Refine your search
Collections
Journals
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z All
Patil, Suhas V.
- A Comparative Study of Renal Parameters and Serum Calcium Levels in Birth Asphyxiated Neonates and Normal Neonates
Abstract Views :358 |
PDF Views:103
Authors
Affiliations
1 Department of Pediatrics, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
2 Department of Pediatrics, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
1 Department of Pediatrics, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
2 Department of Pediatrics, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
Source
MVP Journal of Medical Sciences, Vol 4, No 2 (2017), Pagination: 97-101Abstract
Background and Objectives: Acute renal failure is a frequent clinical condition in neonatal intensive care units. The leading cause of neonatal acute renal failure is perinatal asphyxia. Early recognition of acute renal failure is particularly important in asphyxiated neonates, in whom a stable biochemical milieu is vital, because it facilitates the administration of appropriate fluid and electrolyte replacement. This study was done to determine the incidence of renal failure and its correlation with severity of asphyxia. Methods: 45 term neonates born with Apgar score of < 7 at 5 minutes after the birth are selected as cases and 45 term normal neonates as controls. All asphyxiated neonates (as per World Health Organization definition) with clinical features of Hypoxic ischemic encephalopathy are staged by Sarnat and Sarnat staging. The relevant blood and urine investigations done at 24, 48 and 72 hours of life and urine output was monitored. The babies were managed according to standard protocol. The renal indices were calculated after 48 and 72 hours. Results: The incidence of renal failure was significantly higher among cases (66.67%, 30 of 45 cases). All cases had non oliguric (100%) renal failure -11 (24.44%) cases had intrinsic renal failure. The renal parameters were higher among cases and correlated with the severity of asphyxia. Hyponatremia was seen in cases and its severity correlated with asphyxia severity. The serum calcium level was lower among cases and severity of hypocalcaemia correlated with severity of asphyxia. Fractional excretion of sodium (FeNa) was higher among cases and 11 cases had value more than 3. Renal failure Index was higher among cases and 12 cases had value more than 4. Interpretation and Conclusions: Perinatal asphyxia is an important cause of renal failure in the neonatal period. Acute renal failure in birth asphyxia is predominantly Pre renal failure and depends on the severity of asphyxia. Renal failure in birth asphyxia is predominantly non-oliguric, monitoring of urine output for renal failure alone does not help to identify renal failure. The renal parameters should be monitored and if possible the renal indices should be calculated to identify pre-renal and intrinsic renal failure.Keywords
Acute Renal Failure, Birth Asphyxia, Hypoxic Ischemic Encephalopathy, Neonate.References
- Hansen AR, Soul JS. Perinatal asphyxia and Hypoxic ischemic encephalopathy in Manual of neonatal care. 7th ed.India: Wolters Kluwer; 2011. p. 711-728; 350-376.
- Casey BM, McIntire DD, Leveno KJ. The continuing value of the Apgar score for the assessment of newborn infants. New Engl J Med. 2001; 344:467–71. https://doi.org/10.1056/ NEJM200102153440701 PMid:11172187
- Moster D, Lie RT, Irgens LM, Bjerkedal T, Markestad T. The association of Apgar score with subsequent death and cerebral palsy: A population based study in term infants. J Pediatr. 2001; 138:798–803. https://doi.org/10.1067/ mpd.2001.114694 PMid:11391319
- Gupta BD, Sharma P, Bagla J, Parakh M and Soni JP. Renal failure in asphyxiated neonates. Indian Pediatrics. 2005; 42:928–34. PMid:16208054
- Perlman JM, Tack ED, Martin T, Shackelford G, Amon E. Acute systemic organ injury in term infants after asphyxia. Am J Dis Child. 1989; 143:617–20. https://doi.org/10.1001/ archpedi.1989.02150170119037
- Singh M. Care of Newborn. 7th ed. Sagar Publications; 2010 p. 85–107. PMCid:PMC2873439
- Aggarwal A, Kumar P, Chowdhay G, Mazumdar S, Narang A. Evaluation of renal functions in asphyxiated newborns. J of Trop Pediatrics. 2005; 51(5):295–9. https://doi.org/10.1093/tropej/fmi017 PMid:16000344
- Jayashree G, Dutta AK, Sarna MS, Saili A. Acute renal failure in asphyxiated Newborns. Indian Pediatrics. 1991; 28:19–23. PMid:2055607
- Gupta BD, Sharma P, Bagla J, Parakh M, Soni JP. Renal failure in asphyxiated neonates. Indian Pediatrics. 2005; 42:928–34. PMid:16208054
- Misra PK, Kumar A, Natu SM, Kapoor RK, Srivatsava KL, Das K. Renal failure in symptomatic perinatal asphyxia. Indian Pediatrics. 1991; 28:1147–51. PMid:1797666
- Basu P, Som S, Das H, Chaudhuri N. Electrolyte status in birth asphyxia. Indian Journal of Pediatrics. 2010; 77:259–62. https://doi.org/10.1007/s12098-010-0034-0 PMid:20177828
- Asphyxia relation between hypoxic ischemic encephalopathy grading and development of acute renal failure in indoor term neonates at Chandka Medical College children hospital Larkhana. Medical Channel. 2009 Oct-Dec; 148–52.
- Rai S, Bhatiyani KK, Kaur S. Effect of birth asphyxia on serum calcium and glucose level: A prospective study. Int J Sci Stud. 2015; 3(7):3–6.
- Clinical Study on Etiology, Onset and Clinical Manifestations of Neonatal Seizures
Abstract Views :214 |
PDF Views:83
Authors
Affiliations
1 Department of Paediatrics, Dr. Vasantrao Pawar Medical College Hospital & RC, Nashik - 422003, IN
2 Department of Paediatrics, Dr. Vasantrao Pawar Medical College Hospital & RC, Nashik - 422003, IN
1 Department of Paediatrics, Dr. Vasantrao Pawar Medical College Hospital & RC, Nashik - 422003, IN
2 Department of Paediatrics, Dr. Vasantrao Pawar Medical College Hospital & RC, Nashik - 422003, IN
Source
MVP Journal of Medical Sciences, Vol 5, No 1 (2018), Pagination: 64-68Abstract
Background: Neonatal seizures are clinically significant because very few are idiopathic. Further investigation leading to prompt diagnosis of the underlying condition is important because many of the etiologies have specific treatment. Time of onset of seizures has correlation with etiology. Objectives: The objective of the present study is to know the etiology of neonatal seizures, to know the time of onset of neonatal seizures and its relation to etiology and to know the various types of seizures in neonates. Methodology: The present study included 127 neonates presenting with Neonatal seizures admitted to NICU (Neonatal Intensive care Unit) of tertiary care hospital from August 2014 to December 2016. Detailed antenatal, natal and post natal history were taken and examination of baby done and HIE staged according to Modified Sarnat’s staging. Then relevant investigations were done and etiology of neonatal seizures was diagnosed. Results: In the present prospective study, out of 127 neonates studied, 118 were full-term, among these 88 (69.3%) were AGA (Average for gestational age) and 30 (23.6%) were SGA (Small for gestational age). 7 babies (5.5%) were preterm. Male: Female ratio in our study was 1.6:1. In our study onset of seizures within first 3 days of life was seen in 101 neonates (79.5%). After 3 days of life, 26 neonates developed seizures (20.5%). Onset of seizures within first 3 days of life of had statistically significant correlation with birth asphyxia as the etiology with p<0.001. Subtle seizures were the commonest type of seizures in our study (49 cases – 38.6%), followed by GTS (Generalized tonic seizures - 42 cases – 33.1%), multifocal clonic (19 cases – 15%) and focal clonic seizures (8 cases - 6.3%). Birth asphyxia was the commonest cause of neonatal seizures in our study (84 cases – 66.1%) followed by hypoglycemia (22 cases – 17.3%) and meningitis (11 cases 8.7%). Out of 84 cases of birth asphyxia 66 (78.6%) mothers had prolonged second stage of labour and 28 (33.3%) had MSAF (Meconium Stained Amniotic Fluid). Hypoglycemic seizures were more common in LBW (Low Birth Weight) babies with statistically significant p<0.001. Conclusion: The recognition of etiology of neonatal seizures is often helpful with respect to prognosis and treatment. The most common etiology for neonatal seizure is HIE (Hypoxic ischemic encephalopathy) and is frequently associated with perinatal risk factors. Onset of seizures during first 3 days of life has significant correlation with HIE as etiology. Hypoglycemic seizures are more common in LBW babies. Subtle seizures are commonest type of clinical seizures, which is difficult to identify, therefore careful observation of at risk newborns is necessary.Keywords
Birth Asphyxia, Hypoxic Ischaemic Encephalopathy, Neonatal Convulsions, Neonatal Seizures.References
- Ronen GM, Penney S, Andrew S. The epidemiology of clinical neonatal seizures in Newfoundland: A populationbased study, J Pediatr. 1999 Jan; 134(1):71–5. https:// doi.org/10.1016/S0022-3476%2899%2970374-4
- Maurice V, Ropper AH. Epilepsy and other seizure disorders. Adam and Victors’ Principles of Neurology, 7th edition. USA, New York: McGraw Hill; 2001. p. 331–2.
- David E, Malcom L. Neonatal seizures. Archives of Diseases in Childhood. 1998 Jan; 78(1):70F–5F. https://doi.org/10.1136/fn.78.1.F70
- Ravneet S, et al. A clinical study of seizures in neonates. Shah NK, Agrawal R, Yewale V, editors. Abstracts XXXX National Conference of the Indian Academy of Pediatrics; Mumbai. 2003 Jan 2-5. p. 209–10.
- Rima MS, et al. Risk factors for neonatal seizures- A population based study, Harris County, Texas, 1992-1994. American Journal of epidemiology. 2001 Jul; 154(1):14–20. https://doi.org/10.1093/aje/154.1.14
- Mahaveer L, et al. Profile of neonatal seizures in a rural medical college. Shah NK, Agrawal R, Yewale V, editors. Abstracts XXXX National Conference of the Indian Academy of Pediatrics; Mumbai. 2003 Jan 2-5 p. 209–10.
- Arun S, et al. Clinical profile of seizures in neonatal intensive care unit. Fernandez A, Dadhich JP, Saluja S, editors, Abstracts, XXIII Annual Convention of National Neonatology Forum; Hyderabad. 2003 Dec 18-21. 2003 p. 109–11.
- Cloherty JP, Eichenwald EC, Hansen AR, Stark AR. Neonatal seizures. Manual of Neonatal Care. 7th ed. 2016. p. 732.
- Tushar BP, Rekha HU, Ruchi NN. C-reactive protein and diagnosis of neonatal meningitis. Fernandez A, Dadhich JP, Saluja S, editors, Abstracts, XXIII Annual Convention of National Neonatology Forum; Hyderabad. 2003 Dec 18-21. p. 157–8.
- Ronen GM, et al. Seizures characteristics in chromosome 20 benign familial neonatal convulsions. Pediatrics. 1990; 116:78–83.
- Andersen ML, et al. Familial neonatal convulsions linked to genetic mutations of Chromosome 20. Nature. 1989; 337:647– 8. https://doi.org/10.1038/337647a0%20 PMid:2918897
- Ross EP, Gerald MF. Benign familial neonatal seizures. Arch Neurol. 1980 Jan; 37:47–8. https://doi.org/10.1001/archneur.1980.00500500077012
- Goldberg HJ, et al. Fifth day fits- An acute zinc deficiency syndrome? -Archives of Disease in Childhood. 1982; 57:633–5. https://doi.org/10.1136/adc.57.8.633%20 PMid:7114883 PMCid:PMC1627716
- Volpe JJ. Neonatal seizures. Textbook of Neurology of Newborn, 3rd ed. Philadelphia: WB Saunders; 2002. p. 181–2. PMid:21782601
- Philip JB, et al. Prediction of outcome based on clinical seizures type in newborn infants. The Journal of Pediatrics. 2002 Jun; 140(6):707–12. https://doi.org/10.1067/mpd.2002.124773 PMid:12072874
- Mahaveer L, Vilhekar KY, Pushpa C. Clinico-biochemical profile of neonatal seizures in a rural medical college. Fernandez A, Dadhich JP, Saluja S, editors, Abstracts, XXIII Annual Convention of National Neonatology Forum; Hyderabad. 2003 Dec 18-21. p. 121–2.