Indian Journal of Maternal-Fetal & Neonatal Medicine

Introduction:Encephalocele is one of the commonest neural tube defects, with the frequency of approximately 1–4 : 1000 births. We conducted a study of epidemiology of encephalocele, at our institution in rural set-up , to know the role of antenatal checkups (folic acid supplementation and prenatal sonography) of mother, in decreasing the incidence of encephalocele in rural and tribal population. Aims & Objectives:To study the role of antenatal checkups of mother, on the incidence of encephalocele in rural and tribal population. Materials & Methods:The study has been conducted at A.C.P.M Medical College, Dhule for a period of five years from 1998 to 2003.The study consists of twenty three patients of encephalocele. Age of presentation was observed. All the patients underwent routine investigations and sonography. They all were surgically managed. Progress of the patients was followed up. All the data was collected, tabulated and analysed. Result:None of the patients’ mother has received preconceptional counselling and antenatal care. Therefore none of them received folic acid supplementation, during pregnancy or prior to it. Consequently, sonographic detection of encephalocele was missed.Hence, we would like to postulate, that lack of antenatal checkups, has resulted in increased incidence of encephalocele in tribal population. Conclusion:Improvement in antenatal checkups (folic acid supplementation and prenatalsonography) of mother has resulted in decreasing incidence of enceohalocele in rural and tribal population. 

Keywords:Encephalocele; Antenatal;Folic acid supplementation;Prenatal sonography.

Childhood coughing is a common problem that can cause anxiety in parents. Chronic cough in children is generally defined as a cough lasting longer than eight weeks. Cough is a nonspecific reaction to irritation anywhere from the pharynx to the lungs. Common causes are hyperactive airway disease (Asthma), allergic rhinosinusitis , infections (TB, pertussis, Chlamydia), environmental irritants and psycogenic habit cough. A detailed history with relevant clinical examination will solve the majority of the problem. A very few may need targeted investigations. Management is addressed to specific causes. Symptomatic therapy e.g honey or demulcents ( after counseling care givers) may reduce nonspecific cough to a great extent.

Keywords: Chronic cough; Cough syrups; Airway disease.

Birth asphyxia is an important cause of acute neurologic injury, occurring in 2 to 3 cases per 1000 term live births in developed countries, with a higher incidence in less developed countries. Birth asphyxia related neonatal mortality and morbidity including long-term neuro-developmental sequele was seen in 25%-60% of survivors. It is estimated that around 23% perinatal deaths are due to birth asphyxia, with a large proportion of stillbirths. Asphyxia should not be confused with hypoxic ischemic encephalopathy (HIE) or cerebral palsy (CP) since not all asphyxiated neonates develop HIE or CP and there are other causes for the same. In this article there is description of definitions, aetiologies, pathophysiology, clinical features, basic and recent investigations, older and newer treatment of birth asphyxia. Although there is no specific treatment for birth asphyxia only supportive treatment (fluid and electrolytes balance, oxygenation and ventilation etc.) to prevent the complications and primary preventive measures (electronic fetal heart monitoring, training to birth attendants, home based newborn care) are helpful. In the developed world, for the HIE, hypothermia has been the only treatment that has worked somewhat (8 -18%). The preferred cooling is whole body with a heart-lung bypass or ECMO; since that is rarely available, external whole body or external head cooling is the next best option. Prevention of reperfusion injury by early (within 6 hours) antioxidant therapy seems to hold the promise for future and should be studied. 

Key words:Birth Asphyxia; HIE; Hypoxic- Ischemic Encephalopathy; Neonatal Encephalopathy; Neonatal Depression. 

The goal of this article is to pay tribute to the Fetus who develops maternal bonding in intrauterine life. This bonding is healthier, secure and strengthened if preconception care is rendered to mother. Medical ethics demand that fetus is a patient, fetus has rights. Several of the medical conditions , personal behaviors, psychosocial risks and environmental exposures associated with negative outcomes can be identified and modified before conception through clinical interventions. For certain conditions , opportunities for preventive interventions occur only before conception. Preconceptional Care for chronic medical conditions is discussed. 

Keywords: Preconceptional care; Fetus medical conditions; Interventions.

Neonatal infections represent an important cause of morbidity and mortality in neonatal period. NICU patients are at increased risk of neonatal infections because of poor intra-partum and postnatal infectioncontrol practices and also having poor immune defence mechanism. Sepsis is characterized by lethargy, poor feeding, fever or hypothermia and various nonspecific features. Sepsis screen is useful for diagnosis. Blood culture is gold standard. Simple hand washing is a good effective measure to reduce sepsis. 

Keywords: Neonatal infection; Hand washing; Sepsis screen.

Eclampsia is the prominent cause of maternal and perinatal mortality and morbidity. Prevalence of Hypertensive disorders is more in developing countries in contrast to developed countries. Eclampsia, clinical manifestation of severe preeclampsia is discussed with symptomatology. Differential diagnosis of convulsions in pregnancy is reviewed. MgSO4 & Labetalol these two drugs are the backbone in the treatment of eclampsia and ramin boon in desguise. Various protocols for management of Eclampsia are evaluated.

Keywords: Maternal mortality; Eclampsia; Convulsions; MGSO4; Edema.

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