A study of postnatal assessment of gestational age of neonates by new Ballards and Parkins score

Background: The aim, of the study was to find the correlation between new Ballard score and Parkin’s score and whether they correlate with obstetric gestational age estimated by LMP and/or 1st-trimester USG.Methods: A cross-sectional clinical study for 6 months duration was carried out at tertiary care NICU and postnatal ward of a teaching hospital. Any intramural neonate admitted in NICU and neonates examined after randomized selection in postnatal ward within the first 24 hours of life were included in the study after written informed consent. Their demographic profile was documented using preset Performa and gestational age was assessed using both New Ballard score and Parkins score.Results: Total 387 new-borns were screened with mean age of 12.86±11 hours. Out of which 209 (54.0%) were males and 178 (46.0%) were females. The 259 (66.0%) new-borns were normal vaginal delivered and 128 (33.0%) new-borns were delivered by caesarean section. In the study it was found that the obstetric gestational age strongly correlates to gestational age by new Ballard score (r=0.880, p<0.001), and to gestational age by Parkins score (r=0.880, p<0.001). The gestational age by new Ballard score also strongly correlates to gestational age by Parkins score (r=0.937, p<0.001). Scatter diagram shows that there is strong positive linear correlation between gestational age assessed by LMP and NBS. While that gestational age accessed by Parkins having weak positive relationship compared to NBS.Conclusions: New Ballard score predicts new-born gestational age better in preterm and term new-borns, but Parkin’s Score, being simpler assessment method, takes very less time and has the advantage of no subjective neurological criteria and lesser interpersonal variation.

SARS-CoV-2 Exposure from Health Care Workers to Infants: Effects and Outcomes

Objective This study aimed to evaluate the risk and outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission from positive health care workers (HCW) to infants in the neonatal intensive care unit (NICU) and the postnatal ward. Study Design We conducted a retrospective analysis of infants in NICU and the postnatal ward postexposure to a COVID-19 positive HCW between May 1 and July 31, 2020. HCW had the detection of SARS-CoV-2 after being symptomatic. Infants exposed to these HCW were tested for SARS-CoV-2 and were classified as confirmed positive when test was positive 24 hours after exposure; confirmed negative when test was negative with no escalation of respiratory support provided; and probable if test was negative. However, infant required escalation of respiratory support. Infants were followed at 14 days postexposure then at the end of the study period for admitted infants. Results A total of 31 infants were exposed to SARS-CoV-2 positive HCWs (42 exposure incidences). The median age at exposure was 21 days. None of the infants was confirmed positive. Nine infants were classified as probable cases of whom five infants with underlying chronic illnesses died, two were discharged home, and two were still admitted. Of the 22 confirmed negative cases, 15 were discharged and were well on follow-up, and 7 were still admitted. Conclusion No active transmission of infection from infected HCW to admitted infants was identified. Although some infants had respiratory escalation postexposure none were confirmed positive. Adhering to personal protective equipment by HCW or low susceptibility of infants to SARS-CoV-2 infection may explain the lack of transmission. Key Points

Study on outcome of guided newborn care in postnatal ward and common practices of newborn care among mothers followed in outpatient department at Hi-Tech medical college and hospital, Bhubaneswar

Background: Neonatal period is the most vulnerable phase in a child's life. The aim and goal of newborn care is not only to reduce neonatal mortality but more importantly to ensure their survival to the fullest. The neonatal mortality rate of India is 22 per 1000 live births. The neonatal period is only for 28 days yet it accounts for significant deaths under 5 years of age. Newborn morbidity and mortality contribute significantly to the infant mortality and under-five mortality rates in developing countries. About two-thirds of all infant deaths and 38% of all under-five deaths occur during the neonatal period, resulting in about 4 million neonatal deaths globally per year. Infant and under-five mortality ratio in developing countries have declined significantly in the past couple of decades, yet neonatal mortality rates have remained relatively static. The objective of this study was to understand the outcome of guided newborn care along with the patterns and determinants of essential newborn care and practices.Methods: A prospective cohort study was done among newborns in the postnatal ward and the outpatient (OPD) based newborns at HMCH Bhubaneswar from July 2020 to June 2021. The mothers in the postnatal ward were taught cord care, skin care, optimal thermal care and neonatal feeding practices. The regular follow-up was done maximum up to 7 days. Newborn who came to OPD were evaluated on perspective of essential newborn care and practices, followed by their mothers at home. A questionnaire was formulated for the OPD based patients to be answered before and after guidance.Results: 100 early neonates were taken (N=50 from postnatal ward and N=50 from OPD). Out of 50 neonates in the postnatal ward. 4 (8%) had abdominal colic, 10 (20%) had skin rashes, 2 (4%) had fever, 5 (10%) had feeding issues and 9 (18%) had neonatal hyperbilirubinemia respectively. In OPD neonates 3 (6%) were diagnosed with early onset neonatal sepsis (EONS), 7 (14%) had refusal to feed, 12 (24%) had skin rashes, 5 (10%) had abdominal colic, 14 (28%) were applying coconut oil and 7 (14%) developed hyperbilirubinemia. Whereas in OPD 5 (10%) neonates needed admission NICU and rest were managed symptomatically.Conclusions: Newborn care education and guidance helped in reduction of EONS, in gaining appropriate weight, in delivering optimal thermal care, practicing healthy skin care and implementing proper feeding techniques. All mothers need proper counselling and guidance in essential newborn care.

Women's views on the visiting restrictions during COVID-19 in an Irish maternity hospital

Background Due to the coronavirus infection, visitors to all hospitals were greatly restricted in the UK. In maternity hospitals, only partners of women in labour were permitted to attend the hospital. Aims This study aimed to gain an understanding of women's experiences of visiting restrictions imposed due to COVID-19. Methods Women who attended the hospital for outpatient appointments and who were inpatients on the antenatal or postnatal ward during a two-week period were asked to complete an anonymous survey. Findings A total of 422 surveys were completed. The majority of women (97.6%) agreed that the hospital made adequate preparations for them to feel safe. Most women reported that the restrictions are a good thing and several advantages were identified. Women cited not having their partner with them as the main negative consequence to the restrictions. Conclusions Although women miss having their partner for support during scans and to help after the baby is born, during the COVID-19 pandemic, the safety aspect of the restrictions and the support received from staff is considered by women when making recommendations to a maternity hospital about whether, or how, to ease restrictions on visiting.