Princess Royal Maternity Hospital

BackgroundLate preterm and early term infants are a large proportion of all births. Historically, outcomes were thought to be similar to those of full term infants, but recent evidence demonstrates worse outcomes. Although serious morbidity is less common than in very preterm infants, the impact of modest illness in large numbers of more mature neonates is significant, with 30–40% requiring neonatal unit (NNU) admission, primarily for respiratory disease. The SurfON trial aims to evaluate whether early surfactant therapy improves outcomes compared with expectant management in late preterm and early term infants with respiratory distress. The primary objectives are to compare neonatal hospital stay and incidence of severe respiratory failure, with secondary objectives assessing other perinatal outcomes and cost-effectiveness.MethodsThe SurfON trial is a multicentre, open-label, randomised controlled trial involving 45 UK NNUs, aiming to recruit 1522 infants over 30 months. Eligible infants are those born at 34+0 to 38+6 weeks’ gestation who require noninvasive respiratory support for respiratory distress within 24 h of birth. Infants are randomised in a 1:1 allocation ratio to either early surfactant therapy or expectant management. Infants randomised to the early surfactant therapy group will receive a single dose of CUROSURF®, a natural animal-derived surfactant. IMP administration reflects local site policy and procedure and may be completed by any clinician for whom this falls within their usual scope of practice, following confirmation of eligibility. The IMP is a commonly used drug in neonates and is being used in line with standard care. Side effects are uncommon and usually transient. Timing and dosage of IMP administration will be collected. Surfactant is a stock drug for all NNUs and will be administered and accounted for as per local practice.DiscussionEvidence-based guidance for the management of late preterm and early term infants is sparse, and no previous large randomised controlled trials have focused on this population. Management of respiratory distress in late preterm and early term infants varies. Some clinicians prefer early surfactant administration to prevent deterioration—78others delay treatment to avoid mechanical ventilation. This inconsistency highlights the need for trials to establish an evidence base. Unexpected neonatal morbidity and prolonged hospitalisation cause significant psychological distress for families, impacting breastfeeding and maternal well-being. High intensive care workload and associated costs pose challenges for the NHS (National Health Service). Evidence-based management could improve outcomes and reduce healthcare burdens.Trial registrationISRCTN 15915394. Registered on 20th February 2020 https://www.isrctn.com/ISRCTN15915394.

Sexological interviews in gynecological consultations remain a practice that is not routinely undertaken despite the importance of sexual health. The objectives of this study were to investigate patients' expectations from a sexological interview, and the elicitation of sexual dysfunctions. A cross-sectional study was performed at the Maternity and Neonatology Center of Tunis. We included patients aged >18 years who consulted for gynecological reasons outside of any emergency or pregnancy. Our study included 200 patients with a mean age of 41 (±10) years. We found that72.5% of the patients appreciated the approach to sexuality during gynecological consultations. A total of 77.5% of the women indicated that their current gynecological pathology affected their sexuality. The mean of female sexual function index score was 25.05 (±5.03). The most affected domain was desire, with a mean of 3.54 (±1.05). The main predictive factors for sexual dysfunction were: age > 40 years, endometriosis, gynecological cancer, and abnormal uterine bleeding. Thus, it's important to introduce sexological interviews in gynecology consultations, especially for patients at risk of sexual dysfunction.

The article presents a personal observation of the course of pregnancy and childbirth in a patient with spinal muscular atrophy type III. The diagnosis was established at the age of 8 according to clinical data, confirmed by electroneuromyography and the results of a molecular genetic study. During pregnancy planning, a genetic prognosis was made for the birth of a child with SMA in this couple. Pregnancy occurred after further examination of the respiratory system, preparation of the endometrium with gestagen preparations and prevention of thromboembolic complications, proceeded with the phenomena of obstructive sleep apnea, impaired carbohydrate metabolism, cardiac arrhythmias and hypercoagulation. At 37 weeks, she was delivered by caesarean section due to the occurrence of preeclampsia.

Backgroung: Maternal deaths are a major public health issue and serve as a crucial indicator for assessing a country's level of health development.The aim of this study is to describe the epidemiological characteristics of maternal deaths occurring at the Souissi Maternity Hospital in Rabat between 2018 and 2021.Methods: This is a retrospective descriptive study.All cases of maternal death occurring at the Souissi Maternity Hospital in Rabat between January 2018 and December 2021 were included in this study.Data were collected from medical records.We divided the study into two phases (2018-2019 and 2020-2021), to be able to compare the mortality rate before and after COVID-19.Causes of death were also compared between these two phases using Khi 2 test or fisher's exact test. Results:During the entire study period (2018 -2021), the Maternal Mortality Rate was 156.03 deaths per 100,000 live births.This rate rose from 88.84 to 261.49 per 100,000 live births between the two study phases (p < 0.001).Sixty-eight cases were linked to a direct cause (73.9 %).Preeclampsia and eclampsia was the leading cause of maternal mortality by direct cause (30.9 %), and hemorrhage was the second leading cause (25.0 %). Conclusion:The study identified preeclampsia and postpartum hemorrhage as the leading causes of death, both of which are highly preventable.Recognizing risk factors through a case-control study is essential, and targeted interventions could help reduce maternal mortality.

IntroductionLassa fever is a viral haemorrhagic disease endemic to West Africa. While most infections are mild, severe cases have high morbidity and mortality, with case fatality rates ranging from 15% in mild cases to 60% in severe cases. Survivors often experience chronic health complications, but these long-term effects remain understudied despite their public health significance.ObjectivesThis scoping review synthesises evidence on the long-term health sequelae of Lassa fever, maps key findings from existing studies, and identifies critical gaps to guide future research and clinical care.MethodsA systematic literature search was conducted in PubMed/MEDLINE, Embase, and Google Scholar (up to September 2024) for English-language studies reporting physical, psychological, and functional outcomes ≥ 4 weeks post-recovery. Studies were selected using PCC framework (Population: Lassa survivors; Concept: Long-term sequelae; Context: Endemic regions globally). PRISMA-ScR guidelines were followed.ResultsNine (9) studies from Nigeria, Sierra Leone and Germany were included, comprising three cross-sectional studies, two case-control studies, two case reports, one retrospective descriptive study and one retrospective cohort study. Hearing loss was the most prevalent sequela (16–35% of survivors), often bilateral and sensorineural with associated balance disorders (55%) and social isolation. Neurological sequelae included delayed-onset paraparesis, seizures (37% in on cohort) and cognitive impairment (8.8%). 42% of survivors in one study had ophthalmic manifestations such as cataract and retinal hemorrhage. Depression and delirium were frequently reported.ConclusionLassa fever has significant long-term health consequences requiring multidisciplinary care. More research, particularly longitudinal and interventional studies is needed to improve post-recovery outcomes, survivor rehabilitation, inform evidence-based policies and guide resource allocation in endemic regions.

Abstract This scoping review explores the long-term health effects and chronic sequelae among Lassa fever survivors, highlighting significant physical, psychological, and functional challenges. Hearing loss, a prominent sequela, often coexists with neurological deficits, such as balance difficulties and cognitive dysfunction, impacting survivors' quality of life. Persistent renal, ophthalmic, and psychiatric complications, including depression and delirium, further underscore the multifaceted consequences of the disease. Despite the critical nature of these findings, research gaps remain, particularly the lack of longitudinal studies and limited geographic scope beyond Sierra Leone and Nigeria. These gaps hinder a comprehensive understanding of the disease's long-term impact. Addressing these issues through targeted interventions and expanded research is essential for improving post-recovery care and outcomes for Lassa fever survivors.

We present a case of a pregnancy complicated by multiple fetal abnormalities, cystic hygroma, hypoplastic aortic arch, short limbs, bilateral talipes, and Dandy-Walker malformation. The baby became hydropic and subsequently the intrauterine demise was diagnosed at 21+5w gestation. The patient declined prenatal invasive diagnostic tests, however postmortem examination confirmed the ultrasound finding of Dandy-Walker malformation and the karyotype was confirmed as a monosomy X (Turner`s syndrome). A Dandy-Walker malformation is an unusual finding in Turner's syndrome. This is just the second case report that we found in the literature. In conclusion, we should consider a Turner's syndrome as a possible cause for a Dandy-Walker malformation. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

Abstract Background Adequate and safe blood supply has remained a challenge in developing countries, including Nigeria. Young students can play a fundamental role in blood donation, saving the lives of many people; hence, studying their knowledge, attitudes, and practices related to blood donation is essential. Objective The objectives of this study were to assess the knowledge, attitudes, and practices of voluntary blood donation among Ambrose Alli University students and the factors associated with the prevalence of blood donation. Methodology: This was a cross-sectional descriptive study carried out at Ambrose Alli University, Ekpoma. A total of 250 students were recruited. Pretested questionnaires were used to assess their knowledge, attitudes, and practices related to voluntary blood donation. Statistical analysis The responses were collated and analysed with the Statistical Package for Social Sciences (SPSS) v21. The associations between blood donation practices and the gender of the respondents and the age, year of study, department, and employment status of the parents were tested via chi-square tests where appropriate; p &lt; 0.05 was considered statistically significant. Result The study revealed that the mean age of the respondents was 22.3 ± 9.049) years, with females accounting for 51.6% of the sample. A total of 34% (85) have good knowledge, and the respondents have a positive attitude (mean 3.23) toward donation; however, only 13.6% have donated blood with a male-to-female ratio of 2:1. The study revealed significant associations between knowledge of blood donation and several sociodemographic features, including age (p = 0.003), year of study (p = 0.025), faculty of the respondents (p &lt; 0.001) and employment status of the father or male guardian (p = 0.035). Furthermore, blood donation practices were significantly associated with the year of study (p = 0.028) and faculty (p &lt; 0.001). Logistic regression revealed that senior students were less likely to donate blood than first-year students were. Fourth-year students had an odds ratio (OR) of 0.20 (95% CI: 0.05–0.87, P = 0.032), and fifth-year students had an OR of 0.23 (95% CI: 0.06–0.93, P = 0.039). Conclusion Despite having a fair level of knowledge regarding blood donation as well as a positive attitude toward it, the respondents portray a poor practice culture with respect to blood donation.

ObjectivesTo describe a case report on cricopharyngeal achalasia in an infant with 49XXXXY genetic disorder.MethodsThe case report describes a rare diagnosis of cricopharyngeal achalasia in a rare genetic disorder of 49XXXXY. Informed consent was obtained from parents. It highlighted the presentation with nonspecific clinical symptoms and signs leading to challenges in the final diagnosis, also the supporting investigations to confirm the diagnosisResultsAn 11-month-old male infant with a rare genetic disorder of 49XXXXY presented with recurrent choking, aspirations, and chest infections. Born at 36 weeks due to intrauterine growth restriction, after an uneventful antenatal course with a birth weight of 2.28 kg. Admitted postnatally due to respiratory distress, and hypotonia. He had electrolyte imbalance with high sodium and serum osmolarity and MRI brain suggestive of conatal cysts adjacent to the frontal horns of both lateral ventricles. He had ongoing issues of striking hypotonia, recurrent aspirations with chest infections, poor weight gain, developmental delay and micro-penis on examination, that led to investigations including genetics and metabolic diseases. At 8 months, he was diagnosed to have a rare genetic disorder of 49XXXXY. A video fluoroscopy was performed showing indentation at cricopharyngeal muscle, consistent with cricopharyngeal achalasia, explaining, recurrent aspirations.ConclusionCricopharyngeal achalasia is a rare diagnostic entity. The spectrum of associated signs and symptoms can reflect numerous diseases and rare genetic disorders, hence it can be misleading. The key to diagnosis is to have a high index of suspicion as early diagnosis and management can prevent any morbidity or mortality.