BackgroundMeconium aspiration syndrome (MAS) is considered a major cause of respiratory morbidity. It is a common issue encountered in the delivery room and newborn nursery. There is a need to identify the factors that lead to MAS to develop strategies to screen such patients at an early stage to decrease the mortality and morbidity. The objective of this study was to determine the factors leading to MAS in neonates delivered at ≥37 weeks of gestational age.MethodsA cross-sectional study was conducted through non-probability consecutive sampling technique at Liaquat University Hospital, Hyderabad from August 2016 to February 2017. All neonates at ≥37 weeks of gestation with meconium-stained amniotic fluid (MSAF) detected during delivery were included in this study after obtaining informed consent from their parents. The demographic and factors related to MAS were recorded through predesigned proforma and analyzed using SPSS version 22. Mean and standard deviation were determined for quantitative variables whereas frequency and percentages were calculated for qualitative variables.ResultsOverall 136 neonates were included in the study. The mean gestational age was 38 ± 1.43 weeks. The major factors for MAS were detected as fetal distress (67.0%, n = 91), non-reassuring fetal heart rate (54.0%, n = 73), cesarean birth (48.0%, n = 65), intrauterine growth restriction (IUGR; 17.0%, n = 23), and post maturity (12.0%, n = 16).ConclusionWe conclude that the major factors for MAS are fetal distress, non-reassuring FHR tracing, cesarean birth, IUGR, and post maturity. Screening of such patients at an early stage may minimize morbidity and mortality related to MAS.
BackgroundGlobally, approximately 14.6% children are born with low birth weight (LBW) annually. In Pakistan, this figure however reaches approximately 16%. Low birth weight infants are vulnerable to develop early morbidities like hypothermia, hypoglycemia, respiratory distress syndrome and hypocalcemia. There is a scarcity of statistics which creates a gap in development of strategies for improving quality of care in developing countries. The aim of our study was to determine the frequency of early morbidities such as respiratory distress syndrome (RDS), hypoglycemia, hypothermia and hypocalcemia in low birth weight neonates.MethodologyA prospective descriptive study was conducted via non-probability sampling technique from 1st April 2016 to 30th September 2016 at The Aga Khan University Hospital, Karachi. All low birth weight infants, i.e., those with birth weight < 2500 grams were included in this study and observed for early morbidities, including hypothermia, hypoglycemia, hypocalcemia and respiratory distress syndrome. Descriptive analysis was done using SPSS version 22 (IBM Corp., Armonk, NY), mean and standard deviation were determined for quantitative variables, whereas frequency and percentages were calculated for qualitative variables.ResultsA total of 2082 neonates were born during the study period, of which 271 (13%) were born with low birth weight. One hundred and eighty-five (68.1%) of these LBW neonates were preterm babies while 86 (31.9%) were born at term. Among LBW neonates 137 (51.0%) were males and 134 (49.0%) females. In the study population, hypoglycemia was seen in 17.3%, hypocalcemia in 13.6%, respiratory distress syndrome in 11%, and hypothermia in 2.5%.ConclusionOur study highlighted major early morbidities of LBW neonates, and their association with birth weight, gestational age and gender. Significant association of birth weight was found with hypothermia and hypocalcemia, whereas hypocalcemia and RDS were significantly associated with gestational age. However, none of the early morbidities had significant association with gender. Keeping in perspective the early morbidities in this population we propose that priority be given to providing adequate attention to low birth weight neonates.
Aim: To compare the outcome of intermittent phototherapy versus continuous phototherapy in treatment of neonatal jaundice. Study Design: Randomized clinical trial (RCT). Place and Duration: This study was conducted at Department of pediatrics, neonatal ward, Liaquat university hospital Hyderabad/Jamshoro, from 8 January to 7 July 2020 Methodology: There were 222 neonate with jaundice, which were randomly allocated into two groups. One hundred and one neonates were in group “A” who received continuous phototherapy while 111 neonates were treated with intermittent phototherapy called group B. Phototherapy units were identical regarding their manufacture and radiance with 5 blue light tubes at a distance of 15-20 cm above neonate that produced the irradiance of 20µW/cm2/nm at 420-470 nm. Serum bilirubin levels were measured every 12 hourly after starting phototherapy up to 48 hours. SPSS version 22 was used for data analysis. Results: The average age of the neonates was 2.23±1.45 days. In this study, the reduction of bilirubin level in both groups after 12, 24, 36, 48 hours of phototherapy and at the time of discharge was not different between groups. Conclusion: Intermittent and continuous phototherapies were found to be equally effective. Because of its additional benefits, intermittent phototherapy can be adopted as a routine procedure instead of continuous phototherapy in neonatal care units, however, it needs to be confirmed by large scale RCTs.
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