Indian Journal of Neonatal Medicine & Research

Clinico-bacteriological Profile of Neonates Born with Risk Factors of Septicemia

Priyamvada Roy, Ashwani Kumar, MMA Faridi, Iqbal R Kaur, Bineeta Kashyap

Background: Septicemia is the single most important cause of neonatal morbidity and mortality in the world, accounting for over half of the cases. Aim: This study was conducted to establish the clinical and bacteriological profile in newborns with risk factors of septicemia. Subjects and Methods: One hundred and fifty consecutive neonates delivered with risk factors of septicemia were recruited after obtaining informed consent. Blood culture was done using BACTEC PEDS PLUS/F CULTURE vials as a part of sepsis screen used to diagnose septicemia. In addition acute phase reactants like total leucocyte count and C-reactive protein measurements were also documented. Statistical analysis: Correlation of all risk factors with laboratory findings was obtained by using Pearson chi-square test and Fisher’s exact test. p-value of less than 0.05 was considered as significant. Results: Blood culture positivity was found in 28% neonates born with risk factors of septicemia out of which 57.1% were gram-positive and 42.9% were gram-negative isolates respectively. Staphylococcus aureus being the most common among the gram-positive bacteria, was isolated in 19 (45.2%) of cases. Among the gram-negative bacteria, Acinetobacter baumannii was the most common being present in 13 (30.9%) of cases. Among all the risk factors studied, fever in the mother was significantly correlating with positive sepsis screen. Conclusion: Blood culture positivity increases with increase in number of risk factors in neonatal septicemia. Hence screening tests for septicemia must be done routinely in such cases.

Magnifying Glass on Why Newborns Die : Low Birth Weight and Maternal Factors

M. Benjamin Sagayaraj, Lal Devyani Vasudevan Nair, Radha Kumar, Nidhi Sharma

Background: Low birth weight babies weighing less than 2000gms weight are immunologically deficient. In addition, they are at risk of birth asphyxia, hypothermia, respiratory distress, hyperbilirubinemia, hypoglycaemia, coagulopathy, sepsis and neonatal death. The apt way to reduce mortality is to identify the prepregnant and antenatal factors which ascertain the uterine milieu and nutrient bioavailability to the fetus in utero. Aim: This study was designed to reduce the mortality in low birth weight babies. We studied the various maternal and placental factors which affect the fetus in utero. Intrapartum events like presentation, premature rupture of membranes and cord accidents were also recorded. Materials and methods: This prospective study was carried out on 100 low birth weight babies out of 1800 deliveries in the Department of Paediatrics at Saveetha Medical College and hospital, Chennai, India between 1 October 2012 and 30 September 2013. Maternal factors like age, parity, prepregnancy body mass index, haemoglobin levels, preeclampsia, placental abnormalities, presentation, premature rupture of membranes and mode of delivery were studied. Cases of still birth, chronic maternal illness and gestational diabetes mellitus were excluded. Result: Seven newborns out of hundred died despite the level 2 neonatal intensive care. We found that maternal age (<20 and >30), weight <45kg, preeclampsia, anaemia, placental abnormalities and breech presentation were the maternal factors significantly associated with increased mortality in low birth weight babies. However in 28.6% of low birth neonate mortality no maternal cause could be identified. A literature search revealed that these could be inherent foetal genetic and/or chromosomal anomalies. Conclusion: Maternal age, Prepregnancy Body mass index, preeclampsia, maternal anaemia, breech presentation and placental abnormities are significant maternal factors resulting in mortality in low birth weight babies. Only in one third cases no maternal cause can be identified. Timely correction of maternal body mass index and anaemia can reduce the death rates of our low weight newborns.

Riga Fede Disease: Fibrous Hyperplasia Associated with Natal Teeth in an Infant – A Case Report and Clinical Update

Jingarwar MM., Bajwa NK., Pathak A.

Early diagnosis is the key to successful management of this neonatal condition. One of the modern guiding principles of dentistry is to provide early and comprehensive infant care during the first year of life. Untoward complications can be avoided by simply diagnosing the lesion at an early stage and treating them by eliminating the cause of trauma. The present case report describes early diagnosis and successful management of Riga Fede disease in a 17 days old infant by using conservative approach.

Sonographic Detection of Portal Venous Gas in Necrotising Enterocolitis in Newborn

NISHANT S BANAIT, PRADEEP B SURYAWANSHI

Preterm baby 28 week gestation and birth weight of 900 gm. Baby was initially treated for respiratory distress syndrome with surfactant and subsequently CPAP. Baby was on full feeds enterally with expressed breast milk and fortified with human milk fortifier. On day 18, baby became unwell and had abdominal distension. Abdominal x ray revealed pneumatosisintestinalis and portal venous gas [Table/Fig-1,2]. Ultrasound abdomen done at the same time classically revealed portal venous gas. Demonstration of portal venous gas on X-ray is pathognomic of Necrotising enterocolitis. But it is not always very easy to be sure of portal venous gas on X-ray. Ultrasound is very helpful in demonstrating portal venous gas, and is advocated when x ray is not reassuring.