Keywords : neonates


Types ,Frequency,Clinical Presentation of Congenital Central Nervous System Anomalies in Al- Kadmayhia Teaching Hospital

Lamyaa Abdul Kareem Hamoodi

Iraqi Postgraduate Medical Journal, 2014, Volume 13, Issue 4, Pages 524-531

ABSTRACT:
BACKGROUND:
The central nervous system (CNS)anomalies are the most severe, difficult to detect its etiology, and predict its clinical presentation and course.
OBJECTIVE:
To find out the common types of congenital malformations in central nervous system.,determine the frequency and the clinical features of these malformations.
And to study the risk factors associated with congenital central nervous system malformations.
PATIENTS AND METHODS:
This cross-sectional study was performed at Al-Kadhimiyia Teaching Hospital (Neonatal care unit) from the 1st of January to the 1st of July, 2011.
One hundred newborn infants were proved to have congenital abnormalities by physical examination alone. Fifty five neonates were diagnosed as having CNS congenital anomalies.
neonatal evaluation include: gestational age, sex, body weight, type of CNS congenital anomaly.
Maternal age, parity, antenatal care, any history of abortion, previous baby with CNS congenital abnormality, still births, or drug intake during pregnancy.
the residency of the family and consanguinity .
RESULTS:
The number of neonates delivered alive was 2700 neonates, one hundred of them (3.7% of total deliveries) were delivered with congenital anomalies, and 55 cases from those (2% from total deliveries / 55% from congenitally abnormal deliveries) have had CNS congenital anomalies,the most frequent anomalies aremeningocele 25( 45.5%),the second and third in frequency were hydrocephaly 12 (21.8%), and myelomeningocele 10 (18.2%) respectively.
There were 34(61.8%) male and 21 (38.2%) female. There were 30(54.5%) full term and 25(45.5%) preterm.
Thirty cases out of the total 55 cases (54.5%) with body weight 3-3.5 kg.
Most of the affected neonates to mothers with an age range of 20-40 years where 34 mothers (61.8%) aged between 20-30 years .
Most of the mothers were multipara (45 cases / 81.8%) .The majority of the neonates were the product of a consanguineous marriage 39 (70.9%).
Maternal peri-conceptional folic acid supplementation was not taken in the vast majority of cases (43 cases / 78.2%).
Positive family history of CNS congenital anomalies was reported in 4 cases only (7.3%) .
Familial residence was documented as urban in 30 cases (54.5%), and rural in 25 cases (45.5%).
CONCLUSION:
The most common type of CNS anomalies is meningocele with relatively higher male to female ratio.These anomalies occur in full term multipara mothers. Occur more frequent in infants with larger body weight and to younger multipara mothers. Consanguinity is a major risk. There was a low utilization of maternal peri-conceptional folic acid supplementation

Neonatal Polycythemia: Risk Factors, Clinical Manifestation and Treatment Applied

Sawsan Sati Abbas; Hamed Fakhri Fayadh

Iraqi Postgraduate Medical Journal, 2013, Volume 12, Issue 3, Pages 390-395

BACKGROUND:
Polycythemia is defined as a venous hematocrit above 65%.Polycythemia is sometimes associated
with hyper viscosity of blood .The etiology of polycythemia is related either to intra-uterine hypoxia
or secondary to fetal transfusion. Increased viscosity of blood is associated with symptoms of hypoperfusion.
Clinical
features
related
to
hyper
viscosity
may
affect
all
organ
systems.


OBJECTIVE:
To evaluate the prevalence of polycythemia among neonates who were admitted to the nursery care
unit, to evaluate the difference between peripheral and central hematocrit (PCV) and to have an idea
about the main presentation and modes of treatment of polycythemia.
PATIENTS AND METHODS:
A case – control study was done in the nursery care unit of AL - Kadhyimia Teaching Hospital , one
hundred neonates (50 polycythemic and 50 control healthy neonates ) were taken , for each neonates ,
information regarding (name ,age , sex , gestational age , mode of delivery , body weight ,length, head
circumference , clinical presentation and risk factors ) were taken, investigations including
hematocrite (PCV) , random blood sugar and total serum bilirubin were done for all neonates.
RESULTS:
The prevalence of neonatal polycythemia was (2.2%) , male was affected more than female with male
: female ratio equal to ( 1.5:1) . The difference between peripheral and central PCV was (4 - 15%)
with a mean and standard deviation of
( 7 ± 0.33%). The main signs & symptoms were jaundice (58%), lethargy (30%) , respiratory distress
(26%) and hypoglycemia (26%) . Risk factors were preterm (36%) , neonates of diabetic mother
(20%) , small for gestational age (18%) , twin pregnancy (12%) and down's syndrome (10%) . Partial
exchange transfusion was done to 28 cases (56%).
CONCLUSION:
Males were affected more than females. Jaundice was the main presentation followed by lethargy,
respiratory distress and hypoglycemia .Higher risk in twin pregnancy ,neonates of diabetic mother ,
small for gestational age , preterm and down's syndrome while delivery by caesarian section reduce
the risk of polycythemi