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Annals of Neonatology Journal
Number of Followers: 6  Open Access journalISSN (Online) 2636-3569 Published by Minia University  [2 journals]
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- Optimal Gestational Weight Gain According to Pre-pregnancy Body Mass Index
That Reduces Fetal and Maternal Complications: A Prospective-Cross
Sectional Study
Abstract: Background: Guidelines identified maternal and infant relationships with gestational maternal weight gain but were based on lower general population BMI with limited ethnic diversity. Aim of the work: The aim of this study was to evaluate the effects of gestational maternal weight gain (GWG) on pregnancy outcomes in pregnant women with different pre-pregnancy body mass index (BMI) to establish optimal GWG for each BMI category. Methods: This is a prospective cross-sectional included 550 pregnant women who attended antenatal care unit, department of obstetrics and gynecology, faculty of medicine, Minia university starting from 1st of April 2021. Result: The current study included 550 pregnant females, their age ranged 18 – 42 years; 30.1% of them were primi-gravida and 25.3% were multigravida ≥ 4. About one-third of our cases (32.36%) developed complications; the commonest complications were medical complications 25.09% followed by infant complications in 23.37%, then obstetric complications in 19.3%. Medical, obstetric, fetal complications and LGA were statistically significant higher in obese than non-obese females (p-< 0.001). Diabetes Mellitus (DM), hypertension, cholycystitis, PROM and infant complications were statistically significant higher in severe obese than moderate-obese females (p-< 0.001). The commonest infant complication was LGA in 16.7%. Conclusions: Obese females are more susceptible for more medical, obstetric and fetal complications. DM, hypertension, cholycystitis, PROM, infant complications, LGA and prematurity were the most common complications especially in severe obese than moderate-obese females; so more attention should be paid during antenatal care and follow up of obese pregnant women.
- The Etiological Factors of Polyhydramnios in Pregnant Women. A Prospective
Cross Sectional Study
Abstract: Background: The amniotic fluid is required for the proper growth and development of the fetus, and it also acts as a barrier against infection and helps in fetal lung maturity. It varies with gestational age. Polyhydramnios is the excess of the amniotic fluid relative to the gestational age, which may be associated with adverse fetal and maternal outcomes. Aim and objectives: to detect the etiological factors of polyhydramnios in the Minia governorate with limited tools. Methods: This prospective study was conducted in the department of Obstetrics & Gynecology at Minia University. A group of 100 pregnant ladies irrespective of gestational age with an amniotic fluid index of more than 20 was included in the study.Results: the mean AFI was 30.3± 6.1 among the participants. 46% had mild polyhydramnios, 28% had moderate polyhydramnios and 26% had severe polyhydramnios. There 14% had turbid amniotic fluid among the participants. Conclusions: Women with polyhydramnios had an increased risk for delivery by a cesarean section. Both diabetes mellitus and gestational diabetes are the main risk factors of polyhydramnios. Neonates delivered for women with polyhydramnios were at risk for late-term gestational ages, neonatal birth weighs > 2.5 Kg and increased NICU admission rates.
- Maternal and Perinatal Outcomes in Pregnant Women with Covid-19: A
Retrospective Egyptian Study
Abstract: Background: Severe acute respiratory distress coronavirus 2 is the causative agent of the newly identified coronavirus disease 2019 (COVID-19) (SARS CoV-2). Infections caused by coronavirus may produce a wide spectrum of symptoms, from moderate to life-threatening conditions including viral pneumonia accompanying systemic damage. Pregnant women may be more susceptible to developing respiratory infection problems, which may increase the risk of both maternal and fetal morbidity and mortality due to the physiological and immunologic changes that occur during pregnancy.Aim of work: to assess maternal and perinatal outcomes in Egypt's isolation hospitals in relation to SARS-CoV-2 infection during pregnancy, hospitalization, and newborn survival.Patients and methods: Minia University Hospital's Obstetrics and Gynecology ward was the site of this retrospective cohort research. Between March 2020 и June 2021, 46 pregnant women who've been tested for SARS-CoV-2 were included in the research. Results: According to the distribution of trial information among the women who were evaluated, one baby was born with COVID infectious agent and four newborns required admission to the neonatal intensive care unit. Neonatal jaundice was the only minor consequence. Most patients were successfully released from the hospital, and the care of one patient was transferred to a different facility. Conclusions: COVID-19 is associated with a greater risk of mortality, mechanical ventilation, and intensive care unit hospitalization among pregnant women. Preterm delivery is common among pregnant women with Covid-19, and their babies often need care in the neonatal intensive care unit (NICU). Therefore, pregnancies with covid-19 should be considered high-risk.
- Prevalence of Early Miscarriage among Female Teenagers in Minia and Sohag
Governorates: A Prospective Cross–Sectional Study
Abstract: Background: Approximately three million teenage girls are presumed to have had unsafe abortions that may end up with serious reproductive consequences or mortality. In 2008, approximately 13% of teenagers aged <15 years and 14% of adolescents aged 15-17 years had a miscarriage. Aim: This study aimed to determine the prevalence and rates of related factors of teen early miscarriage at Minia and Sohag governorates. Methods: A cross–sectional study carried out at Minia university hospital and Sohag general hospital obstetrics and gynaecology departments during the period from July 2018 to November 2020. Result: A total of 400 teenage pregnant were included. The age of respondents at their 1st pregnancy ranged from 15 to 19 years. About 16% of cases had complications related to previous pregnancy. About one-fifth (19.5%) had a previous history of abortion. Also, about one-tenth (10.5%) experienced miscarriage. Further, about half cases (n=198) used contraception. Likely, about two-thirds (n=242) of the sample delivered by CS. Similarly, 198 cases (49.5%) experienced complication during pregnancy. Also, 4% of mothers had birth injury while only 1% of neonates had birth injury. Additionally, 48% of cases had depression, 3.5% had thoughts of suicide, 1% had suicide attempts and 50.5% had stress disorders, 48% were exposed to violence by the parents/exposed to neglect and 51.5% exposed to abuse. Conclusion: The majority of teenage pregnant mothers were uneducated and housewives. Most teenage mothers had no pre-existing diseases and irregular antenatal care. Higher rates of preeclampsia and low Apgar scores were notably increased among teenage pregnant. Pregnancy complications were closely associated with the patients’ socio-demographics.
- Outcomes of Premature Neonates Less Than 35 Weeks in Low Income Countries,
Case of Democratic Republic of Congo
Abstract: Background: Prematurity is cause of perinatal mortality and morbidity. Mortality is higher in newborns under 32 weeks in almost sub-Saharan African countries.Aim of work: To determine factors associated with preterm mortality less than 35 weeks of gestational age.Patients and methods: A retrospective study was conducted at Monkole Hospital on date base of preterm babies, born during the period from January 1, 2018 to December 31, 2021. Results: The study included 398 hospitalised preterms. The prevalence of prematurity was 8.3%, 220 (55.6%) were female preterms and 176 (44.4%) were males, with a sex ratio of 1.25. Their average weight was 1482 + 434 g. Caesarean sections were induced in 47% of cases (186). Central cyanosis was present in 32.1% (127), the majority was less than 28 weeks. The rate of antenatal steroid use was 45% (75/167). Mortality rate was higher in preterm infants less than 28 weeks. The rate was 80.1% at 26 weeks, 69.1% at 27 weeks and 56.5% at 28 weeks. A multivariate logistic regression analysis noted that the mortality of preterm infants decreased with increasing gestational age (OR= 0.544, 95% CI: 0.450-0.659, p=0.000). Morbidity was associated with the absence of antenatal corticosteroid therapy (OR = 2.768, 95% CI: 1.071-7154, p=0.036), absence of Continuous Positive Airway Pressure CPAP use (OR= 0.259, 95% CI: 0.109-0.619, p=0.002) and with transfer (OR = 0.338, 95% CI: 1.470-5.534, p = 0.002).Conclusions: Prematurity is one of the major causes of neonatal mortality especially in developing countries. The absence of antenatal corticosteroid therapy and non-use of CPAP increases the mortality of premature babies in this study.
- Maternal and Neonatal Benefits of Prophylactic Administration of Vitamin K
Before Elective Cesarean Section; A Randomized Control Trial
Abstract: Background: We aimed to assess the efficacy of prenatal prophylactic maternal vitamin k administration in decreasing blood loss during and after elective cesarean section (CS) and its effects on neonatal outcomes. Methods: A clinical trial included 200 pregnant women planned for elective CS, were randomized into two equal groups. The study group included 100 women who received vitamin K (10 mg) intramuscularly once daily for three days before elective CS, while the control group included 100 women who did not have vitamin K before CS. Maternal PT, PC, APTT, and hematocrit were evaluated pre-and postoperatively. Maternal blood loss during CS was assessed by counting the soaked gauzes. Vitamin K levels in the umbilical cord, neonatal APGAR score, and the neonatal PT and PC were measured. Results: Postoperative PT and APTT of women in the vitamin K group were shorter than the control group (p<0.001). Also, women's postoperative PC and hematocrit in the vitamin K group were higher than that of the control group (p<0.001). Neonates who received vitamin K had significantly shorter PT, higher PC, and less bleeding than the control group (p<0.001). Cord blood vitamin K levels in the group who received vitamin K were considerably higher than in the controls (p<0.001). Conclusion: Administration of prophylactic vitamin K had a beneficial effect on maternal bleeding tendency but to somewhat added no value in neonates as both PT and PC values were within normal despite of significant differences in both groups.
- Predictive Value of Heart Rate Observation (HeRO) Score for Sepsis in
Preterm Neonates
Abstract: Background: Neonates admitted to neonatal intensive care units (NICU) are at an increased risk to develop sepsis, especially preterm neonates because of their immature immune systems. Early detection of sepsis, before pronounced clinical deterioration, would allow earlier administration of supportive treatments and antibiotics this will improve morbidity and lead to favorable outcomes.Objective: The aim of this study was to determine the effectiveness of HeRO score to detect neonatal sepsis in preterm neonatesMethods: This prospective observational study included 170 preterm infants. All studied neonates were subjected to HeRO scores initially and throughout hospital stay. Confirmation of neonatal sepsis was done by withdrawal of positive C-reactive protein (CRP) and positive blood culture.Results: The studied neonates were divided into initial septic group and non-septic neonates; HeRO score showed statistically significant increase in septic patients than non-septic (median (IQR) 2 (2-3) vs. 1 (0-1) respectively for day 1 of admission (p <0.001) and 2 (1-2) vs 0 (0-1) on day 4 of admission (p <0.001) with a cut off value of > 1 in both day 1 and 4 with sensitivity and specificity 92.75% & 98.02% for day 1 and 65.22 % and 85.15% in day 4 respectively. Conclusion: Heart Rate Observation (HeRO) Score can be used for early detection of neonatal sepsis in preterm neonates.
- Newborn Screening for Congenital Hypothyroidism and Congenital Adrenal
Hyperplasia in Egypt
Abstract: Two disorders, congenital adrenal hyperplasia (CAH) and congenital hypothyroidism (CH), when untreated, can lead to devastating, irreversible and fatal outcomes. Permanent cognitive impairment, growth failure and dysmorphic features are seen in congenital hypothyroidism (CH) and early infant death in males with salt loosing CAH (as most females are discovered by presence of atypical genitalia, while males appeared normal).Newborn screening (NBS) for congenital hypothyroidism (CH) was more rapidly adopted throughout Egypt, while NBS for congenital adrenal hyperplasia (CAH) was recently added.Early treatment of CAH is much simpler with taking a pill a day unlike CAH requiring multiple medication doses, and possibly surgery apart from enteral and parenteral stress doses during adrenal crisis.Early newborn screening specifically for those two disorders has a great importance for early diagnosis, early intervention and prevention of catastrophic outcomes.
- What to Know about Neonatal Alloimmune Thrombocytopenia (NAIT) '
Abstract: Neonatal alloimmune thrombocytopenia (NAIT) is the most common cause of severe thrombocytopenia in full-term newborns. In the mother and fetus with incompatible platelet antigens, there is a risk of developing anti-platelet alloimmunization. It corresponds to Rhesus (Rh) alloimmunization in pathophysiology. These platelet alloantibodies pass trans-placentally into fetal circulation and cause fetal platelet destruction. Although its presentation may be isolated thrombocytopenia, some affected infants may suffer major hemorrhages, including intracranial hemorrhage (ICH), which may occur as early as 16 weeks of gestational age, and the first pregnancy may not be spared. Death or neurologic impairment occurs in up to 25% of the affected infants. NAIT is managed both ante- and postnatally. Postnatal management of NAIT depends upon the platelet count and the neonate's clinical condition. At the same time, antenatal management of NAIT aims to ameliorate fetal thrombocytopenia in subsequent pregnancies after diagnosis of NAIT in a previous pregnancy and thus prevent fetal and neonatal ICH.
- Acknowledgement for Reviewing
Abstract: The Editor-in-Chief expresses his gratitude to the following individuals, who reviewed manuscripts for Annals of Neonatology from Vol. 1 to Vol. 5.
