Admission Cardiotocography as a Predictor of Low Apgar Score: An Observational, Cross-Sectional Study.

Background and objective Cardiotocography (CTG) has been used more frequently in recent decades to reduce intrapartum fetal mortality rates. The purpose of this study was to determine whether pathological or non-reactive CTG could predict a low Apgar (Appearance, Pulse, Grimace, Activity, and Respiration) score. An abnormal trace would indicate a distressed fetus, whereas a normal trace would indicate a well-oxygenated fetus. Methods This study included a total of 470 women with a gestational period of more than 37 weeks. Based on the results of their CTGs, they were divided into three groups. An emergency cesarean section (CS) was performed if there was any sign of fetal distress on CTG. The Apgar scoring for newborns was recorded in the proforma following delivery. Results The study was carried out at two major tertiary-care hospitals in Pakistan. A reactive CTG was found in more than one-third (39.36%) of the 470 patients. An Apgar score above 8 was obtained by 34.26% of the newborns, while an Apgar score below 8 was obtained by more than half (63.40%). Only 2.34% of newborns had an Apgar score below 6. A third (30.64%) of the patients had grade-1 meconium-stained liquor (MSL), 24.89% had grade-2 MSL, 19.79% had grade-3 MSL, and 24.68% had no MSL. One-third (32.34%) of the neonates were admitted to the neonatal intensive care unit (NICU) shortly after birth. When CTG was pathological or non-reactive, the odds of securing a higher Apgar score decreased by 70.45% (OR: 0.30; 95% CI: 0.20-0.44; p<0.001). Conclusion The main conclusion drawn from this study's findings is that a pathological CTG is an indicator of a low Apgar score.

Transgenerational effects of historic radiation dose in pale grass blue butterflies around Fukushima following the Fukushima Dai-ichi Nuclear Power Plant meltdown accident.

Low dose radiation effects have been investigated in Chernobyl for many years but there is uncertainty about initial doses received by many animal species. However, the Fukushima Dai-ichi Nuclear Power Plant accident opens an opportunity to study the effects of the initial low historic dose on directly exposed species and their progeny during a time where the contaminating radionuclides are decaying. In this paper, it is proposed that historic acute exposure and its resulting non-targeted effects (NTEs) may be partially involved in the high mortality/abnormality rates seen across generations of pale grass blue butterflies (Zizeeria maha) around Fukushima. Data from Hiyama et al. (2012) on the morphological abnormality frequencies in Z. maha collected around Fukushima and their progeny were used in this paper. Two dose reconstruction methods based on the Gaussian plume model were used to determine the external absorbed dose to the first exposed generation from both ground shine and plume shine. One method involved the use of the dose rate recorded at the time of collection and only took Cs-137 into account. The other involved using release rates and atmospheric conditions to determine the doses and considered Cs-137 and Cs-134. The reconstructed doses were plotted against the mortality rates and abnormality frequencies across generations. The mortality rates of the progeny from irradiated progenitors increased linearly with the increasing historic radiation doses reconstructed using both Cs-137 and Cs-134 sources. Additionally, a higher level of morphological abnormalities was observed in progeny than in the progenitors. The mean abnormality frequencies also increased throughout generations. As these results are a sign of NTEs being involved, it can be suggested that increasing mutation levels across generations may result, in part, from NTEs induced by the initial low dose received by the first exposed generation. However, continual accumulation of mutations over generations in their natural contaminated habitats remains a likely contributor into the observed outcome.

Long-term effects of ionizing radiation after the Chernobyl accident: Possible contribution of historic dose.

The impact of the Chernobyl NPP accident on the environment is documented to be greater than expected, with higher mutation rates than expected at the current, chronic low dose rate. In this paper we suggest that the historic acute exposure and resulting non-targeted effects (NTE) such as delayed mutations and genomic instability could account at least in part for currently measured mutation rates and provide an initial test of this concept. Data from Møller and Mousseau on the phenotypic mutation rates of Chernobyl birds 9-11 generations post the Chernobyl accident were used and the reconstructed dose response for mutations was compared with delayed reproductive death dose responses (as a measure of genomic instability) in cell cultures exposed to a similar range of doses. The dose to birds present during the Chernobyl NPP accident was reconstructed through the external pathway due to Cs-137 with an estimate of the uncertainty associated with such reconstruction. The percentage of Chernobyl birds several generations after the accident without mutations followed the general shape of the clonogenic survival percentage of the progeny of irradiated cells, and it plateaued at low doses. This is the expected result if NTE of radiation are involved. We suggest therefore, that NTE induced by the historic dose may play a role in generating mutations in progeny many generations following the initial disaster.