Femitha P

Early Neonatal Outcome in Late Preterms

ObjectivesTo study the maternal risk factors, morbidity, mortality of late preterm in comparison to term neonates.MethodsThis Cohort study involved two hundred fifty consecutively born late preterm and equal number of term newborns delivered in a tertiary care hospital. They were followed till discharge for morbidities and mortality. Detailed maternal and neonatal factors were studied and compared between the two groups.ResultsLate preterm babies constituted 55% of all live preterm births during the study period. The odds of babies developing major morbidity was significantly more in those whose mothers had hypertension and infections (OR 2.69 95% CI: 1.55, 4.68 and 2.08, 95% CI: 1.6, 2.71 respectively). In the study group, 42.4% and 20.8% babies suffered major and minor morbidity compared to 8.4% and 6.8% of term controls respectively. Late preterm neonates had significantly higher odds of developing morbidity like respiratory distress (12.4% vs. 5.6%, OR 2.21, 95%CI 1.21,4.11), need for non invasive(17.3% vs. 5.7%, OR 3.05 95% CI 1.69, 5.47) and invasive ventilation (14.6% vs. 1.7%, OR 8.62, 95% CI 3.09, 24.04), sepsis (20.8% vs. 5.2%, OR 5.20, 95% CI 2.71, 9.99), seizures (22.8% vs. 4.8%, OR 4.75 95%CI 2.61, 8.63), shock (17.6% vs. 4.4%, OR 4.00 95% CI 2.12,7.56), and jaundice (26% vs. 6%, OR 4.33 95%CI 2.54, 7.39). By logistic regression, the odds of developing major morbidity decreased with increasing gestational age (aOR 0.28 95% CI 0.18, 0.45; p < 0.001) and increased with hypertensive disease of pregnancy (aOR 2.16 95% CI 1.09, 4.260; p = 0.026).ConclusionsLate preterm neonates have significantly more mortality and morbidity compared to term controls. Maternal hypertension and lower gestational age are the strongest predictors of morbidity.

Frank -Ter Haar Syndrome in a Newborn

Frank-Ter Haar syndrome is an unusual type of skeletal dysplasia with megalocornea and developmental delay. It is usually transmitted as autosomal recessive disorder. Only a few cases have been reported in the literature and none from India. The authors report a case with other unusual features and a short review of the condition.

Silencing a noisy goitre sans scalpel

A term male baby weighing 2.6 kg born by spontaneous vaginal delivery was noted to have a large neck swelling and respiratory distress. Antenatal ultrasonography had revealed a large thyroid swelling encasing the trachea but not extending into the mediastinum or causing obstruction. The mother was clinically euthyroid and was not on any drugs. On examination, he had severe stridor and tachypnoea and required oxygen by nasal prongs. His neck was hyperextended …

Atrial flutter in a newborn

Abstract Fetal and neonatal arrhythmias present as diagnostic and therapeutic challenges to obstetricians and neonatologists. We present a case of antenatally detected atrial flutter in which the infant presented with congestive cardiac failure at birth and a short review of tachyarrhythmias in the perinatal period.