Clinical and Epidemiological Features and Management of Neonatal Hypoglycemia at the University Teaching Hospital of Treichville (Abidjan-Côte d’Ivoire)

The purpose of this study is to determine the prevalence, the characteristics of hypoglycaemia in the newborn admitted to emergency departments of teaching Hospital of Treichville, Abidjan and to evaluate the relevance of capillary blood glucose in this diagnosis. Patients and Methods: This prospective cross-sectional study was held from 01 February to 25 June 2017 in the Pediatric Emergency Department. It involved 201 newborns under 24 hours of age who consulted in pediatric emergency for any reason. Data were collected from parent direct interviews, analysis of the follow-up record, physical examination of the newborn, results of glucose level in the capillary blood at heel and in venous blood. On dry tube and gray tube (containing sodium fluoride and potassium oxalate), the blood glucose on the latter tube constituting the reference blood glucose, with neonatal hypoglycaemia defined by a venous blood glucose less than or equal to 2.5 mmol/l (0.45 g/l). The statistical tests used were the frequency comparison, the Chi Square, the Fisher Test with a significance threshold p 0.05 or the Odds-ratio with a confidence interval of 95% and a significance threshold of 5%, but also with the correlation coefficient. Results: Newborns of less than 3 hours of life (70.6%) were the most represented with a male predominance (sex ratio = 2.9). The reasons for consultation were dominated by neurological disorders (36.5%), prematurity (31.8%), and fever (22.2%). The average time to complete the blood glucose test was less than one hour after the sampling in 6.5% of the cases. The mean blood glucose was 0.59 g/l (3.28 mmol/l) with extremes ranging from 0.15 to 1.8 g/l (0.83 mmol/l to 10 mmol/l). The prevalence of hypoglycemia by the instantaneous glycemic method was 15.9%. On tube containing sodium fluoride and potassium oxalate, it was 20.4%, while the prevalence of red blood cell hypoglycemia was 38.1%. A good correlation was found between capillary glycemia and gray tube with r = 0.97. Signs associated with hypoglycemia were predominantly male (p 0.05), prematurity (p 0.05). As for cerebral suffering, it had proved to be a protective factor (Fisher: 0.002). The mortality rate was 2.5%. Hypoglycemia was not found. Conclusion: Hypoglycaemia is relatively common in our working setting, particularly in premature infants. However, it should be carefully sought in any newborn admitted to emergency regardless of the reason for admission. The use of capillary blood glucose proves to be a good alternative because it allows a fast management.

Neonatal Hemoperitoneum: Diagnosis Always Delicate

The hemoperitoneum is a rare and severe disease in neonatal period that can cause a condition of hemorrhagic shock. We presented the case of an infant hospitalized for hemodynamic disorders which could to suspect maternofetal infection. The clinical deterioration with the appearance of shock signs, anemia, abdominal distension and Ultrasound allowed to correct diagnosis. Labour dystocia (apart from unnoticed minimal obstetrical trauma) does not seem to be responsible for hemoperitoneum as the majority of the reported cases. According to current recommendations, the treatment of this condition is primarily based on reanimation measures. Surgery is rarely needed in certain cases. Conservative treatment should be considered.