A B C D E F G H I J K L M N O P Q R S T U V W X Y Z All
Srinivasa, B. S.
- A Study of Prevalence, Risk Factors and Clinical Profile of Neonatal Hypoglycemia
Authors
1 Hassan Institute of Medical Sciences, Hassan, Karnataka 573201, IN
Source
Indian Journal of Public Health Research & Development, Vol 3, No 3 (2012), Pagination: 210-213Abstract
Objectives: The objectives of the study was to know the prevalence of neonatal hypoglycemia, clinical presentation and the various risk factors resulting in hypoglycemia.
Method: Babies born in our hospital were screened for hypoglycemia. Babies having hypoglycemia at birth and babies with risk factors for hypoglycemia were included in our study. These babies were monitored for hypoglycemia by using glucose strips and confirmed by laboratory method for the first 72hrs and these babies were also observed for clinical presentation. Data collected was statistically analysed by using 't' test.
Results: The prevalence of neonatal hypoglycemia was 9.4% in our hospital with male to female ratio was 1.46:1. Study shown percentage of hypoglycemia is more common in infant of diabetic mother and in birth asphyxia (06.59% each) followed by meconium aspiration syndrome babies (04.30%). Hypoglycemia was more in Cesarean born babies 57.14% than other modes. Hypoglycemia was observed in significant number during first 24hours of life and symptomatic cases were only 36.27%. In Clinical presentation respiratory distress was the commonest symptom followed by jitteriness, lethargy; seizures and combination of all these symptoms were in large number. Hypoglycemia was common in preterm babies 54.94%. Hypoglycemia in intrauterine growth retardation babies was significant number 63%, off these asymmetrical intrauterine growth retarded babies were71.42%. Neonatal hypoglycemia by laboratory(GOP)method was only 37.30%.
Conclusion: Hypoglycemia is a common metabolic disorder in neonatal period leading to brain dysfunction causing significant neonatal morbidity and mortality, it has to be evaluated and intervened early.
Keywords
Clinical Profile, Neonatal HypoglycemiaReferences
- Haworth JC, Vidyasagar. Hypoglycemia in newborn: Clinical Obstetrics and Gynecology. 1971; 14: 821-839.
- Haworth JC, MC Rae KN. The neurological and developmental effects of neonatal hypoglycemia. A follow up of 22cases. Canadian med. Ass. J, 1965; 92: 861-864.
- Beard AG et al: Perinatal stress and the premature neonates-II. Effect of fluid and calorie deprivation on blood glucose. J. Pediatr., 1966; 68: 329-343.
- Hawdon JM et al: Neonatal hypoglycemia-blood glucose monitoring and baby feeding. Midwifery, 1993; 9: 3-6.
- Hawdon JM et al: Patterns of metabolic adaptation for preterm infants in the first neonatal week. Arch. Dis. Child, 1992; 67: 357-365.
- Meharban Singh; Metabolic disorders: Hypoglycemia. Care of Newborn. 6th edition New Delhi. Sagar publications 2004 PP. 353-357.
- Richard E.Wilkder, Estate Ann R.eds. Hypo and hyperglycemia in newborn, In: John.P Cloherty. Manuel of neonatal care. 5th Edition. Newyork Lippincott Williams and Wilkins; PP.569.
- Ballard JL et al: New Ballard Score, J. Pediatric., 1991; 119: 417.
- Cornblath M et al: Symptomatic neonatal hypoglycemia associated with toxemia of pregnancy. Journal of Pediatr, 1959; 55: 545-562.
- Lubchenco LO, Bard H: Incidence of hypoglycemia in newborn infants classified by birth weight and gestational age. Pediatr, 1971; 47: 831-838.
- Sexon WR: Incidence of neonatal hypoglycemia- A matter of definition. J. Pediatr., 1984; 105: 149- 150.
- Anderson S et al: Hypoglycemia-A common problem among uncomplicated newborn infants in Nepal. J. Tropic Pediatric, 1993; 39: 273-277.
- Gutberlet RL, Cornblath M: Neonatal hypoglycemia revisited. Pediatrics, 1975; 58: 10- 17.
- Plides RS et al: The incidence of neonatal hypoglycemia-A complete survey. J. Pediatr., 1967; 70: 76.
- Cornblath M et al: Hypoglycemia in infancy: The need for a rational definition. Pediatrics, 1990; 85: 834-837.
- Singhal PK et al: Neonatal hypoglycemia-clinical profile and glucose requirements. Ind. Pediatr, 1992; 29: 167-171.
- Mushtaq Ahmed Bhat, Anil Bhansali et al: Hypoglycemia small for gestational age babies. Indian Journal of Pediatrics, 2000; 67(6); 423.
- Cornblath M, Schwartz R: Hypoglycemia in the neonate. J. Pediatr. Endocrin. 1993; 6: 113-129.
- Mushtaq Ahmed Bhat, Anil Bhansali et al: Hypoglycemia small for gestational age babies. Indian Journal of Pediatrics, 2000; 67(6); 425-427.
- Carter PE, Lloyd DJ, Duffy B et al; Glucogon for hypoglycemia in; Infants of small for gestational age; Arch.Dis.Child;1988; 63: 1264-1266.
- V. Gupta, Alka Khadwal, M Agnihotri: Clinical profile of neonatal hypoglycemia – clinical study, Asian journal of Paediatric practice Oct–Dec 2004, Vol.8, No.2, page 24.
- R Boyd, B Leigh, P Stuart; Capillary VS Venous blood glucose estimation; Eng; Med.J; 2005: 177-179.
- A Study of Transvaginal Ultrasound in Asherman Syndrome
Authors
1 Hassan Institute of Medical Sciences, Hassan, Karnataka, IN
Source
Indian Journal of Public Health Research & Development, Vol 3, No 3 (2012), Pagination: 217-219Abstract
Objective: To determine the accuracy of transvaginal ultrasound in evaluation of uterine sonomorphology in nongestational amenorrhoea following curettage producers (Asherman Syndrome).
Methodology: The study population comprised all adult females in reproductive age group who presented with amenorrhea following a curettage procedure. Those with positive serum BHCG, and raised serum prolactin were excluded. Transabdominal (TAS) as well as transvaginal ultrasound (TVS) scan was carried out in all patients. Hystero-salpingography (HSG) was done in nearly all patients. Age, parity, indication for referral and curettage, duration of amenorrhea, frequency of curettage and previous menstrual and obstetric history, were obtained. Transvaginal scan findings were recorded and compared with HSG. Two patients came for a follow up after adhesionolysis.
Results: There were 17 patients in all with a mean age of 28.6 years, mean parity of 4.5 and mean amenorrhea duration of 5.5 months. Sixteen were primarily referred for evaluation of amenorrhea. Twelve had history of previous pelvic infection, 8 had previous menstrual irregularity and 15 had abortions. Repeat curettage was done in 09 patients. Trans abdominal ultrasound was positive in only one patient and transvaginal ultrasound was positive in all cases. Findings on the later examination included normal to thickened endometrium with heterogeneous echo texture, irregular outline, non-shadowing echogenic foci and sparse sub-endometrial vascularity. Calcification at endo-/myometrium junction was seen in one case on both techniques. The sensitivity of TVUS in diagnosing intra uterine adhesions was 92%, specificity 100%, positive predictive value 100% and negative predictive value 92%.
Conclusion: Transvaginal ultrasound shows accurate and specific uterine sono-morphologic features in traumatic amenorrhea and can be used as a reliable screening test.
Keywords
Asherman Syndrome, Amenorrhea, Curettage, Intrauterine Adhesions, Endometrium, Transvaginal UltrasoundReferences
- Asherman AG. Amenorrhea traumaticum (atretica). J Obstet Gynecol British Emp 1948; 55: 23-30.
- Krolikowski A, Janowski K, Larsen JV. Asherman syndrome caused by schistosomiasis. Obstet Gynecol 1995; 85: 898-899.
- Fletcher H, Kulkarni S, Brown E. Successful pregnancy outcome after hysteroscopic adhesionolysis in Asherman syndrome. West Indian Med J 1997; 46: 124-125.
- Westendorp IC, Ankum WM, Mol BW,Vonk J. Prevalence of Asherman syndrome after secondary removal of placental remnants or a repeat curettage for incomplete abortion. Hum Reprod 1998; 13: 3347-3350.
- http://www.ashermans.org/ Medical%20 Description.htm (accessed on 4/17/2003).
- Magos A. Hysteroscopic treatment of Asherman’s syndrome. Reprod Biomed Online 2002; 4 Suppl 3: 46-51.
- Goldstein SR. Use of endovaginal ultrasound in the over all gynecologic examination. Obstet Gynecol Clin North Am. 1991; 18: 779-796.
- Critchley HOD. Amenorrhea and oligomenorrhea and hypothalamic pituitary dysfunction. In gynecology (3rd edition). Shaw RW, Soutter WP, Stanton SL (edi); Churchill Livingstone, London, 232, 2003.
- Sohail S. Variables affecting pain tolerance in xray hysterosalpingography. J Coll Physicians Surg Pak. 2004; 14: 170-172.
- Ombelet W, Lauwers M, Verswijvel g, Grieten M, Hinoul P, Mestdagh G. Endometrial ossification and infertility: the diagnostic value of different imaging techniques. Abdom Imaging. 2003; 28: 893-896.
- Confino E, Friberg J, Giglia RV, Gleicher N. Sonographic imaging of intrauterine adhesions. Obstet Gynecol 1985; 66: 596-8.
- Mendelson EB, Bohm-Velz M, Joseph N, Neiman HL. Endometrial abnormalities: evaluation with transvaginal sonography. Am J Roentgenol 1988; 150:139-142.
- Qureshi IH, Hidayatullah, Akram AH, Ashfaq S, Nayyar S. Transvaginal versus transabdominal sonography in the evaluation of pelvic pathology. J Coll Physicians Surg Pak 2004; 14: 390-393.
- Timor-Tritsch IE, Rottem S. Pathology of the early intrauterine pregnancy. In: Transvaginal Sonography(2nd edition): Timor-Tritsch IE, Rottem S (edi).; Elseiver, New York.312-3,1991.
- Jensen PA, Stromme WB. Amenorrhea secondary to puerperal curettage (Asherman syndrome) Am J Obstet Gynecol 1972; 113: 151-157.
- Tsapanos VS, Stathopaulo LP, Papathanassopaulou VS, Tzingounis VA. The role of Seprafilm bioabsorbable membrane in the prevention and therapy of endometrial synechiae. J Biomed Mater Res 2002; 63: 10-14.
- Fedele L, Bianchi S, Dorta M, Vignali M. Intrauterine adhesions: diagnosis with transvaginal ultrasound. Radiology 1996; 199: 757-759.