Impact of antenatal corticosteroids on frequency and mortality due to respiratory distress syndrome in preterm neonates.

BACKGROUND: Prematurity is still a major problem for health care services throughout the world. Before the late 1980s, respiratory distress syndrome (RDS) was the primary cause of morbidity and mortality in preterm new-borns. Frequency of RDS and ensuing mortality in infants treated with antenatal steroid is less than those delivered without this therapy. Many pregnant females deliver before term or 37 weeks, hence may be advised this prophylactic therapy without creating significant maternal or foetal side effects. METHODS: It was a descriptive case-series conducted in the department of obstetrics and gynaecology, unit II of Jinnah Hospital Lahore for a period of 6 months. RESULTS: The study sample of 230 was divided into two groups on the basis of exposure to dexamethasone. RDS was reported 76 (33.0%) cases (preterm neonates) in the study, out of these 26 (22.4%) cases belonged to exposed group and 50 (43.9%) cases belonged to non-exposed group. Mortality due to RDS among all preterm neonates with RDS occurred in total 29 (12.6%) preterm neonates in the study, out of these 5 (4.3%) cases belonged to exposed group and 24 (21.1%) belonged to non-exposed group. CONCLUSIONS: Frequency of RDS and mortality due to this disease in group of infants treated with antenatal steroid is far less than the group of preterm new-borns delivered without this therapy.

Pregnancy in a Treated Case of Ectopia Vesicae.

The patient was born with bladder exstrophy and underwent multiple surgeries for its correction. Finally, she had ureterosigmoidostomy at the age of 9 years, which ultimately led her to live till reproductive age. The children born with this defect are capable of surviving till adult life. She was received by us with preterm labour, referred from Hafizabad. She also had hyperchloremic metabolic acidosis and mild hydronephrosis. She was managed with multidisciplinary, modified care but the pregnancy ended up in an emergency cesarean section due to non-reactive cardiotocograph and persistently reduced fetal movements. She had fortunately successful pregnancy outcome. To the authors'knowledge, this is the first reported case of pregnancy in a treated case of ectopia vesicae in Pakistan.

Serum 25-Hydroxy Vitamin D Level in Preeclamptic and Normotensive Pregnancies.

OBJECTIVE: To compare serum 25-hydroxy vitamin D level between preeclamptic and normotensive pregnancies. STUDY DESIGN: Cross-sectional analytical study. PLACE AND DURATION OF STUDY: Department of Physiology, Federal Postgraduate Medical Institute, Shaikh Zayed Hospital, Lahore, in collaboration with Sir Ganga Ram Hospital and Lady Willingdon Hospital, Lahore, from March 2012 to April 2012. METHODOLOGY: Thirty registered preeclamptic patients with systolic and diastolic blood pressure > 140/90 mm Hg on more than two occasions, 6 hours apart, and proteinuria at least 300 mg in 24-hour urine collection; and 30 normotensive uncomplicated pregnant women matched for age, gestational age, parity and BMI were included by convenient sampling technique. Vitamin D levels of less than 50 n mol/l (< 20 ng/ml) was the cutoff point. Spearman's rank correlation of vitamin D with systolic blood pressure and arterial pressure in both preeclamptic and normotensive pregnant women was presented in a tabulated form. RESULTS: Vitamin D deficiency was found in 95% of preeclamptic and normotensive pregnant women. The difference of vitamin D level between the two groups was not found significant. Although there was an inverse correlation between serum vitamin D and systolic blood pressure and arterial pressure in preeclamptic group, but this was not statistically significant. CONCLUSION: Vitamin D deficiency does not seem to be affected by the state of preeclamptic and normotensive pregnancy. The correlation of systolic blood pressure and arterial pressure and vitamin D needs to be explored further by increasing the sample size.