European Journal of Cardiovascular Medicine

Introduction: Perinatal hypoxia is one of the leading causes of perinatal mortality in developing countries. Birth asphyxia is an important cause of static developmental and neurological handicap both in term and preterm infants (in 3 to 13% of infants with cerebral palsy (CP) have evidence of intrapartum asphyxia). Though there are more and more studies and understanding of the mechanisms leading to birth asphyxia, early determination of tissue damages due to birth asphyxia are still lacking. Methods: This is a Hospital based Case Control study carried out in -Neonatal ICU, DEPARTMENT OF PEDIATRICS, Surat Municipal Institute of Medical Education and Research, Surat City. Study was conducted for period of 12 months and data analysis was conducted over the period of 12 months. Sample size was 56 patients of birth asphyxia admitted in NICU and compared against 56  controls admitted in NICU for some other disease. Results: .In this study, Mean UA/Cr ratio among cases was 2.58±1.15  as compared to control group where the ratio was 0.71±0.21 . This difference was statistically significant. (p<0.00001). Conclusion: Mean UA/Cr ratio among asphyxiated newborns was high and statistically significant and hence the ratio can be used as early, cost effective, simple, quick and non-invasive parameter, a supportive tool to the diagnosis of birth asphyxia using Apgar score

Background: Early-onset neonatal sepsis (EONS) remains a significant cause of neonatal morbidity and mortality, particularly in resource-limited settings. EONS is defined as sepsis occurring within 72 hours of birth, often associated with maternal risk factors such as premature rupture of membranes and intrapartum infections. Identifying risk factors and improving early diagnosis are critical to reducing adverse outcomes in neonates. Objective: This study aimed to assess the incidence, microbial profile, cutaneous manifestations, risk factors, and diagnostic accuracy of early-onset neonatal sepsis (EONS) in a large urban hospital. Methods: A retrospective cohort study was conducted at the Neonatal Intensive Care Unit (NICU) of a large urban hospital in Khammam. The study included 100 neonates admitted within 72 hours of birth between January and December 2023. EONS was diagnosed based on clinical suspicion and confirmed by blood cultures and laboratory markers. Data collection included demographic, clinical, and maternal risk factors. Multivariable logistic regression identified significant risk factors for EONS, while receiver operating characteristic (ROC) curve analysis assessed diagnostic accuracy. Results: Eighteen neonates (18%) were diagnosed with EONS, with Escherichia coli being the most common pathogen (44%). Significant risk factors included premature rupture of membranes (OR = 4.3, p = 0.001), maternal intrapartum fever (OR = 2.8, p = 0.03), and low Apgar scores. The ROC curve for the diagnostic model showed strong accuracy (AUC = 0.85, 95% CI: 0.78-0.92). Conclusion: EONS remains a prevalent issue in urban NICUs, with identifiable risk factors and microbial profiles. Early identification through clinical and maternal markers can significantly improve outcomes.

Introduction: Hypertension is a significant health concern for pregnant women, potentially leading to adverse maternal and fetal outcomes. This study aims to investigate the maternal and fetal consequences in pregnancies complicated by preexisting hypertension. Objectives: To evaluate the maternal and fetal outcomes in pregnant women with preexisting hypertension. Methods: Study Design: Prospective cohort study. Setting: Two tertiary care hospitals. Participants: 200 pregnant women with a confirmed diagnosis of preexisting hypertension. Data Collection: Data were collected on maternal age, hypertension severity, medication use, prenatal care, and lifestyle factors. Fetal outcomes included gestational age at delivery, birth weight, and incidence of congenital anomalies or distress. Statistical Analysis: Descriptive statistics, chi-square tests for categorical variables, and t-tests or ANOVA for continuous variables. Results: The study found significant associations between the severity of hypertension and maternal complications such as preeclampsia, gestational diabetes, and preterm labor. There was a higher incidence of low birth weight, preterm birth, and neonatal intensive care unit (NICU) admissions in the hypertensive group compared to national averages. Results were statistically significant with p-values <0.05. Conclusions: Preexisting hypertension in pregnant women is strongly associated with adverse maternal and fetal outcomes. Early intervention and careful management of hypertension during pregnancy are crucial to improve health outcomes for both mother and child.

Background: Neonatal sepsis remains a leading cause of morbidity and mortality among newborns, requiring early diagnosis and appropriate antimicrobial therapy. This study aims to evaluate the bacteriological profile and antimicrobial sensitivity patterns of blood culture isolates in neonates with sepsis admitted to the Neonatal Intensive Care Unit (NICU) at GGH, Guntur. Methods :A prospective observational study was conducted on 150 neonates diagnosed with sepsis. Blood culture samples were analyzed to identify causative organisms and their antimicrobial susceptibility patterns. Clinical, maternal, and neonatal risk factors were documented. Statistical analysis was performed using SPSS v16, with significance set at p < 0.05. Results: Among the 150 neonates, late-onset sepsis (60%) was more common than early-onset sepsis (40%). Klebsiella (60.7%) was the predominant pathogen, followed by Staphylococcus aureus (22%), Pseudomonas (9.3%), and Acinetobacter (8%). Prematurity (44.6%) and perinatal asphyxia (36%) were significant neonatal risk factors. CRP positivity (89.3%) was observed in most cases. Antibiotic resistance was highest for ampicillin and cefotaxime, while piperacillin/tazobactam and meropenem were effective against Gram-negative isolates. Vancomycin remained effective against Staphylococcus aureus. Overall mortality was 21.3%, with Klebsiella infections associated with the highest fatality rate. Conclusion: Neonatal sepsis is primarily caused by Gram-negative bacteria, with Klebsiella and Staphylococcus aureus being the most common pathogens. The study highlights the increasing resistance to first-line antibiotics, emphasizing the need for regular antimicrobial surveillance and targeted therapy to improve neonatal outcomes

Background: Neonatal sepsis remains a major cause of morbidity and mortality, particularly in rural healthcare settings with limited diagnostic and therapeutic resources. Understanding the microbial profile and antibiotic resistance trends is essential for guiding empirical therapy and improving clinical outcomes. Materials and Methods: A retrospective study was conducted in the neonatal intensive care unit (NICU) of a rural tertiary hospital over a five-year period (January 2019 to December 2023). Blood culture reports from neonates with clinically suspected sepsis were reviewed. Positive cultures were analyzed to determine the prevalence of bacterial isolates and their antibiotic susceptibility patterns using the standard Kirby-Bauer disk diffusion method in accordance with CLSI guidelines. Results: Out of 1240 neonates evaluated for sepsis, 368 (29.7%) had culture-positive results. Gram-negative organisms constituted 62% of the isolates, with Klebsiella pneumoniae (27%), Escherichia coli (18%), and Pseudomonas aeruginosa (9%) being predominant. Among Gram-positive isolates, Staphylococcus aureus (15%) and Enterococcus spp. (6%) were most common. High resistance was observed against ampicillin (78%), cefotaxime (64%), and gentamicin (55%). Carbapenems retained the highest sensitivity among Gram-negative isolates, while vancomycin and linezolid showed effectiveness against Gram-positive organisms. A rising trend in multidrug-resistant organisms was noted over the study duration. Conclusion: The study highlights a high burden of Gram-negative infections and an alarming rate of antimicrobial resistance among neonatal sepsis cases in rural settings. Regular surveillance of bacterial profiles and antibiotic susceptibility is critical for formulating effective empirical treatment strategies and curbing resistance

Respiratory Distress Syndrome (RDS) is a common and significant cause of morbidity and mortality in preterm infants. Continuous Positive Airway Pressure (CPAP) is a vital non-invasive ventilatory support used in the management of RDS. This study aimed to evaluate the clinical profile and outcome of preterm babies with RDS who were treated with indigenously assembled CPAP (i-CPAP) in the Neonatal Intensive Care Unit (NICU) of a tertiary care hospital. The study population included preterm infants under 37 weeks of gestation admitted with RDS, as indicated by a Silverman Anderson score of ≥3 within 6 hours of birth and suggestive chest X-ray findings. The study prospectively collected data on gestational age, gender, mode of delivery, birth weight, Silverman Anderson score, duration of CPAP, complications, and outcomes. The findings revealed that i-CPAP was utilised for varying durations, with the majority of neonates requiring it for less than 7 days. The primary outcomes assessed included weaning to room air, need for further ventilation, and survival. The study provides insights into the effectiveness and safety of i-CPAP in a resource-limited setting.

Background: Pre-pregnancy body mass index (BMI) is a crucial determinant of maternal and neonatal health, significantly influencing the mode of delivery, maternal complications, and neonatal outcomes. With the increasing prevalence of maternal obesity and undernutrition, obstetricians face challenges in managing pregnancy-related risks. Obesity has been linked to gestational diabetes mellitus (GDM)1, hypertensive disorders, macrosomia, prolonged labor4, and an increased likelihood of cesarean delivery, while underweight mothers are more prone to intrauterine growth restriction (IUGR)6, low birth weight (LBW), and neonatal intensive care unit (NICU) admissions8. Understanding the relationship between BMI and delivery outcomes is essential for improving antenatal care, risk stratification, and maternal-fetal health management. Materials And Methods: This study was conducted as a prospective observational study at the Department of Obstetrics and Gynecology, Kempegowda Institute of Medical Sciences, Bangalore, from August 1, 2024, to October 31, 2024. A total of 40 term pregnant women were categorized into four BMI groups based on the WHO classification: underweight (<18.5 kg/m²), normal (18.5–24.9 kg/m²), overweight (25–29.9 kg/m²), and obese (≥30 kg/m²). Data collection included patient demographics, obstetric history, mode of delivery, maternal complications, and neonatal outcomes. Statistical analysis was performed using SPSS v23, with chi-square tests, logistic regression, and Pearson’s correlation coefficient applied to evaluate associations between BMI and pregnancy outcomes. A p-value <0.05 was considered statistically significant. Results: The results revealed that cesarean section rates increased with maternal BMI, with 100% of obese women undergoing cesarean delivery, compared to 62.5% in overweight women, 25% in normal BMI women, and 16.7% in underweight women. Vaginal delivery was most frequent in normal BMI (75%) and underweight (83.3%) women, whereas obese women had the highest incidence of labor complications, including prolonged labor (50%) and gestational diabetes (50%). Hypertensive disorders were significantly higher in overweight (37.5%) and obese (50%) women, indicating an increased risk of metabolic and vascular dysfunction in these groups. Neonatal outcomes were also significantly affected by maternal BMI. Low birth weight (50%) was most common in underweight mothers, suggesting nutritional insufficiency and placental insufficiency99. Conversely, macrosomia (25%) was prevalent in obese women, aligning with higher rates of gestational diabetes and excessive fetal growth1010. NICU admissions were highest in underweight (3.3%) and obese (50%) neonates, emphasizing the importance of BMI regulation before pregnancy to minimize neonatal morbidity. Statistical analysis confirmed that BMI was positively correlated with cesarean section rates (p < 0.001, OR = 4.2), while underweight mothers had a significantly higher risk of delivering low birth weight neonates (p < 0.001). Additionally, gestational diabetes was strongly associated with obesity (p < 0.001), reinforcing the need for early glucose screening in overweight pregnancies. Conclusion: In conclusion, this study demonstrates that both underweight and obese women face increased pregnancy-related risks, emphasizing the importance of achieving an optimal BMI before conception. Obese women are at a significantly higher risk of cesarean delivery, gestational diabetes, and hypertensive disorders, while underweight women are more likely to deliver low birth weight infants and experience increased NICU admissions. These findings highlight the need for preconception weight management programs, targeted antenatal monitoring, and early interventions for high-risk pregnancies. Future research should explore larger-scale studies to evaluate long-term neonatal outcomes and assess the effectiveness of maternal weight optimization programs in reducing pregnancy-related complications.