Indian Journal of Maternal-Fetal & Neonatal Medicine

A trichobezoar is a rare condition characterized by ingestion and
accumulation of undigested hair inside the gastrointestinal tract.
Three and half year old male child presented with complaints of
chronic abdominal pain, decreased appetite since two months. Patient
also had persistent vomiting and not passed stool since 3 days. Patient
posted for exploratory laparotomy with enterotomy and mass of
trichobezoar was delivered. Thus, It is an important differential
diagnosis to be remembered in cases of chronic abdominal pain and
epigastric mass.
Keywords: Trichobezoar; Pica; Plain abdominal radiograph;
Exploratory laparotomy; Enterotomy

Three year old girl child born out of non consanguious marriage,
4th by birth order presented with sever respiratory distress and was
unable to walk since the age of 1.5 years due to multiple recurrent
fractures following minor trauma. Her 3 siblings died due to similar
complaint. On examination she was malnourished, frontal bossing
was present, oral examination dentition normal, sever respiratory
distress with b/l crepitations and gallop rhythm heard. X-ray long
bones showed multiple fractures with osteopenia. 2d echo-suggestive
of dilated cardiomyopathy with cardiac failure. Results: Based on
clinical examination and radiological features, and on ruling out other
differentials: metabolic bone disease,fanconi syndrome,child abuse
diagnosis is osteogenesis imperfecta.
Keywords: Osteogenesis imperfect; Recurrent fractures; Dilated
cardiomyopathy.

Sideroblastic anemia comprise a heterogeneous group of disorders
characterized by ‘Ringed sideroblast‘ in nucleated erythroid precursors
of bone marrow. Lead based paint eating in children is more commonly
associated with secondary acquired sideroblastic anemia. A 6 year
old male child presented with complaints of feeling of weakness,
decreased appetite and short stature. History of pica was present.
Examination reveals marked pallor with no hepatosplenomegaly.
While approaching a child with short stature, detailed investigations
should be done and non endocrine causes should also be considered
at the back of our mind.
Keywords: Sideroblastic Anemia; Erythroid precursors;
Hepatosplenomegaly.
 

It is the goal of every obstetrician to ensure that mother and fetus
tolerate labor well. Assessing the fetal response to labor is challenge.
Fetal surveillance during labor helps in recognizing the fetus that
is not tolerating labor well and is hypoxic. Recognition of fetal
compromise guides decision about appropriate intervention so that
short and long-term neurological damage may be avoided. Fetal
scalp blood sampling carried out if there is an abnormality in FHR.
It is done to confirm the presence of fetal hypoxia and or acidemia.
Two constituents that are commonly tested by this method are pH and
lactate. Low pH indicates acidosis. Increased lactate is associated with
hypoxia. EFM is associated with increased intervention rates which
can be reduced with FBS.
Keywords: Fetus, Scalp Blood pH; Scalp Blood Lactate; Asphyxia;
Acidosis.

Context: Eclampsia is a serious complication of pregnancy that
not only affects maternal health but also influences the prospect of
neonatal outcomes. Aims: The study was carried out to identify
different types of adverse neonatal outcomes of eclamptic mothers and
to evaluate correlation of those outcomes and physical parameters of
neonates with maternal diastolic blood pressure (DBP) recorded at the
time of admission. Design and Setting: A prospective, cross-sectional,
observational, epidemiological study was conducted from April,
2012 to March, 2013 at a tertiary-care Government teaching hospital
catering rural population of Eastern India. Materials and Methods:
The participants comprised of 100 consecutive admitted eclamptic
mothers and neonates born to them. Correlation between maternal
DBP with each adverse neonatal outcome was studied and analysed in
SPSS software (version 25). Results: Neonatal outcomes were observed
as preterm (40%), low birth weight (LBW) (60%), intra-uterine growth
retardation (IUGR) (12%), birth asphyxia (33%), hypoxemic ischemic
encephalopathy (HIE) (8.8%), early onset sepsis(EOS) (9.9%), still
birth (SB) (9%), early neonatal death(END) (5.5%). Significant inverse
correlation was observed between the neonatal physical parameters
like body weight, gestational age, Apgar scores (1 min and 5 minutes)
and DBP of eclamptic mothers on admission. Maternal DBP ≥ 100
mmHg on antenatally to keep DBP to less than 100 mmHg have a
favourable prospect on neonatal outcomes of eclampsia in rural areas.
Keywords: Eclampsia; Neonatal outcomes; Diastolic Blood
Pressure (DBP).

Objective: To determine the adequacy of fluids provided to sick
appropriate and small for gestational age preterm neonates and
compliance with prescribed fluids. Design: Prospective exploratory
study. Setting: Level III neonatal intensive care unit, KBNIMS,
Kalaburagi. Participants: Neonates between 28 to 34 weeks of gestation, on exclusive intravenous fluids at 12 hours of life were enrolled and followed up till day 7 of life. Intervention: Sick neonates 28–34 wks gestations were started on exclusive intravenous fluids. Babies < 1500 greceived fluids at 80 ml/kg/day and ≥1500 g at 60 ml/kg/day on day 1. Fluids were then increased by 20 ml/kg/d till day 5 upto a maximum of 160 ml/kg/d by day 7, provided acceptable levels of weight loss, serum sodium, urine output and urine specific gravity were achieved. Feeds were introduced when baby was hemodynamically stable. Outcome measures: Total fluids prescribed and received, weight ,serum sodium, any discrepancy in prescribed and received fluids, the frequency of PDA, NEC, IVH, jaundice and polycythemia, were assessed. Results: 100 consecutive neonates with mean birth weight of 1302 g and gestational age of 31.4 wks were studied. Thirty neonates were small for gestational age (SGA). The cumulative median weight loss was 8.6% and AGA neonates lost more weight than SGA (9.3% vs 4%, p = 0.006). There was no significant difference between the fluids prescribed and received and serum sodium levels. SGA neonates received more fluids than AGA neonates. On 85 occasions out of 609 times there was discrepancy in the fluids prescribed and received. All morbidities were similar in AGA and SGA neonates. Conclusions: Our current fluid policy resulted in appropriate fluid and electrolyte balance with no significant increase in morbidities of sick preterm neonates.
Keywords: SGA: small for gestational age; LGA: Large for
gestational age; PDA: Patent Ductus Arteriosus; NEC: Necrotising
Enterocolitis; IVH: Intra Ventricular Haemorrhage

Background: Proper breast feeding practices are very effective
in reducing childhood morbidity and mortality. Breast feeding is
beneficial to both the infants and mothers. However, despite of its
knowledge and awareness, its implementation is affected by various
faiths, especially in the Indian society. The aim of this study is to
assess the knowledge and attitude towards breast feeding practices
among Indian postnatal mothers. Methodology: For this study, we
conducted a cross-sectional descriptive study. We randomly selected
500 postnatal mothers from outpatient department at our hospital.
Data was collected through face-to-face interview using a structured
questionnaire. Results: Our findings revealed that a majority (88.5%)
of the mothers were breast feeders. However, out of this majority
only 27% of the mothers were exclusive breast feeders and only
36.9% initiated breast feeding within the first hour of birth, amongst
various other results. Conclusion: This study emphasizes the need for
breastfeeding intervention programs which must include advantages,
frequency, technique, duration of breastfeeding. These programs
should not only be for mothers but should also be provided for the
community as a whole. It is important to provide prenatal education on
exclusive breastfeeding. Group talks should be encouraged for better
implementation provided the person who is conducting it has correct
knowledge on breastfeeding. Prelacteal feeds, self assumptions of lack
of breast milk, discarding colostrum, etc. are still practiced widely.
These undesirable practices must be discouraged. We recommend
strengthening of public health education through various campaigns
and programs to promote and implement breast feeding.
Keywords: Breastfeeding; Knowledge; Education