The frequency of Down syndrome in Libya was 1 in 516 live births. The mean age of Down mother was 35.62 years. Eighty two percent of the Down mothers were over 30 years of age as compared to 36% of the control Libyan mothers. As there was a greater percentage of late conceptions, the maternal age appears to be influential in the birth of Down syndrome in Libya. Cytogenetically 96% of the cases were that of trisomy 21. There was one case each of mosaic and 21/21 translocation, and four cases of 14/21 translocation as evidenced by Giemsa banding. Twenty two percent of the cases of Down syndrome also had other associated congenital abnormalities. The unique features involved in genetic counselling in this population are discussed. This study reflects the enormous problem of Down syndrome in the Arab world.
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.
Over a period of one year, 16,365 consecutively live born neonates were prospectively studied for evidence of birth asphyxia using the requirement of greater than one minute of positive pressure ventilation for identifylng infants suffering from birth asphyxia. Asphyxia occurred in 2.8% of all neonates. Multivariate analysis of high risk factors associated with increased risk of asphyxia showed that low birth weight was the most significant predictor of asphyxia: asphyxia occurred in 68% of infants of <1,000 g birth weight and decreased to 1.2% in infants of 3-4 kg birth weight. Perinatal risk factors associated with a higher incidence of asphyxia include: postmaturity, birth weight (< 2.5 kg) and with the presence of maternal and/or obstetric complications,The impact of asphyxia on neonatal mortality was most pronounced in more mature infants and the mortality was increased 3 fold in infants of <34 week gestation and greater than 27 fold for infants >38 week gestation. OE the asphyxiated neonates, intrauterine growth retardation, fetal macrosomia, hypothermia, hyaline membrane disease, seizures, hypoglycemia and hyponatremia were significantly associated with an increased risk of death.
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