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Mortality among neonates has long been largely neglected by research in all developing nations of world including India. This study aims to identify the primary and secondary causes of neonatal deaths among the tribes of Gujarat by retrospectively analyzing 106 neonatal deaths that occurred during the year 2008 and 2009. The socio-economic, biological and traditional newborn care practices impacting newborn survival were also studied. Case studies including in-depth interviews of 33 women who had experienced neonatal deaths in period of 2008 and 2009 have also been conducted. The results show that the main causes of neonatal deaths in the study area were birth asphyxia, prematurity, aspiration, infection and congenital anomalies, irrespective of place of delivery. Absence of trained and skilled personnel for newborn resuscitation was the main cause of perinatal birth asphyxia related deaths. Around 36% mothers had a history of infant deaths. Low birth weight is one of the important causes of neonatal deaths among mothers who had a history of child loss. Cyclicality of neonatal deaths continued among clustered families with social factors initiating the cycle. Qualified trained birth attendants practicing essential newborn care are necessary during home deliveries.

BACKGROUND: The possible role of heme oxygenase and its byproduct carbon monoxide (CO) in the regulation of blood pressure is under investigation. The aim of this study was to compare end tidal breath CO (ETCO) levels in women with gestational hypertension (GH) or pre-eclampsia to the levels in healthy pregnant and nonpregnant women. MATERIALS AND METHODS: We prospectively performed ETCO measurements corrected for ambient CO (ETCOc) in two medical centers (Stanford, CA and Cleveland, OH). A Natus® CO-Stat® End Tidal Breath Analyzer (Natus Medical Inc., San Carlos, CA) was used. The study group included a convenience sample of 31 women with GH/pre-eclampsia (PE). Control groups included 46 nonpregnant healthy women, 44 first-trimester and 48 third-trimester pregnant healthy women. RESULTS: Mean±SD ETCOc measurements were significantly lower in the GH/PE group compared to first-trimester (p=0.004) and third-trimester (p=0.001) normotensive pregnant and nonpregnant women (p=0.002) (1.36±0.30 vs 1.76±0.47, 1.72±0.42 and 1.78±0.54 ppm, respectively). The ETCOc values were ≤1.6 ppm in 89% of GH/PE women compared with, respectively, only 45, 54, and 46% of nonpregnant, first- and third-trimester normotensive pregnant women (p

Noninvasive prenatal testing utilizing free fetal DNA is commonly used in pregnancy to screen for trisomy 13, 18, 21 and also fetal sex aneuploidy. We report on two cases of discrepancy between phenotypic and genotypic sex and potential medical implications. In our first case, a patient with known male gender via cell free fetal DNA (cffDNA) testing had an ultrasound at 18 weeks' gestation, which identified Dandy-Walker malformation and female-appearing ambiguous genitalia. As Dandy-Walker malformation could not be considered isolated in the presence of ambiguous genitalia, this finding allowed for more complete counseling of the parents as well as extensive genetic workup. Our second case involved a fetus with intrauterine growth restriction diagnosed by ultrasound and normal-appearing female genitalia. After birth, adrenal insufficiency was diagnosed and chromosome analysis identified normal male chromosomes. These two cases showed that fetal sex determination by cffDNA can be used as a tool for earlier identification of affected pregnancies, allowing for parental decision-making, genetic testing and earlier intervention.