Cyclopic malformation in infants of diabetic mothers.

Two cases of cyclopic malformations are described among 450 infants of diabetic mothers during a period of four years. Both died within 30 min. of birth. Both belonged to unrelated Libyan families with absent consanguinity and family history. No chromosomal defect was found in either. A possible etiological association with uncontrolled maternal diabetes is discussed.

Perinatal outcome at Benghazi and implications for perinatal care in developing countries.

PIP: Using 1984 perinatal mortality rates as indicators of the level of maternal and newborn health care service quality and efficiency, Libya's high perinatal loss is compared to perinatal losses of 9 other developing countries. Timely antenatal care is identified as the essential component needed to reduce perinatal loss. Libyan perinatal, still birth, and early neonatal death rates were 26.3, 11.4, and 14.9/100, respectively. Perinatal death rates of other countries in the study ranged from 18.8 to 100/thousand. The major causes of still births in Libya included antepartum hemorrhage, cord accidents, maternal diabetes mellitus, and fetal malformations. The effect of timely obstetric care in reducing still birth rates (SBR) is evidenced by comparing SBRs of 16.8 to 63.8 in pregnant women receiving or not receiving minimal antenatal care at a peripheral health center, respectively. The clinical causes of early neonatal death were major congenital malformation (24.9%), hyaline membrane disease and aspiration syndrome (26.1%), birth asphyxia and injury (17.9%), very low birth weight (17.2%), and sepsis/meningitis (13.1%). High general fertility rates of developing countries leads to increased proportions of women under 20 and over 35 years of age bearing children. These women are prone to bearing offspring comparatively more vulnerable to early neonatal death. Consanguineous marriages leading to congenital malformation, and lack of maternal immunization with tetanus toxoid are also cited as factors contributing to high perinatal mortality. In closing, the authors call for future community-based studies, and recognize socioeconomic level as a main determinant in obtaining obstetric care.^ieng

Brachial plexus injuries in babies born in hospital: an appraisal of risk factors in a developing country.

The present study was undertaken to evaluate the magnitude of risk factors associated with brachial plexus in infants born in hospital in Benghazi. A total of 7829 babies were examined over a period of 6 months. Twenty-eight had brachial palsy, giving an incidence of 3.6 per 1000 livebirths. Significant (P less than 0.001) perinatal risk factors observed were maternal parity greater than or equal to 6, maternal diabetes, instrumental deliveries, shoulder dystocia and foetal macrosomia. Other risk factors observed included breech extraction, postmaturity and prematurity (P less than 0.02). Complete brachial plexus injury was seen in 12 cases and six infants had residual handicap on follow-up at 18-24 months.