Background: The amniotic fluid is a cocoon of protection in fetal life. Amniotic fluid volume is an indicator of fetal wellbeing. Too little amniotic fluid is called oligohydramnios and is associated with increased incidence of congenital malformations and neonatal mortality. Aims & Objective: To estimate the incidence of congenital malformations and to study the perinatal outcome in oligohydramnios. Material and Methods: This prospective study was conducted in the Neonatal intensive care unit and the maternity wards of Father Muller Medical College Hospital, Mangalore. Ultrasound assessment of amniotic fluid index was recorded and cases of oligohydramnios detected were followed up. Congenital malformations were observed both by ante natal and post natal ultrasounds, other relevant investigations were also done when necessary. The perinatal outcome in terms of fetal distress, mortality and intrauterine growth retardation were recorded. Results: 120 cases of oligohdramnios were recorded. Seven newborns with congenital malformations were detected (5.8%). The most common congenital malformation was hydronephrosis. Four neonatal deaths were recorded in the study (3.3%). Fetal distress was observed in nine neonates (7.5%) and thirty neonates (25%) had intrauterine growth retardation. Conclusion: Congenital malformations, neonatal mortality, fetal distress and intra uterine growth retardation are significant risks in oligohydramnios. The lower the amniotic fluid index more is the risk of both mortality and congenital anomalies.
Objectives:
Serial C-reactive protein (CRP) monitoring helps to rule out and prognosticate sepsis. Small blood volumes in neonates make it difficult for repeated blood draws for serial CRP monitoring. Hence, the need of the hour is a non-invasive method such as CRP estimation in saliva. This study aims to correlate salivary CRP with serum CRP levels and establish the potential clinical utility of salivary CRP in diagnosing neonatal sepsis.
Materials and Methods:
Twenty-three consecutive neonates diagnosed with clinically suspected sepsis and admitted to the NICU were the study subjects. Demographics such as gestational age and weight at birth, sex and detailed clinical features, and comorbidities were noted. Blood samples for CRP estimation and blood culture were collected as soon as clinical suspicion of sepsis arose. Saliva samples were collected for CRP estimation within 1 h of blood sample collection. The saliva was collected in a 2 mL syringe using low suction. Salivary and serum CRP were estimated by the particle enhanced immunoturbidimetric assay.
Results:
In our study, the CRP levels in saliva correlated moderately well with CRP levels in serum (Spearman correlation coefficient r = 0.582, P = 0.004). The sensitivity and specificity of salivary CRP to predict a serum level of ≥10 mg/L were observed to be 0.75 and 0.93, respectively.
Conclusion:
Our study shows the promise of salivary CRP as a potential clinically meaningful biomarker of neonatal sepsis and warrants the need for larger studies to validate the utility of salivary CRP to serially monitor neonatal sepsis.
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