BACKGROUND/AIMS: Birth asphyxia occurs when a baby does not receive enough oxygen before, during or after birth . It is an insult to the fetus or newborn due to lack of oxygen (hypoxia) and /or a lack of perfusion (ischemia) to various organs . Fetus totally depends for its oxygen supply and other nutrients on the blood supplied through placenta. In any case, if blood supplied through placenta is hampered, it leads to asphyxial injury. We performed this study to determine the incidence of liver failure in birth asphyxia and to correlate the severity of hepatic disorder with asphyxia by estimating serum AST and ALT. MATERIAL AND METHODS: The study included 70 asphyxiated neonates and 50 healthy neonates as controls. Serum AST and ALT were estimated by IFCC method for Aspartate aminotransferase and IFCC method for Alanine aminotransferase respectively. RESULT: Serum AST and ALT were found significantly higher in asphyxiated babies compared to control groups (p<0.001). The mean AST and ALT of asphyxiated babies were 80.3±47.4 U/L and 88.8±43.5 U/L, respectively and those of normal babies were 20.5±8.5 U/L and 27.5±8.5 U/L respectively. The rise of AST and ALT also showed a significant positive correlation with the severity of asphyxia. Hence it can be concluded from present study that estimation of hepatic enzymes can be used as markers to diagnose the incidence of perinatal asphyxia and also to assess its severity.

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An adnexal pregnancy after tubal clamping is a very rare entity. Very few such cases have been reported in the past. Here, we discuss a case of such an occurrence. A 35-year-old female with third gravida and a history of two abortions with secondary infertility conceived via in vitro fertilization was admitted to the ward for observation with a history of amenorrhea of one and a half months and a known case of hypothyroidism. The ultrasonography showed left ectopic adnexal pregnancy that was managed conservatively. With a previous history of left ectopic pregnancy, the patient was managed with exploratory laparotomy with left partial salpingectomy. This case is used to illustrate the need to gather a complete medical history and take ectopic pregnancy into account in women who are of reproductive age and have a history of ectopic pregnancies.