management is phototherapy. Amongst other commoncomplications a less known complication of phototherapy is hypocalcemia. Objectives: To studythe incidence of phototherapy induced hypocalcemia in neonates and to have a comparisonbetween preterm and term neonates. Study design: Descriptive cross-sectional study.Setting: Paediatric Unit II DHQ Hospital Faisalabad, which is a tertiary care centre for all kind ofpatients. Duration of study with dates: Six months from 1-11-2012 to 30-04-2013. Methods:196 neonates with hyperbilirubinemia full term / preterm neonates admitted in pediatric DHQhospital faislabad were selected. Inclusion criteria. 1) Hyperbilirubinemia. 2) No hypocalcemiaon admission. 3) Received phototherapy for hyperbilirubinemia. Serum Calcium levels weremeasured in all neonates before and 48 hours after receiving phototherapy. Incidence ofhypocalcemia among all neonates was calculated as an absolute percentage and the samplepopulation was also divided into preterm / full term neonates to evaluate the incidence ofhypocalcemia in these two groups individually. RESULTS: Mean serum calcium in neonateswas 7.5+- 1.5 mg / dl .16.84 % of neonates were found to have calcium level below the cut offvalue. 33 out of 196 developed hypocalcemia after phototherapy and out of these 54 % werepreterm and 45 % were term neonates < P-value (0.01)>. Conclusion: Phototherapy induceshypocalcemia in neonates more so in preterm neonates. Impact: Consideration for additionalcalcium supplementation should be undertaken in all neonates undergoing phototherapy andfurther randomized trials need to be done with these concerns.

A RETROSPECTIVE ANALYSIS OF MATERNALAND FETAL OUTCOMES OF PRETERM DELIVERIES IN A TERTIARY CARE HOSPITAL IN SOUTH INDIA.

2021 ◽  
pp. 42-44
Author(s):  
Varsha Konyala ◽  
Poornima M ◽  
Suma K.B
Keyword(s):  
Preterm Delivery ◽  
South India ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Preterm Births ◽  
Late Preterm ◽  
Preterm Neonates ◽  
Care Hospital ◽  
Maternal Complications ◽  
Record Keeping

Aim:To study preterm delivery outcomes in a tertiary care hospital in South India. Methods: The study was conducted for a 7 month period from July 1, 2020 to January 31, 2021at JSS Hospital, Mysuru. Relevant details of every pregnant woman who underwent a preterm delivery and the subsequent neonate born were collected and followed till discharge. Results: The prevalence rate of preterm births was 11.81%. There were 44 early preterm deliveries and 88 late preterm deliveries. The most common maternal complications that lead to preterm births PPROM and preeclampsia.36 early preterm and 29 late preterm neonates required an NICU admission. This included 7 pairs of twins in the early preterm and 1 pair of twins in the late preterm. In the NICU, the most common complications noted were RDS, and sepsis.4 neonates remained by mother's side soon after delivery in the early preterm subset, whereas 54 of late preterm neonates were kept by the mother's side soon after delivery. 31 of 40 early preterm, 86 of the 88 of late preterm neonates were healthy and t for discharge. Conclusion:The prevalence of preterm birth rate in our study stands comparable to the reported global average. Preterm births have a multifactorial etiology. Timely referral to higher centers, experienced obstetricians, and a good NICU facility proved helpful to both the mother and neonate. Thorough record keeping also allows a true picture of preterm prevalence on the basis of which, policies and decisions can be made to further improve preterm care.

scholarly journals Clinical Presentation of Preterm Neonates with Intraventricular Hemorrhage: Experience in a Tertiary Care Hospital in Dhaka

2017 ◽  
Vol 7 (3) ◽  
pp. 194-197
Author(s):  
Tasnima Ahmed ◽  
Abdul Baki ◽  
Tahmina Begum ◽  
Nazmun Nahar
Keyword(s):  
Clinical Features ◽  
Intraventricular Hemorrhage ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Sudden Onset ◽  
Morbidity And Mortality ◽  
Preterm Neonates ◽  
Cranial Ultrasound ◽  
Care Hospital ◽  
One Year

Background: Intraventricular hemorrhage (IVH) is common among preterm infants as many of them survive with the advancements in neonatal care. Severe IVH may lead to significant morbidity and mortality. The objective of our study is to find out the significant clinical signs of IVH in preterm neonate for early detection by ultrasonography.Methods: This prospective observational study was done in special care baby unit (SCABU), Bangladesh Institute of Research & rehabilitation of Diabetic, Endocrine & metabolic Disorder (BIRDEM) for a period of one year. Eighty five preterm neonates were included in this study. Clinical features of IVH like- convulsion, lethargy, irritability, bulged fontanelle, recurrent apnea, sudden onset of respiratory distress, sudden pallor and bradycardia were observed. Cranial ultrasound studies were done within 7 days of life in all cases to identify IVH.Result: Mean gestational age of these neonates was 31.31(±2.2) weeks & mean birth weight was 1413.42 (±330.55) gm. Among 85 preterm neonates 21(24.7%) developed IVH, confirmed by ultrasonography of brain. Clinical features like convulsion, bulged fontanel, repeated apnea & sudden pallor were significantly present in IVH group.Conclusion: Intraventricular Hemorrhage constitutes an important cause of morbidity and mortality in neonate. This study showed that clinical features like convulsion, bulged fontanel and sudden pallor had a significant relationship with intraventricular hemorrhage which will help for its early detection.Birdem Med J 2017; 7(3): 194-197

scholarly journals Transport Factors Affecting the Outcome of Referred Neonates Admitted in A Tertiary Care Hospital

2018 ◽  
Vol 41 (3) ◽  
pp. 159-164 ◽  
Author(s):  
Madhabi Baidya ◽  
Mahfuza Shirin ◽  
Liton Chandra Saha
Keyword(s):  
Perinatal Asphyxia ◽  
Care Center ◽  
Tertiary Care ◽  
Preterm Neonates ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Neonatal Transport ◽  
Group I ◽  
Group Ii

Background: Adequate neonatal transport is a key component of care of the sick newborns who require referral to tertiary care center. Poor transportation is one of the iatrogenic factors associated with greater neonatal mortality. Neonatal transport is the greatest challenge faced today in our country. The purpose of this study was to find out characteristics of transport of referred neonates and to idention the factors that contribute to mortality.Methodology: This cross sectional study was conducted in Dhaka Shishu (Children) Hospital from June 2013 to November 2013. Both term and preterm neonates who were referred within first seven days of life were included and those with gross congenital abnormalities and left against medical advice were excluded from the study. After enrollment, data were collected using a structured questionnaire including birth details, interventions before transportation, reasons for referral, and details of transportation. Outcome & duration of hospital stay were also recorded. Neonates who were expired considered as group I and who were survived considered as group II. The study variables were analyzed for their association with immediate outcome by applying chi square test and t test. P value <0.05 was considered significant.Results: This study found that out of 332 neonates 181 were expired with 54.5% mortality rate. One eighty one neonates who were expired, considered as group I and one fifty one neonate were survived, considered as group II. The mortality was significantly high in male neonates [RR 0.80 (0.66-0.97)] and neonates those delivered at home [RR 1.34(1.10-1.64)] (p<0.05). Perinatal asphyxia, pre-term low birth weight, neonatal sepsis were the main causes of referral. It was found that transportation without any referral note [RR 1.40 (1.14- 1.71)], no advice regarding maintenance of airway[RR 1.50(1.17- 1.92)]and keeping warm [RR 1.51(1.17-1.950], resuscitation on admission [RR 1.63(1.23-2.17)] and transportation required > 3hours [RR 1.36(1.09-1.69)] were associated with significantly higher mortality among referred transported neonates(p<0.05).Conclusions: This study found that male neonates, home delivery, transportation without any referral note, no advice regarding maintenance of airway and keeping warm, resuscitation needed on admission and prolonged transportation time were significantly associated with mortality of referred transported neonates.Bangladesh J Child Health 2017; VOL 41 (3) :159-164

Does a prenatal diagnosis affect mortality and morbidity for neonatal arterial switch operation

2022 ◽  
pp. 1-5
Author(s):  
Osman Guvenc ◽  
Serdar Beken ◽  
Aysegul Inamlik ◽  
Eda Albayrak ◽  
Bahar Temur ◽  
...  
Keyword(s):  
Prenatal Diagnosis ◽  
Arterial Switch Operation ◽  
Tertiary Care ◽  
Operation Time ◽  
Care Hospital ◽  
Mortality And Morbidity ◽  
Arterial Switch ◽  
Switch Operation ◽  
Neonatal Icu ◽  
Group 1

Abstract Background: The effect of prenatal diagnosis on prognosis in patients with transposition of the great arteries is not clear. In this study, we compared the outcomes after arterial switch operation. Methods: Outcome of 112 patients who had arterial switch operation in the neonatal period were analysed. The patients were divided into two groups: those who had prenatal diagnosis (Group 1; n = 34) and those who did not (Group 2; n = 78). The patients were also classified based on their diagnosis: simple transposition, transposition with ventricular septal defect and/or aortic arch hypoplasia, and Taussig–Bing anomaly. Results: In Group 1, the C-section delivery rate was higher (82% vs. 44%; p = 0.004), and it was observed that patients in Group 1 were more often intubated upon admission to the neonatal ICU (38% vs. 9%; p = 0.005). No differences were found between the two groups in terms of operation time, cardiopulmonary bypass time, post-operative invasive respiratory support duration, or extracorporeal membrane oxygenation support. It was observed that those who had Taussig–Bing anomaly had a higher mortality. Conclusions: Timely treatment have a positive effect on neonatal mortality and morbidity. That’s why all families with prenatal diagnosis of critical CHD should be recommended to have the delivery in a tertiary care hospital. Although it could not be demonstrated in this study, prenatal diagnosis has a potential to improve surgical results especially in countries or cities, which does not have enough resources for transfer and surgical units. Further efforts are needed to improve prenatal screening programmes.

P5477Usefulness of hypocalcemia at admission as a prognostic marker in patients with acute coronary syndromes

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J C Gomez Polo ◽  
C F Ferrera ◽  
V Ruiz-Pizarro ◽  
Z Gomez-Alvarez ◽  
T Romero-Delgado ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Prognostic Marker ◽  
Serum Calcium ◽  
Tertiary Care ◽  
Multivariable Analysis ◽  
Care Hospital ◽  
Bleeding Events ◽  
Killip Class ◽  
St Segment Elevation ◽  
Hospital Patients

Abstract Background Few studies have focused on the role of serum calcium levels (SCa) in patients with acute myocardial infarction (AMI). Purpose This study aimed to analyze the value of SCa as a prognostic marker in patients with AMI, including both with or without ST elevation. Methods From January-2015 to December-2017, all consecutive patients with AMI admitted to a tertiary care hospital were included. For the purpose of this study, total SCa levels were recorded at admission in each patient. Blood samples were obtained at the first medical contact when the patient arrived to the hospital. Patients were classified according to quartiles depending on their SCa at admission: Q1, under 8.3 mg/dl (N=300); Q2, between 8.4–8.7 mg/dl (N=264); Q3, between 8.8–9.1 mg/dl (N=279) and Q4, over 9.1 mg/dl (N=283). Results A total cohort of 1126 patients was included, 679 (60.3%) had STEMI and 447 (39.7%) were NSTEMI patients. Patients in the Q1 had more in-hospital complications, such as heart failure, bleeding events, new onset AMI, atrioventricular block and contrast induced nephropathy. Patients in the Q1 had higher in-hospital and one-year mortality as compared to that of patients in the Q2-Q4. After multivariate adjustment (Table), low SCa (<8.3mg/dl) remained as an independent predictor of in-hospital mortality (OR 2.91, 95% CI (1.15–7.41), p=0.025). These results were consistent in STEMI and NSTEMI patients. Multivariable analysis Variable OR (95% CI) p GRACE score 1.00 (0.99–1.02) 0.727 CRUSADE score 1.03 (1.01–1.06) 0.011 Age (per year) 1.05 (1.00–1.09) 0.034 STEMI 1.35 (0.41–4.46) 0.617 Diabetes 2.57 (0.97–6.79) 0.056 Low SCa (<8.3) 2.91 (1.15–7.41) 0.025 Killip class at admission   1 Reference   2 4.73 (1.31–17.1) 0.018   3 6.83 (1.70–27.5) 0.007   4 9.83 (1.44–67.1) 0.020 STEMI: ST segment elevation myocardial infarction; SCa: Serum calcium levels; OR: Odds ratio; CI: Confidence interval. Conclusion In patients with AMI, low SCa levels at admission (<8.3mg/dl) are independently associated with higher mortality.

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