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Patel, Kinjal G., and Chintu Chaudhary. "Study of congenital malformations in newborns: a hospital based prospective study." International Journal of Contemporary Pediatrics 4, no. 4 (June 21, 2017): 1409. http://dx.doi.org/10.18203/2349-3291.ijcp20172676.
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Background: Congenital malformations represent a defect in the morphogenesis during fetal life. Since the introduction of primary health care and immunization programme, congenital malformations have emerged as one of the commonest cause of perinatal mortality. The objective was to study the incidence, systemic distribution, various maternal risk factors and immediate outcome of congenital malformations in hospital delivered neonates.Methods: This study was conducted at a tertiary care hospital for a period of 2 years. All the hospital delivered live neonates and stillbirth babies with congenital malformations are included in this study. Detailed history, examinations and investigations are carried out to identify etiological factors. Their outcome in form of morbidity and mortality are taken up to their hospital stay.Results: Out of 9600 babies with malformations 171(1.88%) having single malformation and 23(0.25%) having multiple malformations. Incidence of malformations was higher in stillbirths (24.25/1000 livebirths) against than in live births (19.96/1000 livebirths). The cardiovascular system was involved in 23.4% of babies, followed by musculoskeletal system (22.3%) then gastrointestinal (15.9%) and genitourinary system (15.4%). Multiple malformations were seen in 11.8% cases. Maternal risk factors associated with malformations were oligohydramnios in 4.12%, previous abortion in 2.5%, eclampsia in 2.5%, polyhydramnios in 1.54%, maternal diabetes in 1.54% and consanguinity in 1.03%. Maximum mortality occurred in babies with gastrointestinal system malformations (56.5%) followed by cardiovascular system malformations (21.7%). Majority of babies with malformations discharged (78.9%) only 11.8% of babies expired and 2.6% of babies left against medical advice (LAMA).Conclusions: Congenital malformations represent one of the causes of neonatal mortality. Stillborn babies have higher incidence of malformations. Antenatal ultrasonography and maternal risk factors has important role to identify malformations. Early detection and timely management required to decrease the mortality.
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Ansari, Imran, Rateena Rajbhandari, Shiva Chilise, Ganesh Shalh, Pratistha Maskey, Rashmila Maharjan, Rajiv Yadav, Biplav Manandhar, and Rahil Ansari. "Congenital malformations at birth in 7,922 consecutive deliveries at Patan Hospital, Nepal." Journal of Patan Academy of Health Sciences 1, no. 2 (December 1, 2015): 4–7. http://dx.doi.org/10.3126/jpahs.v1i2.16636.
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Introductions: Congenital malformations need to be identified and intervened early to save lives and prevent sufferings. Many birth defects have well known incidence/prevalence rates but these have not been studied thoroughly in the local population of Nepal. The current study was undertaken to determine the prevalence of congenital malformation at birth, to classify them systematically, to study risk factors and immediate outcome of the newborn babies afflicted.Methods: This was a cross sectional study. All newly delivered babies were examined carefully for congenital malformation and when detected, the parents were interviewed in detail.Results: Over the 10 months of study period 7,922 babies were delivered out of which 90 were stillborn. The number of babies with malformations was 64 (0.81%). Polydactyli was observed in 12 (19%) babies whereas cleft lip/palate and malformations of ears in seven (11%) each. Musculoskeletal system was affected in 31 (35%) cases and craniofacial in 18 (21%). Nine (14%) mothers had bad obstetric history and eight (13%) had illness/medication during pregnancy.Conclusions: Congenital malformation is a significant cause of morbidity and mortality in Patan hospital. Our findings support many established thoughts like higher rates in stillbirths but also challenge some age-old beliefs like higher rates in babies born to older mothers.
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Narmadha, V., and M. Nirmala. "Incidence of congenital anomalies in newborn in tertiary care hospital." International Journal of Contemporary Pediatrics 6, no. 4 (June 27, 2019): 1603. http://dx.doi.org/10.18203/2349-3291.ijcp20192170.
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Background: Just about three decades ago (1976) congenital malformations comprised 8% of perinatal deaths, from available data and ranked fifth as a cause of perinatal mortality. But the trend is rapidly changing over the years. perinatal death was due to congenital malformation, is the second commonest cause. This changing trend over years warns us that with the control of nutritional and infectious diseases, congenital malformations will come to the forefront as it is in India. To find out the incidence of congenital anomalies in stillbirth. And the probable etiology of congenital anomalies.Methods: The study was conducted at Government Mohan Kumaramangalam Medical College Hospital, Salem in the year 2017 August- September 2018. Totally 5000 babies born of consecutive deliveries were taken for the study, over the period of one year. All mothers were interrogated within 48 Hours of delivery as per the proforma prepared, which contains the following particulars like, maternal and paternal age, consanguinity, detailed antenatal history with reference to exposure to teratogens, especially during 1st Trimester.Results: Of the five thousand consecutive deliveries 48 deliveries were multiple delivers and a number of stillbirths were 108. The incidence of congenital anomalies was 30.4 per 1000 live birth (152 cases). Major malformations were present in 20.8 per 1000 (104 cases) while minor malformations were 9.6 per 1000 (48 cases).Conclusions: Incidence of malformation were higher in preterm babies 6.31%. Incidence of malformations were higher in male babies, especially genitourinary system anomalies. Antenatal events in the 1st trimester like fever, drug intake could be implicated in the etiology of malformations especially neural tube defects in our study.
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HASAN, SHAMAMA, AMEEN ULLAH, HUMA FARRUKH, and Nadeem Sadiq. "CONGENITAL MALFORMATIONS." Professional Medical Journal 17, no. 01 (March 10, 2010): 140–44. http://dx.doi.org/10.29309/tpmj/2010.17.01.2097.
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Objective: To determine frequency, pattern of distribution of congenital malformations in newborn. Design: Cross-sectionalobservational study. Place and Duration of study: Study was carried out in the Department of neonatology, Military Hospital Rawalpindi duringthe period of January 2008 to Dec 2008. Patients and methods: All the newborns were examined and mothers were interviewed. Baby'santenatal record was also noted and recorded in a Performa. Antenatal ultrasonography record was also recorded. Any internal malformationwas also noted. Babies who were found to have any malformations were screened for the congenital malformations. Screening was done withlatest laboratory tests , radiological evidences and chromosomal studies for suspected trisomies. Result: Congenital anomalies were notedin a Performa. Neural tube defect (NTD) was found to be the commonest type of anomaly. Among the most frequent NTD were hydrocephalusand menigomyelocele. Following that were the cardiac anomalies and genitourinary tract anomalies. Trisomy 21 was detected in two of thebabies while one newborn had trisomy 13. Conclusion: NTD were the most prevalent anomaly detected and early prenatal diagnosis is helpfulin decreasing the indirect prevalence of perinatal mortality by offering early termination. Folic acid supplementation should be advocated beforeconception
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Gandhi, Pooja R., Hetal D. Vora, Halak J. Vasavada, Mehul T. Patelia, Pragneshkumar L. Popatiya, and Naznin Vora. "A study of gross congenital malformation at birth." International Journal of Contemporary Pediatrics 6, no. 3 (April 30, 2019): 1019. http://dx.doi.org/10.18203/2349-3291.ijcp20191022.
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Background: A congenital anomaly is a structural anomaly of any type that is present at birth. Congenital anomalies may be induced by genetic or environmental factors. Most congenital anomalies, however, show the familial patterns expected of multi-factorial inheritance. The aims and objective of this study were to study the incidence of visible congenital malformations at birth, to study risk factors, to find associated internal malformations.Methods: It is a retrospective cross-sectional study carried out in a tertiary care hospital affiliated to a medical college. The Inclusion criteria include all new-borns delivered in the hospital with visible congenital malformations examined within 48 hours of birth. Extramural babies were included if they had presented within 48 hours after birth. The Exclusion criteria include still births were excluded from the study.Results: Percentage of congenital malformation was 1.32%. Most common systems involved were musculoskeletal system (46.34%) followed by genitourinary system (21.34%) and gastrointestinal system (14.02%).Conclusions: All Babies with gross congenital malformation should be screened for internal malformation. The incidence of CNS malformation has reduced than observed in previous studies which suggest awareness about antenatal folic acid supplementation. Other than CNS anomalies, other system anomalies were not diagnosed antenatally despite antenatal ultrasound being done in maximum number of mothers, which suggest use of 3D or 4D scan antenatally.
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Basaula, Yuba Nidhi, Radha Kumari Paudel, and Ram Hari Chapagain. "A Five Years Study of Occurrence and Associated Risk Factors for Birth Defects in a Tertiary Care Hospital in Central Nepal." Journal of Nepal Paediatric Society 39, no. 3 (December 31, 2019): 135–41. http://dx.doi.org/10.3126/jnps.v39i3.28447.
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Introduction: Congenital anomalies account for 7.0% of neonatal deaths in Nepal. The present study was carried out to determine the overall rate of congenital malformations, incidence and prevalence in live births, still birth and incidence affecting various organ systems, at Bharatpur Hospital, Nepal.
Methods: All the intramural deliveries between Jan 2015 to Dec 2019 were included in the study. All the newborns were looked for congenital malformations after birth within seven days. Antenatal ultrasonography findings were noted. 2D echocardiography was also used for all congenital heart diseases, along with routine X-ray chest. A total of 131 babies with congenital problem were studied and the information was recorded in WHO NBBD Proforma. Data were recorded in MS Excel and SPSS 16 version was used for analysis.
Results: Out of the total 60160 deliveries, 131 (0.21% of total birth) were with congenital malformations, sex wise distribution was 65 (49.5%) females and 63 (48.7%) males and three (1.8%) were ambiguous. Oro-facial malformation (49, 37.4%) was the commonest form of malformation followed by the musculoskeletal system (31, 23.6 %), centre nervous system (31, 23.6%) and congenital malformations of genital organs (8, 6.0%).
Conclusions: The incidence of congenital malformation in this study was 0.21%. Females were more common than males and oro-facial malformation was the commonest type of malformation. Lack of antenatal visit, lack of folic acid during pre-conception period and low socioeconomic status were the commonest risk factors.
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Doddabasappa, Prathiba N., Adarsh E., and Divya N. "Prevalence of congenital anomalies: a hospital-based study." International Journal of Contemporary Pediatrics 5, no. 1 (December 21, 2017): 119. http://dx.doi.org/10.18203/2349-3291.ijcp20175571.
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Background: Birth defects are a diverse group of disorders with prenatal origin that can be caused by single gene defects, chromosomal disorders, multifactorial inheritance, environmental teratogens and or micronutrient deficiencies. The objective of this study was to study the prevalence of congenital anomalies in Department of Pediatrics at Rajarajeswari Medical College and Hospital, Kambipura, Bangalore.Methods: The study population includes all babies born between 1 August 2015 and 31st July 2016. The babies were examined and assessed thoroughly for the presence of a congenital anomaly and were then distributed system wise by the pediatrician. Surgical conditions were also reevaluated by a pediatric surgeon.Results: Among the 2,137 deliveries, 86 babies had congenital malformations. Prematurity, consanguinity and increased maternal age elevate the appearance of congenital anomalies. The cardiovascular malformations were most common with a prevalence rate of 4%.Conclusions: Congenital anomalies are a global health problem. Thus, this study supports us to understand the prevalence of congenital anomalies. There is no association of congenital malformations with low birth weight babies. Consanguinity should be discouraged. Early antenatal scan aids in prior detection of congenital anomalies Appropriate genetic counselling can reduce the anomalies in future pregnancies.
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Neelambari, Yazhini C., Prarthana Das, Srinivasan Sadagopan, and A. N. Uma. "Prevalence, pattern and outcome of congenital malformations in a tertiary care centre in South India." International Journal of Contemporary Pediatrics 5, no. 3 (April 20, 2018): 1044. http://dx.doi.org/10.18203/2349-3291.ijcp20181539.
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Background: Congenital malformations are of major concern as they are cosmetically unacceptable, often associated with significant functional abnormalities and may sometimes even be life-threatening. This study was done to explore the prevalence of structural congenital malformation among hospital newborns, both live and stillborn in a tertiary care center in Southern India.Methods: This hospital-based prospective study involving all inborn neonates and still births was conducted for the period from January 2014 to December 2014. A total of 2276 newborn (2217 live births and 59 still births) were clinically examined for detection of gross congenital malformations and relevant investigations including karyotyping was done. Risk factors that had probable associations with birth defects were estimated by calculating the Odd’s Ratio. Statistical analysis was done using Chi-Square test.Results: The prevalence of congenital malformations was 12%. Major malformations accounted for 53.28% and minor malformations 46.71%. The commonest structural malformation involved cardiovascular system. 58% of neonates did not require life style medications whereas 21.17% required surgical intervention. 20.8% of the cases succumbed to death.Conclusions: Autopsy of stillborn babies should be done to evaluate the cause and incidence of malformations. High risk mothers should be identified in the antenatal period to detect malformations early and plan management accordingly.
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Wilmers, Mary J. "CONGENITAL MALFORMATIONS IN BABIES OF DIABETIC MOTHERS." Developmental Medicine & Child Neurology 7, no. 1 (November 12, 2008): 78–79. http://dx.doi.org/10.1111/j.1469-8749.1965.tb10892.x.
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Lowy, C., R. W. Beard, and J. Goldschmidt. "Congenital Malformations in Babies of Diabetic Mothers." Diabetic Medicine 3, no. 5 (September 10, 1986): 458–62. http://dx.doi.org/10.1111/j.1464-5491.1986.tb00791.x.
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Yaragatti, Vikram V., and Shivanagouda . "A cross sectional study to find incidence of clinically detectable congenital malformations and factors affecting it in tertiary care hospital." International Journal of Contemporary Pediatrics 6, no. 6 (October 21, 2019): 2364. http://dx.doi.org/10.18203/2349-3291.ijcp20194556.
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Background: Congenital malformations are emerging as an important perinatal problem, contributing sizably to the perinatal mortality with considerable repercussions on the mothers and the families. Patients with multiple congenital anomalies present a relatively infrequent but tremendously difficult challenge to the pediatrician. Authors objective was to study the incidence of clinically detectable congenital malformations among consecutive births in hospital deliveries examined during hospital stay.Methods: A prospective cross sectional study was conducted in Department of Pediatrics at Dr R N Cooper Municipal General Hospital, Mumbai from June 2016 to June 2017. All live births from June 2016 to June 2017 were considered in the studyResults: The total number of deliveries in our hospital were 3120(100%) and the total number of babies with congenital anomaly were 43(1.4%), So the incidence of congenital anomalies amongst study population was 1.4%. The involvement of various systems was seen in our study. The involvement of CNS (9.3%), Eye (7%), ENT (28%), GIT (20.9%), Urinary Tract (2.3%), Musculoskeletal System (35%), Gentialia (7%), CVS (7%).Conclusions: Congenital malformation, one of the important causes of infant mortality and morbidity can be reduced by proper preconception care and level two anomaly scan. Congenital anomalies must be identified, as early diagnosis and surgical correction of malformed babies offer the best chance for survival.
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Verma, Suniti V., and Ram N. Sehra. "A Study on Incidence of Various Systemic Congenital Malformations at Birth in a Tertiary Care Hospital of North Western Rajasthan." Journal of South Asian Federation of Obstetrics and Gynaecology 8, no. 4 (2016): 309–13. http://dx.doi.org/10.5005/jp-journals-10006-1440.
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ABSTRACT Aims To study the overall incidence, proportion, and type of congenital malformations in newborns and immediate outcome of anomalous neonates. Materials and methods The present study was an observational study. It was carried out between January 2012 to July 2013 among patients admitted to the Department of Gynecology and Obstetrics, PBM Hospital, Bikaner. Results We found that the maximum number of mothers was in the age group of 21 to 25 years (44.9%). Central nervous system (CNS) was the most common anomaly (53.3%), followed by gastrointestinal (GIT) anomaly (13.2%). All three anomalies of respiratory system were diaphragmatic hernia. There were totally 35.7% mothers who had consanguinity. Accuracy of ultrasonography was 71.4%. Out of 167 deliveries, 85 babies were live birth, 79 were still birth, and 3 abortions, in that 92 (55.1%) cases were males while 71 (42.5%) babies were females, and 4 (2.4%) ambiguous genitalia. Maximum number of babies (40.1%) had their birth weight between1.5 and 2.50 kg, while 30.6% babies had their birth weight < 1.5 kg, and 29.3% had their birth weight > 2.5 kg. Conclusion The overall incidence of congenital malformation in our study was 1.23%. The most common anomaly was of CNS (53.3%), followed by GIT (13.2%); multiple system (10.2%); musculoskeletal (9%); urogenital (4.8%); respiratory (4.8%); and central venous system (1.25%). Consanguinity (35.3%) was a common associated factor in this study. Clinical significance These patients need good counseling, balanced diet with folic acid supplementation, treatment of precipitating factors, regular follow-up in subsequent pregnancies, early screening for congenital malformations, and early termination if an anomaly is present. How to cite this article Verma SV, Sehra RN. A Study on Incidence of Various Systemic Congenital Malformations at Birth in a Tertiary Care Hospital of North Western Rajasthan. J South Asian Feder Obst Gynae 2016;8(4):309-313.
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Reinhardt, Zdenka, and Christopher Wren. "Abstracts for the British Congenital Cardiac Association Annual Meeting: The Barbican, London, 24–25 November 2005: Oral Presentations: Twenty year trends in recognition of life-threatening neonatal cardiac malformations." Cardiology in the Young 16, no. 3 (June 2006): 314. http://dx.doi.org/10.1017/s1047951106210230.
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Background: Babies with cardiovascular malformations are usually asymptomatic at birth. Earlier diagnosis is likely to lead to a better outcome. This study examines trends in the timing of diagnosis of potentially life-threatening cardiovascular malformations. Methods: Ascertainment of all cardiovascular malformations diagnosed in infancy in the resident population of one English health region in 1985–2004. Babies considered to have a life-threatening cardiovascular malformation included all those with hypoplastic left heart, pulmonary atresia with intact ventricular septum, transposition of the great arteries, or interruption of the aorta; and babies dying or undergoing operation in the first 28 days with coarctation of the aorta, aortic stenosis, pulmonary stenosis, tetralogy of Fallot, pulmonary atresia with ventricular septal defect, or total anomalous pulmonary venous connection. Results: Of 688,167 live born babies in the 20 years of the study, 4444 had cardiovascular malformations diagnosed in infancy (6.5 per 1000). Cardiovascular malformations were potentially life-threatening in 685 (15%). Over the time of the study, 8% were recognised prenatally, 58% postnatally before discharge from hospital, 31% in life after discharge and 3% after death. Malformations most likely to remain undiagnosed at discharge were coarctation of the aorta (63%), interruption of the aortic arch (50%), and total anomalous pulmonary venous connection (47%). Over the 20 years of the study, the proportion of babies diagnosed antenatally increased from around 1% to 20% and no case was first diagnosed after death in the last 10 years. However, the recent proportion going home without a diagnosis remains around 25%. Conclusions: Overall one third of babies with potentially life-threatening cardiovascular malformations leave hospital undiagnosed. In recent years better antenatal diagnosis has reduced this proportion to one quarter. Better early recognition of such babies is unlikely to be achieved by clinical examination and is more likely to come from further improvements in antenatal diagnosis and more widespread adoption of routine pulse oximetry.
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Siddiqui, Arif, and Syed Manazir Ali. "Burden and pattern of congenital anomalies in newborns in a tertiary care hospital." International Journal of Contemporary Pediatrics 9, no. 6 (May 25, 2022): 560. http://dx.doi.org/10.18203/2349-3291.ijcp20221374.
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Background: Anomaly is defined as a significant morphological or anatomic variation in the phenotype from the standard reference population. Objectives of current study was to investigate the incidence and pattern of congenital anomalies in the hospital delivered neonates, JNMCH, AMU, Aligarh.Methods: All the newborns delivered during the study period from October 2019 to November 2021 at JNMC, AMU, Aligarh were thoroughly examined and assessed for the presence of any congenital anomalies. Neonatal and maternal parameters were recorded in a predesigned proforma. Relevant investigations in the form of X-ray, ultrasonography and echocardiography were carried out in case of any suspected anomaly.Results: Out of the total 10932 neonates delivered during the study period, 197 babies had congenital malformations including 166 live births and 31 still births with an incidence of 1.8%. Musculoskeletal system was the most commonly system involved and congenital talipes equinovarus was the single most common malformation. Higher incidence of malformation was seen to be associated with still birth, prematurity, male gender and low birth weight babies.Conclusions: Regular antenatal checkups and anomaly scans can detect congenital malformations early. Pre conceptional counselling about maternal age at conception and birth order may help in preventing malformations associated with syndromes such as Down’s and Edward syndrome. Peri conceptional folate supplementation can prevent CNS malformations such as Neural tube defects significantly. Early diagnosis and treatment of maternal disease conditions like anemia, preeclampsia, hypertension and diabetes may affect occurrence of malformations.
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Kumar, Krishan, Prakash Thakur, and Shilpi Singh. "Clinical Profile and Outcomes of Congenital Gastrointestinal Malformations: A Single Hospital Study." Journal of Pediatrics Review 10, no. 1 (March 6, 2022): 10. http://dx.doi.org/10.32598/jpr.10.1.989.1.
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Aims: To determine the prevalence, clinical profile and outcomes of gastrointestinal (GI) malformations in neonates in a tertiary care hospital. Settings and Design: A prospective observational case-control study was conducted at a tertiary care hospital in New Delhi. Methods: The study was conducted on live neonates from October 2014 to November 2015. Cases of neonates with GI malformations were compared against healthy babies. Outcome measures assessed were prevalence, associated risk factors, clinical profile, and mortality of GI malformation. Statistical analysis: Qualitative variables were compared using Chi-Square test/Fisher’s exact test. Multivariate logistic regression was used to assess the significant risk factors after adjusting for confounding variables. A P-value <0.05 was considered statistically significant. Results: Among the 25,116 live births, 41 cases were diagnosed with GI malformations. To compare, 82 controls (healthy babies) were taken. The prevalence of GI malformations was 0.163 or 1.63/1,000 live births with a male to female ratio of 1.1:1. The tracheoesophageal fistula was the most frequent anomaly (39.02%). Multivariate analysis revealed a lack of periconceptional iron and folic acid supplementation and baby birth weight <2.5 kg as independent significant factors related to the occurrence of congenital GI defects (when compared to controls). Among 41 cases, 20 neonates died (48.78% mortality rate). Causes of mortality were prematurity, sepsis, asphyxia, and shock. Conclusion: In a developing country like ours, the association of GI malformations (0.163%) with lack of periconceptional iron and folic acid supplementation and low birth weight shows that increased counseling and implementation of the supplements during the pregnancy can help decrease the prevalence. Mortality remains high among such children and thus they demand urgent necessary surgery and management.
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Chandniwala, Shahana I. "Prevalence of congenital anomalies in babies and associated maternal etiological factors at tertiary care hospital." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 10, no. 11 (October 27, 2021): 4189. http://dx.doi.org/10.18203/2320-1770.ijrcog20214330.
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Background: The objective of this study was to know the local prevalence of congenital anomaly and study the maternal risk factors associated with it.Methods: Cross sectional descriptive study was carved out. All live babies were examined for presence of congenital anomalies and mother were looked for presence of socio-demographic factor.Results: In this study of 1 year 5767 live birth took place at tertiary care centre out of which 63 babies had congenital anomalies. Therefore, prevalence of congenital anomalies at tertiary care centre was 1.08%.Conclusions: The incidence of malformations were significantly higher in babies born to mothers over the age of 35 years and with parity 4 and above.
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Poojan Patel and Potdar D B. "Study Of Clinically Manifested Congenital Malformations In Live Births." International Journal of Research in Pharmaceutical Sciences 11, no. 3 (July 7, 2020): 3191–97. http://dx.doi.org/10.26452/ijrps.v11i3.2434.
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Cross-sectional study in 4786 live births prospective study of surviving infants born scope and clinical manifestations of congenital malformations. It was noted that a total of 4786 live births, the number of infants with a congenital malformation of 100 stillbirths, infant mortality and child morbidity are significantly detected by the abnormal impact. The number of infant birth defects, due to the advanced diagnostic technology, especially the increase USG prenatal and neonatal period. In the current study, 2753 (57.5%) and 2033 (42.5%), male and female fertility. Congenital male fertility in the baby was observed to be relatively high (68) as compared to comparative female (32) cases, as per the chi-square test (p<0.05). For a prevalence of 27 babies (27 percent), in our study, congenital abnormalities, though 2 instances (2 percent) of low birth weights, 9 (9 percent) of the children were very low birth weights and 16 (27.5 percent), of the normal birth weight.
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Ewer, Andrew K. "Pulse Oximetry Screening for Critical Congenital Heart Defects: A Life-Saving Test for All Newborn Babies." International Journal of Neonatal Screening 5, no. 1 (February 12, 2019): 14. http://dx.doi.org/10.3390/ijns5010014.
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Pandala, Paramesh, Rakesh Kotha, Himabindu Singh, and Nirmala C. "Pattern of congenital anomalies in neonates at tertiary care centre in Hyderabad, India: a hospital based prospective observational study." International Journal of Contemporary Pediatrics 6, no. 1 (December 24, 2018): 63. http://dx.doi.org/10.18203/2349-3291.ijcp20185103.
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Background: With advancements of perinatal, neonatal care congenital defects were the most common cause of morbidity and mortality in developed world. It is one of the common causes of morbidity and mortality in India. Its incidence also influenced by many preventable risk factors. Hence, we are carried out this study to know the changing pattern of congenital anomalies and to know the effect of environmental risk factors on congenital anomalies.Methods: Prospective observational study conducted at Niloufer hospital Hyderabad during period from November 2017 to 2018. We included intramural and extramural babies. Analysed data by appropriate statistical methods.Results: Most common system involved was Central nervous system (CNS) with 25 cases out of 112 cases followed by Gastrointestinal system (GIT)and Cardiovascular system (CVS). Meningomyelocele, anorectal malformations and acyanotic heart diseases were most common type of congenital anomalies. Thirty seven to forty weeks gestational age group babies were most commonly have congenital anomalies than other gestational age group babies. Low birth weight babies had higher percentage of congenital anomalies (2.64%). Congenital anomalies were more in the male sex (2.53%) as compared to female babies (1.73%). Maternal obesity, consanguineous marriage and previous family history of congenital anomalies associated with increased risk of congenital anomalies with significant p values.Conclusions: Incidence of congenital anomalies was 2.15%. Most of congenital anomalies were involved in CNS. Birth weight, Gestational age, Male sex, consanguineous marriage, maternal Obesity and previous family history of congenital anomalies were significantly associated with increased risk of congenital anomalies.
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Meena, B. S., Nimisha Gupta, Oby Nagar, and Swati Trivedi. "A prospective clinical study of foetomaternal outcome in relation to oligohydramnios in pregnancies beyond 36 weeks of gestation." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 6 (May 27, 2020): 2342. http://dx.doi.org/10.18203/2320-1770.ijrcog20202309.
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Background: Amniotic fluid is contributed by both mother and foetus. It plays a vital role in foetal growth. The main purpose of this study was to evaluate the foetomaternal outcome in pregnant females with oligohydramnios beyond 36 weeks of gestation.Methods: This study was conducted on 230 pregnant females beyond 36 weeks of gestation with decreased liquor clinically and confirmed sonographically. It was conducted from May 2018 to May 2019. Females with leaking per vaginum, patients who did not give consent and with intrauterine foetal death were excluded. Complete labour record was made. Assessment of maternal outcome was done in terms of mode of delivery and foetal outcome was done in terms of birth weight, Apgar score at one and five-minute, respiratory distress, meconium aspiration, seizures in first 24 hours of life, congenital malformations, neonatal intensive care unit admission and death of baby.Results: A total of 230 pregnant females met the inclusion criteria who were having AFI <5. 121 (53%) females were primigravida and 119 (52%) underwent for caesarean section. Most common indication of LSCS was foetal distress. Apgar score at 1 minute was <7 in 97 (42%) babies and after 5 minutes, it was <7 in 93 (40%) babies. Other neonatal outcome results were IUGR in 59 (26%) babies, meconium aspiration syndrome in 52 (23%) babies, respiratory distress in 92 (40%) babies, congenital malformation in 6 (3%) babies, NICU admission of 93 (40%) babies and neonatal death of 11 (5%) babies.Conclusions: Oligohydramnios increases the chances of maternal morbidity and perinatal morbidity and mortality.
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Praneshwari, R. K., N. Nabakishore Singh, Akoijam Tamphasana Devi, Jyoti Priya, and L. Ranjit Singh. "Congenital anomalies in a tertiary care hospital in North East region, India." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 8 (July 26, 2019): 3295. http://dx.doi.org/10.18203/2320-1770.ijrcog20193554.
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Background: Congenital anomalies are important cause of morbidity and mortality in newborns and are defined as structural and functional abnormalities including metabolic disorders present at birth. These defects are of prenatal origin resulting from defective embryogenesis or intrinsic abnormalities in the process of development and are associated with various risk factors.Methods: Our study is a cross sectional study done at Regional Institute of Medical Sciences, Imphal over period of 3 years from January 2015 to December 2017. Aim of study was to find out incidence of congenital anomalies and proportions of different types of congenital anomalies. Outcome was studied in relation to maternal age, religion, parity, and gestational age, sex of the baby, outcome and sex of the baby.Results: Total numbers of congenital anomalies were 257 babies out of 29879 births giving the incidence of 0.86%. Most common congenital anomalies in this study are musculoskeletal followed by craniospinal, genitourinary, cardiovascular and gastrointestinal. It was more common in preterm babies and parity 1-3, more common in 21-30 years of maternal age. Consanguinity was seen in 7 out of 257 patients.Conclusions: Congenital malformations are a major cause of still births and infant mortality. Targeted scan should be done at 18-20 week to find out anomalies and reduce the prevalence. There should be widespread education in the community regarding the common congenital malformations, their outcomes and possible available mode of treatment
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Kulakov, V. I. "Surgical correction of congenital malformations of the fetus and newborn." Journal of obstetrics and women's diseases 54, no. 5S (November 15, 2005): 13–16. http://dx.doi.org/10.17816/jowd86535.
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Over the past decade, the problem of congenital malformations has acquired great medical and social significance. The urgency of the problem and the priority of the development of this direction has increased in connection with the introduction into practice of methods of prenatal diagnostics, which created the basis for the active prevention of the birth of children with multiple developmental anomalies or their timely surgical correction. The significance and state of this problem is evidenced by statistics. According to the National American Center for Birth Defects, 10 to 20 million babies with congenital anomalies are born annually in the world.
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Parikh, Yogesh N., Mitul B. Kalathia, and Dhanya Soodhana. "Clinical profile of congenital limb anomalies in neonates." International Journal of Contemporary Pediatrics 5, no. 2 (February 22, 2018): 299. http://dx.doi.org/10.18203/2349-3291.ijcp20180514.
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Background: Reported birth prevalence of congenital limb defects vary from country to country. Epidemiological studies permit the timely detection of trends in congenital limb anomalies and the associations with other birth defects. The objective of this study was to know the prevalence and the variety of congenital limb anomalies and their association with other anomalies.Methods: A prospective observational study in which all newborns reported to the neonatal department were surveyed to find out the incidence, diversity and association of limb anomalies. Age of the mother, risk factors and other demographic data of the newborns was analyzed. Babies born less than 28 weeks were excluded from the study.Results: The prevalence was 6.34 per thousand live births. The majority of the neonates were term babies and female. 28 % of the babies were born out of consanguineous marriage. The mean age of the mother was 25. Median parity was 1. 9.52 % of the babies had a history of anomaly in the sibling. 4.76 % had a history of still birth. The most common congenital anomaly was congenital talipo equino varus. The other congenital limb anomalies observed were polydactyly, syndactyly, bifid thumb and absence of the radius. There were multiple congenital anomalies in 28.57 % of the babies.Conclusions: The study has given us an insight into the variety of congenital limb malformations and also into the possible etiological factors. A study done on a larger population would probably help us assess the incidence and pattern of occurrence of limb anomalies and help us counsel the parents.
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Radosavljevic, R., J. Popovic-Lazic, N. Antic, E. Garalejic, B. Arsic, M. Pastar, and R. Maglic. "Congenital malformations in babies whose mothers were treated by assisted reproductive technologies." International Journal of Gynecology & Obstetrics 70 (2000): A113. http://dx.doi.org/10.1016/s0020-7292(00)83357-3.
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Sharma, Sunita, Sanghamitra Ghosh, Soma Singh, Astha Chakravarty, Ashalatha Ganesh, Shweta Rajani, and B. N. Chakravarty. "Congenital Malformations among Babies Born Following Letrozole or Clomiphene for Infertility Treatment." PLoS ONE 9, no. 10 (October 1, 2014): e108219. http://dx.doi.org/10.1371/journal.pone.0108219.
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Patole, Monali Madhukar, Mandar Madhukar Patole, and Subhasish Paul. "Hernia of the umbilical cord: a clinical spectrum." International Journal of Contemporary Pediatrics 7, no. 1 (December 24, 2019): 132. http://dx.doi.org/10.18203/2349-3291.ijcp20195741.
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Background: Hernia of the umbilical cord is a rare clinical entity which presents with hernia of the small bowel into the proximal part of the umbilical cord. This is sporadically associated with other congenital malformations. This is usually poorly identified and mistakenly termed as ‘omphalocele minor. Inadvertent clamping of the cord in these cases leads to iatrogenic bowel wall injury. The aim of this study is to present a spectrum of cases presenting with umbilical cord hernia in a tertiary care Govt medical college, along with demography, intra operative findings, associated malformations and postoperative outcome and 1 year follow up.Methods: This is an ambispective study on neonates who attended the Outpatient Department (OPD) or Emergency department. The babies were evaluated by age, birth weight, gender, any gross clinical malformation. They were also evaluated intraoperatively for any associated anomalies. Post-surgery the babies were followed up until 2 years of age in pediatric surgery OPD of the same institute and outcome was recorded.Results: Out of 90 babies, 88 babies (97.77%) had body weight more than 2.5 kg, and rest 2(2.22%) had bodyweight of 1.5kg and 1.8 kg. Regarding content of contents of umbilical cord hernia, out of 87 patients, 43 patients (49.42%) had ileal loop as, 32 patients (36.78%) had ileum with Meckel’s diverticulum, 6 patients (6.39%) had cecum with appendix.Conclusions: Most of this study cases had ileal loops as content of the hernial sacs, and 36.78% cases had Meckel’s diverticulum associated, which is a remnant of Vitello intestinal duct. Prompt identification of the condition and early intervention and adequate post-natal care are affective to prevent long term morbidity.
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Sharma, I., BT Rijal, SB Thapa, and I. Poudel. "Congenital anatomical malformation at birth in Western Regional Hospital, Pokhara, Nepal." Journal of Universal College of Medical Sciences 1, no. 4 (January 12, 2014): 37–40. http://dx.doi.org/10.3126/jucms.v1i4.9572.
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BACKGROUND: Congenital anomalies are any abnormality present at birth, either structural or functional, which may have been inherited genetically, acquired during gestation, or inflicted during parturition. There has not been much studies related to the congenital anomalies in Nepal. METHODOLOGY: One year hospital based review study was conducted to find out the incidence, magnitude of congenital malformation and to know the specific involvement of anatomical structures among babies born at Western Regional Hospital, Pokhara, Nepal. RESULTS: Of 10013 deliveries during the period of 1 year, total number of live birth was 98.82% (9895). Out of 9895 of total live births with any form of conginital anomolies was found amongst 0.42% (42) children, congenital anomalies were ranging from minor to major, single to multiple systems. Musculoskeletal anomalies accounted for the maximum of 57.1% followed by genitourinary anomaly 14.3%. Nervous system anomaly was seen in 11.9% and few cases of gastrointestinal system anomaly and anomalies of the sense organs. CONCLUSION: Incidence of congenital anatomical malformations at birth at Western Regional Hospital, Pokhara was found to be 0.42%. DOI: http://dx.doi.org/10.3126/jucms.v1i4.9572 Journal of Universal College of Medical Sciences (2013) Vol.1 No.04: 37-40
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Kazi, Sajjad Ali, Aamir Memon, and Abdul Hameed Radhan. "Frequency of congenital birth defects in newborn babies born at Hyderabad, Sindh." Professional Medical Journal 27, no. 04 (April 10, 2020): 707–10. http://dx.doi.org/10.29309/tpmj/2020.27.04.3400.
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Objectives: This study has been conducted in a tertiary care hospital to observe the frequency of congenital birth defects in newborn babies born at, Hyderabad, Sindh. Study Design: Prospective observation study. Setting: The Departments of Obstetrics and Pediatrics, Isra University Hospital, Hyderabad. Period: Two years from 2016 to 2018. Material & Methods: All the pregnant women irrespective of their parity and were included in the study after getting informed and written consent from their family heads and after the approval from Hospital’s ethical committee. We have used SPSS version 21.0 software for both data entering and analysis. All the continuous variables were analyzed using student t test and categorical variables were analyzed using chi-square test. P-value of ≤0.05 was taken as statistically significant. Results: A total of 150 pregnant women were included in our study with their mean age and SD was 26.72 ± 7.07 years and the mean years of marriage were 5.95±6 years. Most of the women were multiparous (47%), as compared to nulliparous and grandmultiparous, 33% and 20%, respectively. The prevalence of congenital birth defect was 11.3%, of these 30% had CNS malformations followed by 30% with gastrointestinal, 24% musculoskeletal, 12% genitourinary and 4% had ear malformations. Conclusion: The interfamily marriages (consanguineous marriages) are more common than outside family in study population. The frequency of birth defects was more than i-e: twice higher in interfamily marriages than outside family marriages.
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Adhikari, K. M., and Sandeep Dhingra. "Clinical suspicion of congenital heart diseases during well-baby follow-up and echocardiographic correlation." International Journal of Contemporary Pediatrics 4, no. 6 (October 24, 2017): 2046. http://dx.doi.org/10.18203/2349-3291.ijcp20174728.
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Background: Congenital heart disease (CHD), the most common cardiac malformation in the fetal and neonatal period, represents a heterogeneous group of defects with little known cause. Despite advances in detection and treatment, CHD accounts for 3% of all infant deaths and 46% of death from congenital malformations. CHD patients with minimum or no symptoms are frequently under diagnosed in areas with inadequate health services. The aim of this study was to investigate the role of clinical suspicion of congenital heart disease in babies who presented for well-baby follow-up against echocardiographic findings and to study the clinical spectrum of all the CHD that were diagnosed. Methods: The study involved analysis of data collected by the authors while working in a tertiary care center at Mumbai, India, during 2009 to 2010. All the babies born from April 2009 to August 2010 (17 months) and those who came for well-baby visits (with or without symptoms) were examined carefully for findings on cardiac examination including abnormalities of heart sound and presence of murmur on auscultation. Findings of the echocardiography were recorded for follow up and all the babies were followed up on at least three-monthly basis. Echocardiography was repeated on a quarterly basis in symptomatic babies and six-monthly basis in asymptomatic babies with small septal defects. All the babies on follow up were closely monitored clinically and on echocardiography for ascertaining the natural course of the observed defects. Results: A total of 1856 babies were born at the tertiary care center out of which 1688 were seen at the well-baby clinic. A total of 42 cases were referred for echocardiography on clinical suspicion of CHD and out of these 21 (50%) were positive for some form of CHD. Most common CHD diagnosed was atrial septal defect (ASD). There was no spontaneous closure of ventricular septal defects (VSD), though, 02 cases of ASD less than 3 mm closed during the during the follow up period.Conclusions: This study demonstrated that clinical experience is a valuable tool in early diagnosis of CHD, even if they are asymptomatic. Early echocardiography is justified to diagnose the cases so that appropriate follow-up and management decisions could be planned. Though majority of the cases were moderate to small ASD and VSD, there is a need to diagnose them early and follow them up till closure.
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Becerra, Jose E., Muin J. Khoury, Jose F. Cordero, and J. David Erickson. "Diabetes Mellitus During Pregnancy and the Risks for Specific Birth Defects: A Population-Based Case-Control Study." Pediatrics 85, no. 1 (January 1, 1990): 1–9. http://dx.doi.org/10.1542/peds.85.1.1.
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Although the excess risk for birth defects among children of mothers with diabetes mellitus is well documented, there are few data concerning the risk for specific malformations. In the Atlanta Birth Defects Case-Control Study, those risks for malformations were evaluated. The population-based study included 4929 live and stillborn babies with major malformations ascertained by the Metropolitan Atlanta Congenital Defects Program in the first year of life born to residents of Metropolitan Atlanta between 1968 and 1980. The study also included 3029 nonmalformed live babies who were frequency-matched to case babies by race, period of birth, and hospital of birth. The relative risk for major malformations among infants of mothers with insulin-dependent diabetes mellitu (n = 28) was 7. (5% confidence interval [CI]1.9, 33.5) compared with infants of nondiabetic mothers. The relative risks for major central nervous system and cardiovascular system defects were 15.5 (95% CI = 3.3, 73.8) and 18.0 (95% CI = 3.9, 82.5), respectively. The absolute risks for major, central nervous system, and cardiovascular system malformations among infants of diabetic mothers were 18.4, 5.3, and 8.5 per 100 live births, respectively. Infants of mothers with gestational diabetes mellitus who required insulin during the third trimester of pregnancy were 20.6 (95% CI = 2.5, 168.5) times more likely to have major cardiovascular system defects than infants of nondiabetic mothers. The absolute risk for infants of this group of diabetic mothers was 9.7%. No statistically significant differences were found among infants of mothers with gestational diabetes mellitus who did not require insulin during pregnancy. These results suggest a stronger association than previously reported between maternal diabetes mellitus and specific categories of major malformations and implicate gestational diabetes mellitus as a risk factor for major cardiovascular system defects.
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D, Saminathan, Mythili B, Sirajuddin Nazeer, and Geetha Manivannan. "PATTERN OF BABIES WITH CONGENITAL MALFORMATIONS ADMITTED IN A TERTIARY NEWBORN CARE UNIT." Journal of Evolution of Medical and Dental Sciences 4, no. 36 (May 1, 2015): 6167–71. http://dx.doi.org/10.14260/jemds/2015/899.
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Gulyaeva, Olga N., A. S. Kazitskaya, M. V. Alekseeva, L. V. Renge, and A. G. Zhukova. "THE RELATIONSHIP BETWEEN THE FREQUENCY OF CONGENITAL MALFORMATIONS IN NEWBORNS OF WOMEN RESIDING IN AN INDUSTRIAL REGION WITH THE POLYMORPHISM OF THE GENES OF THE BIOTRANSFORMATION SYSTEM." Hygiene and sanitation 97, no. 7 (July 15, 2018): 585–90. http://dx.doi.org/10.18821/0016-9900-2018-97-7-585-590.
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Introduction. There is a number of polymorphic genes, the products of which take part in the biotransformation process and possess of the different activity. As a result of an imbalance in the processes of xenobiotic biotransformation, there is occurred an accumulation of toxic electrophilic compounds, the rise in a mutagenic activity, that can be very important in the formation of congenital malformations. Therefore, the study of the association of gene polymorphisms of the first and second phases of biotransformation with various congenital malformations is topical. The aim of the study. To investigate the role of the polymorphism of genes of the xenobiotic biotransformation system (CYP1A2*1F, GSTT1, GSTM1) encoding the enzymes I and II detoxification phases in women with the complicated obstetric history, residing in an industrial region. Material and methods. A survey of 53 women of reproductive age living in the territory of Novokuznetsk was carried out. The comparison group (the control) consisted of 27 women. These women did not have spontaneous miscarriages, and they carried the fetus to term without congenital malformations. The study group included 26 women who gave birth to babies with congenital malformations. Genomic DNA was isolated by the phenol-chloroform extraction method followed by the ethanol precipitation. The molecular and genetic analysis of the gene polymorphism of cytochrome 1A2 (CYP1A2), glutathione S-transferase τ-1 (GSTT1) and glutathione S-transferase μ-1 (GSTM1) was carried out using Real-Time mode. Results. A high risk of congenital fetal malformations in women with the A/A CYP1A2*1F genotype and resistance to these pathologies in the presence of a heterozygous form of the gene C/A CYP1A2*1F was revealed. The relationship between the high risk of stillbirth due to the placental insufficiency in women with deletion polymorphism of the gene GSTM1 “-”, while the normal functioning gene GSTM1 “+” was associated with the resistance to antenatal fetal death.
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BERROCAL, Alfredo, Erick RAMÍREZ, and Armando CALVO. "El embarazo no exacerba la dermatomiositis." Revista Medica Herediana 10, no. 3 (June 3, 2013): 125. http://dx.doi.org/10.20453/rmh.v10i3.612.
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We report four pregnancies in three dermatomyositis female patients who had their disease under control from beginning, during the course of their pregnancies, and the Postpartum period. Two females were off steroids and one received prednisone and azathioprine until week 16th of pregnancy when azathioprine was taken off, remaining only on prednisone, Neither case had a disease relapse. All babies were alive and full term newbornes, they also were adequate for gestational age and none had congenital malformations.
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Devi, Kangjam Radhesana, R. K. Praneshwari Devi, Jyoti Priya, Ahanthembi Sanaton, Leimapokpam Roshan Singh, and Lalhlimpuii Murray. "A study of congenital anomalies in a tertiary care hospital in North East region, India." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 7 (June 27, 2018): 2899. http://dx.doi.org/10.18203/2320-1770.ijrcog20182903.
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Background: Congenital anomalies are important cause of morbidity and mortality in newborns and are defined as structural and functional abnormalities including metabolic disorders present at birth. These defects are of prenatal origin resulting from defective embryogenesis or intrinsic abnormalities in the process of development and are associated with various risk factors.Methods: Our study is a cross-sectional study done at Regional Institute of Medical Sciences, Imphal over period of one and half years from May 2016 to October 2017. Aim of study was to find out incidence of congenital anomalies and proportions of different types of congenital anomalies. Outcome was studied in relation to maternal age, religion, parity, gestational age, sex of baby, outcome and birth weight of baby.Results: Total numbers of congenital anomalies were 91 out of 13658 births. Incidence of congenital anomalies was 0.66%. Most common congenital anomaly was cleft lip (17.6%) followed by CTEV (13.2%) and was more common among male term babies. These were most common in 18-24 years of maternal age group (34.1%) followed by 30-34 years (26.4%) and among women of parity P0-P2.Conclusions: Congenital malformations are a major cause of still births and infant mortality. A level II targeted scan should be done at 18-20 weeks to find out anomalies and reduce the prevalence. There should be widespread education in the community regarding the common congenital malformations, their outcomes and possible available modes of treatment.
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Rodríguez, María M., Jocelyn H. Bruce, Xavier F. Jiménez, Rita L. Romaguera, Eduardo Bancalari, Otto L. García, and Peter L. Ferrer. "Nonimmune Hydrops Fetalis in the Liveborn: Series of 32 Autopsies." Pediatric and Developmental Pathology 8, no. 3 (May 2005): 369–78. http://dx.doi.org/10.1007/s10024-005-8089-z.
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Nonimmune hydrops fetalis (NIHF) or generalized soft tissue edema and cavity effusions may be due to cardiovascular diseases, congenital infections, genitourinary malformations, thoracic masses, placental conditions, chromosomal abnormalities, and idiopathic. We report 32 cases of NIHF from among 429 neonates who underwent autopsies (incidence 7.45%). Sixteen cases (50%) had cardiovascular disease; all were due to low output cardiac failure; 7 had structural congenital heart disease. Three of the children with congenital heart disease also had chromosomal abnormalities: 2 had trisomy 18 and 1 had Noonan syndrome. Among myocardial conditions were five subjects with cardiomyopathies (1 of each of the following types): oncocytic, dilated, endocardial fibroelastosis, cardiac glycogenosis, and carnitine deficiency; 3 had myocarditis, and 1 had cardiac rhabdomyomas. Congenital infections were due to cytomegalovirus in 3 cases, bacteria in 2, and parvovirus in 1. The mechanism of NIHF in these cases might be a combination of decreased myocardial contractility due to myocarditis and fetal anemia. Genitourinary diseases were present in 5 newborns: Two had congenital nephrotic syndrome, 1 had VACTER association, 1 had prune-belly syndrome, and 1 had urogenital sinus malformation. Intrathoracic lesions were found in 2 babies (pulmonary sequestration and diaphragmatic hernia). One twin died of volume overload due to twin transfusion syndrome. Only 2 newborns were classified as idiopathic. Our study shows that cardiovascular diseases that lead to heart failure or impaired venous return are more common in the liveborn (50%), whereas congenital infections are more common in the stillborn with NIHF.
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Bhatia, Padma, Harshima Sawlani, Mohan Shinde, and Rajesh Tarachandani. "Magnitude and pattern of birth defect babies at Bhopal district early intervention center under RBSK’s 4Ds approach: an observational study." International Journal Of Community Medicine And Public Health 6, no. 12 (November 27, 2019): 5268. http://dx.doi.org/10.18203/2394-6040.ijcmph20195483.
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Background: As per World Health Organization (WHO) congenital anomalies are also known as birth defects, congenital disorders or congenital malformations. Most common and severe congenital anomalies are congenital heart diseases, neural tube defect and Down’s syndrome. No data on the magnitude of congenital anomalies is available in India. Thus, the study aims to determine the magnitude and pattern of babies with birth defect reporting at District Early Intervention Center, Bhopal in children aged 0 to 6 years.Methods: This was an observational study conducted at DEIC, Bhopal under Rashtriya Bal Swasthya Karyakram services, over a period of one year. Children between 0 to 6 years visiting the center and belonging to Bhopal district were included in the study. Data entry was by Microsoft Excel and analysis was by Epi info.Results: 2891 children were registered for the study out of affected children 18.7% of them were diagnosed with Developmental delays while birth defect was observed in 4.3% cases. Of the birth defect cases majority i.e. 37.7% had congenital heart disease and 16.7% had congenital hearing loss. No case of retinopathy of prematurity was registered.Conclusions: The study also helps to know the magnitude and pattern of congenital anomalies. Any effective health intervention will reduce both direct costs and out-of-pocket expenditure.
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Tenali, Ananya S. L., Santosh K. Kamalakannan, and Kumutha K. Jayaraman. "Spectrum of congenital anomalies of neonates in a tertiary care hospital in Southern India." International Journal of Contemporary Pediatrics 5, no. 2 (February 22, 2018): 314. http://dx.doi.org/10.18203/2349-3291.ijcp20180030.
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Background: Congenital anomalies contribute upto 11% of neonatal deaths globally. Neonates with multiple congenital malformations present a very difficult challenge to the treating physicians. This study was done to know the frequency, pattern of congenital anomalies and various presentations, which may help to develop strategies for patient counseling and management in our setting.Methods: Retrospective hospital based observational study from the period of June 2015 to June 2017. Neonates born in our hospital during the study period with documented congenital anomalies were included in the study and the data was classified as per European Surveillance of Congenital Anomalies and further analysed.Results: Total number of neonates with documented congenital anomalies was 40, of which 6 neonates (15%) had multiple anomalies. The anomalies in the study were divided into major and minor anomaly groups. 70% of the anomalies were classified as major anomalies while 30% were classified as minor anomalies. Multiparity and GDM were found to be major risk factors in the mother. Major anomalies identified involved the Musculoskeletal system (21.6%) and cardiovascular system (20%). Minor anomalies included skin disorders (27.7%) followed by Musculoskeletal (16.6%) and genitourinary system (16.6%). Of the 40 anomalous babies five babies expired soon after birthConclusions: Antenatal screening is an effective tool to detect Musculoskeletal and CNS anomalies. CVS anomalies may be missed by routine anomaly scan. Early intervention and effective follow up have shown that good outcomes are possible even in while managing some of the major anomalies.
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Rizk, Botros, Pat Doyle, S. L. Tan, Paul Rainsbury, June Betts, Peter Brinsden, and Robert Edwards. "Perinatal outcome and congenital malformations in in-vitro fertilization babies from the Bourn-Hallam group." Human Reproduction 6, no. 9 (October 1991): 1259–64. http://dx.doi.org/10.1093/oxfordjournals.humrep.a137523.
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Naik, Manuja, Meena Bhargava, and Kalpana Yadav. "Epidemiological study of congenital malformations at birth in a tertiary health centre in central India." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 7 (June 27, 2018): 2845. http://dx.doi.org/10.18203/2320-1770.ijrcog20182893.
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Background: The proposed study was carried out to determine incidence of congenital malformations, incidence of CM in live and still births, risk factors attributable, maternal and perinatal outcome, to frame the recommendations for early detection and prevention of CM.Methods: Prospective observational study. The cases selected from those attending the antenatal O.P.D. and those admitted in wards of Obs and Gynae Dept., GMH who delivered congenitally malformed baby dated from August 2013-July 2014. A detailed history, examination, relevant investigations was done.Results: Out of 9014 deliveries, 110 babies had CM. The incidence of CMs was found to be 1.22%. Maximum number (24.55%) of CM s were of CNS, most common was NTD (Anencephaly). Incidence of CMs was more in still births, mothers of age >40 yrs and <20 yrs, of illiterate, educated <8 std., house wives, rural areas, unbooked and multigravida. Most CM fetuses were delivered prematurely (67.27%). CVS and CNS systems were more commonly involved in consanguinous married couples. CM was associated with drug intake, 1.82% on antiepileptics, 1.82% on antihypertensives, 3.64% on oral hypoglycaemics,0.91% on NSAID,6.36% on unspecified drugs. 12.73% CMs were seen in passive smokers, 6.36% consumed alcohol, 17.27% pan/gutka intake. Majority were delivered by vaginal route, maximum fetuses (82.73%) were in vertex presentation, maximum (67.27%) CMs were in male babies.Conclusions: Many malformations arise because of the interplay of genetic, environmental and multifactorial factors. The stress imposed may be reduced considerably by understanding the causes of the malformations and adopting the management strategies outlined for the prevention or reduction of CM.
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Khalil, Basem A., Abdalla E. Zarroug, Abubakr Elawad, Saad Moussa, Collette Donnelly, Saleem Mammoo, Guy Brisseau, Alison Bedford Russell, and Helmut Hummler. "Outcomes following the establishment of Qatar’s quaternary neonatal general surgical service in a hospital with a “Tabula Rasa” for service development." Journal of Neonatal Surgery 10 (August 9, 2021): 32. http://dx.doi.org/10.47338/jns.v10.975.
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Background: Sidra Medicine is the first dedicated Children and Maternity hospital in the State of Qatar. This paper describes the preparations for and results of activating quaternary neonatal surgical services in a brand new, "greenfield" hospital. We believe that these are the first published national results of neonatal general surgical services from the Gulf region. Methods: A review of surgical babies below four weeks corrected age from 1st of April 2018 – 31st of March 2020 was undertaken. Patient demographics, primary diagnosis, surgical procedures, 30-day postoperative mortality, overall mortality, and cause of death were recorded. Results: One hundred and sixty-nine babies (169) were identified (44.4% term and 55.6% preterm). Major surgery included laparotomy (76), congenital diaphragmatic hernia repair (20), surgery for anorectal malformations (25), and esophageal atresia (13). One set of conjoined twins were also separated successfully. Fourteen babies died, resulting in overall mortality of 8.3 %. Excluding babies who died of life-limiting conditions, two babies died within 30 days of surgery, resulting in 30 days postoperative mortality rate of 1.2 %. Conclusions: The neonatal surgical mortality rate is comparable with those from top international centers. This low rate could be attributed to the high level of expertise preceded by months of preparations.
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Bosi, Giuliano, Marco Scorrano, Giovanna Tosato, Elena Forini, and Roxana Chakrokh. "The Italian Multicentric Study on Epidemiology of Congenital Heart Disease: first step of the analysis." Cardiology in the Young 9, no. 3 (May 1999): 291–99. http://dx.doi.org/10.1017/s1047951100004960.
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AbstractWe present the aims, methodology and initial results from the Italian Multicentric Study for the registration and follow-up of congenital heart disease. The general aims are to measure the prevalence of congenital heart disease in different geographic areas of Italy, and to assess the survival and outcome of affected babies. During the years 1992 and 1993, eighteen centers for Pediatric Cardiology spread all over the Country enrolled 1445 new babies with congenital cardiac malformations from a population of 341, 647 surveyed livebirths. The new cases were registered using the same methodologic criterions of the EUROCAT study in order to evaluate differences and/or similarities between the studies. The prevalence varied between 1.8‰ and 8.1‰; the average being 4.6%. The large range in prevalence is presumed to be related to different customs and hierarchies in flow and referral of patients. We provide total prevalence of individual lesions, and distribution of sentinel cardiac anomalies, in the Italian study and compare them with EUROCAT. Isolated ventricular septal defect is the most common lesion (39%); followed by atrial septal defect (7.5%); pulmonary valvar stenosis (7.3%); atrioventricular septal defects (5.4%); patency of the arterial duct (3.8%); complete transposition (3.7%); tetralogy of Fallot (3.3%); aortic coarctation (2.4%); aortic valvar stenosis (2.2%); and left heart hypoplasia (1.8%). The echographic stratification of ventricular and atrial septal defects, by location and size, was in keeping with the findings of the EUROCAT study. Because of the recent widespread availability of color-Doppler tecniques, the stratification of aortic and pulmonary valvar stenosis was an innovative approach in our study. Among the complex cardiovascular anomalies, double inlet ventricle and pulmonary atresia had a proportion of about 2% each; with double outlet right ventricle, common arterial trunk, Ebstein's malformation, tricuspid atresia, interrupted aortic arch and totally anomalous pulmonary venous connection having a proportion ranging from 0.5 to 0.8%. We discuss clinical features, such as frequency of extracardiac anomalies and familial aggregation of congenital heart disease, in comparison with the EUROCAT data.
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Shetty, S., N. Kennea, P. Desai, S. Giuliani, and J. Richards. "Length of stay and cost analysis of neonates undergoing surgery at a tertiary neonatal unit in England." Annals of The Royal College of Surgeons of England 98, no. 1 (January 1, 2016): 56–60. http://dx.doi.org/10.1308/rcsann.2016.0034.
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Introduction There is a lack of knowledge on the average length of stay (LOS) in neonatal units after surgical repair of common congenital anomalies. There are few if any publications reporting the activity performed by units undertaking neonatal surgery. Such activity is important for contracting arrangements, commissioning specialist services and counselling parents. The aim of this study was to describe postnatal LOS for infants admitted to a single tertiary referral neonatal unit with congenital malformations requiring surgery. Methods Data on nine conditions were collected prospectively for babies on the neonatal unit over a five-year period (2006–2011). For those transferred back to their local unit following surgery, the local unit was contacted to determine the total LOS. Only those babies who had surgery during their first admission to our unit and who survived to discharge were included in the study. Cost estimates were based on the tariffs agreed for neonatal care between our trust and the London specialised commissioning group in 2011–2012. Results The median LOS for the conditions studied was: gastroschisis 35 days (range: 19–154 days), oesophageal atresia 33 days (range: 9–133 days), congenital diaphragmatic hernia 28 days (range: 7–99 days), intestinal atresia 24 days (range: 6–168 days), Hirschsprung’s disease 21 days (range: 15–36 days), sacrococcygeal teratoma 17 days (range: 12–55 days), myelomeningocoele 15.5 days (range: 8–24 days), anorectal malformation 15 days (range: 6–90 days) and exomphalos 12 days (range: 3–228 days). The total neonatal bed day costs for the median LOS ranged from £8,701 (myelomeningocoele) to £23,874 (gastroschisis). The cost of surgery was not included. Conclusions There is wide variation in LOS for the same conditions in a single neonatal unit. This can be explained by different types and severity within the same congenital anomalies, different surgeons and other clinical confounders (eg sepsis, surgical complications, associated anomalies). These data will enable us to give more detailed information to families following prenatal or postnatal diagnosis. They also allow more detailed planning of resource allocation for neonatal admissions.
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Mehta, Dr Dhwani, Dr Charmi Pawani, Dr Snehal B. Kukadiya, and Dr Nimish Pandya. "The ambit of congenital malformations in the Kachchh district- a hospital-based study at a tertiary care center." Obsgyne Review: Journal of Obstetric and Gynecology 6, no. 6 (December 31, 2020): 114–19. http://dx.doi.org/10.17511/joog.2020.i06.02.
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Background and Aim: Quantifying birth defects in a population is felt as a need as it helpsinappropriate allocation of the health budget to tackle and reduce perinatal, neonatal, and infantmortality rates. Hence a study on congenital anomalies was undertaken in the region of Kachchhdistrict. Material and Methods: Present cross-sectional study was performed on 10 patientsdiagnosed with having congenital malformed fetuses at tertiary care center- G.K. General Hospital,Bhuj, Kachchh district, Gujarat, India over three months – January, February, March 2019. Results:Mean age of the study participants were 22.3 years, most (70%) of the study participants wereprimigravida. Hydrocephalus was the most common birth defect among study participants. Eightypercentages (80%) of study participants had gross anomalies. Sixty percentages (60%) ofparticipants had the outcome of termination. Conclusion: Congenital anomalies were in babies tomothers between 20-30 years of age. Once an anomaly is detected, various management optionsare to be discussed with the patients in consultation with a neonatologist, pediatric surgeon, andneurosurgeon when necessary.
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Kafle, Shyam Prasad, Mukesh Bhatta, Ramesh Shrestha, Sarita Sitaula, Namu Koirala, and Anupam Koirala. "Outcome of Neonatal Hyperbilirubinemia from a Tertiary Care Hospital in Eastern Nepal: A Cross-sectional Study." Journal of BP Koirala Institute of Health Sciences 4, no. 1 (June 30, 2021): 37–42. http://dx.doi.org/10.3126/jbpkihs.v4i1.36324.
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Background: Timely detection and treatment of pathological hyperbilirubinemia in newbornscan prevent acute bilirubin encephalopathy and its consequences. We aimed to identifyitsoccurrence, presentationtime, phototherapyduration, need for exchange transfusion,and outcome.
Methods: In this cross-sectional study, we enrolled all the babies admitted for pathological neonatal hyperbilirubinemia in the university hospital ofBPKIHSin a one-yearduration. Babies with life-threatening congenital malformations or conjugated bilirubin >20% of total serum bilirubin or >2 mg/dl were excluded. Obstetric profile of mothers, clinical and laboratory parameters of babies, onset time of pathological jaundice, duration of phototherapy, need for exchange transfusion or intravenous immunoglobulin were recorded. Neonatal outcome was classified as good and poor and its association with potential predictors analyzed.
Results: One-hundred and fifty babiesdeveloped neonatal jaundice requiring treatment. The most common causes includedABO and Rh setting. No cause was found in 26 (18%) babies. One-hundred and eight babies (72%) were only managed withphototherapy whereas 42 (28%) required both phototherapy and double volume exchange therapy. The majority (84.5%) had good outcome without any residual neurological deficit at discharge.Babies with total serum bilirubin >20 mg/dl at presentation, duration of phototherapy >44.8 h, ABO setting, hemolysis, and out born statussignificantly developed poor outcome (p < 0.05).
Conclusion: About 15% of the babies with hyperbilirubinemia had acute bilirubin encephalopathy at discharge suggestive of poor outcome. Babies with high bilirubin at presentation, longer duration of phototherapy, ABO settings, hemolysis, and out born statusdeveloped poor outcome.
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Shlemkevich, O., and M. Kiselоva. "ISSUES OF THE TEAM OF DOCTORS INVOLVED IN ASSISTANCE AN EXTREMELY PREMATURE INFANT WITH CONGENITAL SCOLIOSIS (CLINICAL CASE)." Neonatology, surgery and perinatal medicine 12, no. 1(43) (May 8, 2022): 72–76. http://dx.doi.org/10.24061/2413-4260.xii.1.43.2022.13.
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The number of newborns who already have various malformations at birth is, according to WHO data, 2.5- 3%. Almost 1% of them are manifestations of monogenic diseases, about 0.5 % - chromosomal diseases, 1.5-2 % are caused by congenital malformations (СМ) caused by the influence of adverse factors of exogenous and endogenous origin. The frequency of СМ increases by the end of the first year of a child's life and reaches 5-7 % due to the manifestations of undiagnosed malformations of vision, hearing, nervous and endocrine systems at birth. The estimate of the incidence of congenital spinal abnormalities in the general population is 0.13-0.5 / 1000 newborns. About 10-12 % of children have scoliosis. In some children, this pathology is congenital and refers to complex neonatal pathologies of spinal malformations.The relevance and priority of issues of prevention and early treatment of congenital scoliosis are due to the development of severe deformities, disorders in the internal organs, as well as cosmetic defects.The article describes a clinical case of congenital scoliosis in a prematurely born child with another congenital pathology specific to the perinatal period, which was detected and confirmed before the end of the first week of the child's life: respiratory distress syndrome of the newborn, intraventricular hemorrhage grade III, signs of periventricular leukomalacia with discrete hemorrhages in the spinal cord, dimorphic syndrome, anemia of premature babies, metabolic disorders (hyperkalemia), prematurity is 28 weeks.The description of this clinical case raised topical questions that inevitably arose from a team of doctors who were involved in the medical care of a child with extremely low birth weight. The components of primary, secondary, and tertiary prevention of the development of hereditary pathology are identified, both at the stage of pregnancy planning and in the prenatal period. The defining role in the complex of measures for the Prevention of congenital and hereditary diseases today belongs to prenatal diagnostics, which makes it possible to prevent the birth of children with severe uncontrolled malformations, socially significant fatal genes, and chromosomal diseases. When providing medical care to children with severe congenital, combined pathology, it is important to discuss the issue of providing palliative care to children.An integral part of making therapeutic decisions about the type and method of medical care for a child is to consider the will of the parents, provided that the opinion of the parents is conscious and based on the comprehensive information received about all possible actions of medical professionals, indicating not only conducive but also adverse consequences in the long term of the life of the sick newborn.
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Matyanova, E. V., N. M. Kosheleva, O. M. Kostareva, E. V. Fedorova, and N. I. Klimenchenko. "Pregnancy outcomes in patients with rheumatoid arthritis and systemic lupus erythematosus. Part II. Neonatal outcomes." Rheumatology Science and Practice 57, no. 3 (July 11, 2019): 289–93. http://dx.doi.org/10.14412/1995-4484-2019-289-293.
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Rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are the most common autoimmune rheumatic diseases (RD) that occur mostly in women of childbearing age, and the occurrence of pregnancy is an expected fact. Due to the ongoing disputes over the ethics of maintaining birth rates among an unhealthy population, modern researchers focus attention on studies of the mutual impact of RD and pregnancy, on the safety of pharmacotherapy during conception and gestation, and on the health of the offspring born to female patients with RD.Objective: to evaluate the neonatal outcomes of pregnancy in patients with RA and SLE.Subjects and methods. An investigation was conducted to study the health status of 73 babies born to 72 female patients with RD (76 cases of pregnancy), of whom 29 patients with RA (32 cases of pregnancy) and 43 with SLE (44 cases of pregnancy) were followed up prospectively at the V.A. Nasonova Research Institute of Rheumatology and the Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology. The health status of the babies was evaluated in the first year of their life. Supervising neonatologists and pediatricians recorded abnormalities in the newborns and subsequently analyzed using their medical records (extracts from maternity hospitals, children's hospitals, and outpatient cards).Results and discussion. Of the 76 supervised pregnancies, 72 (94.7%) resulted in 73 live births (one twin pregnancy in a patient with SLE). There were three (6.8%) cases of pregnancy loss in the second trimester in patients with SLE having antiphospholipid syndrome (APS) and one (3.1%) case of perinatal death (a boy and a girl from a monochorionic diamniotic twin with reversed arterial perfusion) in a patient with seropositive RA. The height and body weight of all the newborns conformed to gestational age. Patients with RA and SLE compared to the population more often gave birth to low birthweight babies (9.7 and 21.4% versus 60.9 per 1,000 live births in the Russian population). In the groups of mothers with RA and SLE, their infants had a high Apgar score of 8–9 at one and five minutes. Various abnormalities were detected in 5 (16.1%) and 15 (35.7%) babies born to mothers with RA and to those with SLE, respectively. Among the neonatal congenital anomalies (malformations), there was patent foramen ovale, patent ductus arteriosus, and hip joint dysplasia, which were more common in the babies born to mothers with SLE having APS and exceeded the population-based incidence of these anomalies. The babies were more commonly diagnosed with congenital pneumonia than those in the population; there were single cases of umbilical hernia, hemangioma, thrombocytopenia, hemorrhagic disease of the newborn, perinatal encephalopathy, and congenital hearing loss.Conclusion. The mothers with RA and SLE more often gave birth to low birthweight babies than did those in the population. The infants born to mothers with RA and SLE had significantly more frequently congenital heart defects (patent foramen ovale, patent ductus arteriosus) and congenital pneumonia. The detected abnormalities were more common in the newborns born to mothers with SLE having APS. Maternal RA and SLE activities and/or performed therapy were not found to have a negative impact on the incidence of abnormalities in babies.
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J., Thinesh Kumar, Vaideeswaran M., and Arasar Seeralar T. "Incidence of hypoglycemia in newborns with risk factors." International Journal of Contemporary Pediatrics 5, no. 5 (August 24, 2018): 1952. http://dx.doi.org/10.18203/2349-3291.ijcp20183538.
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Background: The incidence of hypoglycemia varies worldwide according to the protocols and feeding Policies. There is paucity of data on Incidence of hypoglycemia in institutions where exclusive breastfeeding is followed. Objectives of this study was to study the incidence of hypoglycemia in newborns with risk factors and to study the differences in incidence between at risk groups.Methods: The Observational study was conducted in babies born with risk factors for hypoglycemia, infant of diabetic mother (IGDM/IDM), LGA (birthweight >90th percentile), SGA (birth weight <10th percentile), low birth weight (>1800 to <2500 grams) and preterm (35 - 37 weeks). babies on formula or pre-lacteal feed, major congenital malformations and admitted in NICU for other reasons were excluded. Hypoglycemia screening was done at 2, 6, 12, 24 and 48 hours of life, prior to feeding.Results: The incidence of hypoglycemia in newborns with risk factors was 33.3%. Out of 1883 Babies born with risk factors, 627 Babies developed at least one episode of hypoglycemia. Of these, 576 (30.3%) were asymptomatic hypoglycemia and 51 (3.0%) symptomatic hypoglycemia. Hypoglycemia was seen in 42% of SGA, 33% of IDM, 19% of preterm and 10% of LGA babies. About 51% of newborns developed hypoglycemia at 2 hours of life and about 31% of newborns at 6 hours of life. No hypoglycemic episodes were noted after 24 hours of life.Conclusions: Hypoglycemia screening should be done at regular interval, more specifically at first 24 hours of life in at risk babies where Exclusive Breastfeeding is followed.
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Truta, Brindusa, Ira L. Leeds, Joseph K. Canner, Jonathan E. Efron, Sandy H. Fang, Azah Althumari, and Bashar Safar. "Early Discontinuation of Infliximab in Pregnant Women With Inflammatory Bowel Disease." Inflammatory Bowel Diseases 26, no. 7 (October 31, 2019): 1110–17. http://dx.doi.org/10.1093/ibd/izz250.
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Abstract Objectives Early discontinuation of infliximab (IFX) in pregnant women with inflammatory bowel disease (IBD) decreases the intrauterine fetal exposure to the drug but may increase the risk of disease flaring leading to poor pregnancy outcomes. In this study, we assessed the impact of early IFX discontinuation on mother’s disease activity and on their at-risk babies. Methods In a retrospective study of the Truven Health Analytics MarketScan database from 2011 to 2015, we compared IBD patients who discontinued IFX more than 90 days (“early IFX”) with those who discontinue IFX 90 days or less (“late IFX) before delivery. We evaluated the risk of flaring, defined by new steroid prescriptions, visits to emergency room and/or hospital admissions, the pregnancy outcomes, and the at-risk babies. Results After IFX discontinuation, the early IFX group (68 deliveries) required significantly more steroid prescriptions than the late IFX group (318 deliveries) to control disease activity (P < 001). There were more preterm babies in the early IFX group (P < 049), but no difference within the 2 groups was noticed in the rate of intrauterine growth retardation, small for gestation, and stillborn babies. Similarly, there was no increase in acute respiratory infections, development delays, and congenital malformations in babies of the mothers from the late IFX vs early IFX groups. Conclusions Steroid-free remission IBD mothers are at risk for disease flares and preterm babies when IFX is discontinued early in pregnancy. Continuation of IFX seems to be safe at least for the first year of life.
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Amarendra, M., and M. Yoganand. "Comparison of clinical assessment of nutritional status (CAN) score with other methods in the assessment of fetal malnutrition." International Journal of Contemporary Pediatrics 4, no. 3 (April 25, 2017): 713. http://dx.doi.org/10.18203/2349-3291.ijcp20171070.
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Background: Assessment of nutritional status of new born has been a major concern to many clinicians because of the potentially serious sequelae of malnutrition on multiple organ system and future health. Various methods have been used to identify malnourished babies as early as possible. The objective of the study was to assess the nutritional status of new born at birth using CAN score and to compare the utility of CAN score with other commonly used measures for defining nutritional status of new borns like weight for gestational age, Ponderal index and Kanawati index.Methods: The present study is a hospital based cross sectional study consisting of 250 singleton full term with no major congenital malformations. Clinical assessment of nutritional status was done on the basis of CAN score and compared with other methods like weight for gestational age, Ponderal index and Kanawati index.Results: Out of 250 babies, CAN score detected 171 (68.4%) babies as malnourished, weight for gestational age at birth detected 150 (60%) babies as AGA and 100 (40%) babies as SGA. Based on Ponderal index and Kanawati index, 154 (61.6%) babies and 140 (56%) babies were malnourished respectively. Using CAN score as the gold standard for identifying fetal malnutrition, the sensitivity and specificity of weight for gestational age at birth were 51% and 21.5%, the sensitivity and specificity of Ponderal index were 69.5% and 55.6% and the sensitivity and specificity of MAC/HC (Kanawati index) were 77.7% and 91.1%.Conclusions: CAN score is a simple, systemic method of identifying fetal malnutrition. This method does not require any sophisticated equipments or laborious calculations and is a good indicator in comparison with other methods of determining fetal malnutrition.
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Fernando, S., T. Bandara, R. Sathanantharajah, and K. Withanaarachchi. "Pattern of clinically recognisable congenital malformations in babies born in a tertiary referral centre in Sri Lanka." Ceylon Medical Journal 59, no. 4 (December 27, 2014): 132. http://dx.doi.org/10.4038/cmj.v59i4.7866.
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