Indian Journal of Maternal-Fetal & Neonatal Medicine

Vitamin K is an essential vitamin required for the activation of coagulation factors II, VII, IX, X, and proteins C and S. The deficiency of vitamin K leads to coagulopathy leading to the development of vitamin K deficiency bleeding (VKDB). We present a case of a 2-month-old male child who presented with tonic posturing of all 4 limbs. At birth, vitamin k was not administered. The neonatal period was uneventful, and the child was exclusively breastfed. On further evaluation, a subdural hematoma was detected. A diagnosis of late-onset vitamin k deficiency was suspected. Treatment with intravenous vitamin K was started with complete recovery. The diagnosis of late-onset VKDB should be suspected when an intracranial hemorrhage in a previously healthy newborn is found especially when there is no history of Vitamin K administration after birth

Objective: To compare the efficacy, need for mechanical ventilation within 72 hours of surfactant administration, and primary and secondary outcomes after LISA and INSURE methods. Methodology: A randomized control study was conducted at NICUs at Medical college, Vadodara, and GMERS, Gotri for a period of 8 months. A total of 40 preterm infants between 28 to 34 weeks of gestation with RDS who required surfactant administration were enrolled and randomized into two groups of 20 patients each. Surfactant was administered by LISA and INSURE method according to randomization. Results: There were 70% male infants in the LISA group, and 55% in INSURE group. Mean GA in the LISA group was 30.3±2.2 weeks, and 30.95±1.88 weeks in INSURE group, and mean birth weight was 1.24±0.3 kg in the LISA group and 1.25±0.3 kg in INSURE group. 40% of patients in LISA and 55% in INSURE group had not received antenatal steroids. Basic characteristics and maternal risk factors were comparable in both groups. Mechanical ventilation was required within 72 hours of surfactant administration in 6 patients (30%) in the LISA group and 14 patients (70%) in INSURE group (p-value = 0.0238). 8 patients (40%) from the LISA group and 16 patients (80%) from INSURE group required mechanical ventilation during their entire NICU stay (p=0.0268). Conclusion: The requirement of mechanical ventilation within 72 hours of surfactant administration as well as during the entire NICU stay was more in INSURE group than the LISA group with a statistically significant difference.

Management of lipomyelomeningocele is one of the most discussed and controversial topics in recent years. To date, there is no consensus on the most appropriate mode of management for lipomyelomeningocele, particularly in asymptomatic patients. It represents a complex disorder that may present with neurological deficit secondary to the inherent tethered cord. Here we present an antenatally diagnosed case of huge lumbosacral lipomeningomyelocele with a good post-natal outcome

ART methods are boon to infertile couples. Though ART methods are practiced widely in every country today. There is debate regarding their efficacy, cost-effectiveness, and risk factors. Women who conceive by ART have a high risk of maternal and perinatal complications such as ectopic pregnancy, pregnancy-induced hypertension, placenta previa, placental abruption, morbidly adherent placenta, preterm birth, and low birth weight. Gynecological complications associated with ART are OHHS, pelvic infection, and psychological and laboratory risks. Couples are encouraged to consider psychological counseling as an additional means of stress management. There is a higher incidence of multiple gestations in ART-associated pregnancies.
 

Goldenhar syndrome is an uncommon disorder characterized by a variety of defects including craniofacial tissues, vertebrae, and internal organs. It preferably affects one side of the body. The origin of this illness is unknown because it is genetically variable and can be caused by a variety of factors. We present a case with Goldenhar syndrome with microtia, as well as systemic involvement, that was evaluated clinically and radiographically. The patient had many common symptoms of the illness as well as a few unusual ones. The many elements of this rare disease have been examined, with a focus on early detection and a multidisciplinary management strategy.