Care of the Newborn in Developing Countries by G.J. Ebrahim

By G.J. Ebrahim

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The object of the physical examination is threefold: (1) (2) (3) Has the mother given birth to a healthy baby free of any congenital abnormalities? Some abnormalities are gross and obvious on observation, others like congenital heart defect or anomalies of the gastrointestinal tract will need detailed physical examination and x-ray studies, whereas others such as hypertrophic pyloric stenosis may not be detected until the baby is a little older and develops further symptoms. Have the rigours of delivery incapacitated the baby in any way?

In the human, brain growth is maximal during the latter half of pregnancy and the first two years of life. It is therefore highly likely that prenatal malnutrition may predispose the baby to inadequate brain growth, particularly if postnatal malnutrition occurs as well. Next to protein and calorie deficiency, anaemia is the most common nutritional disorder in pregnancy. Prevalence studies have shown that 15-50 per cent of women in Africa, 10-35 per cent of women in South America and more than 20 per cent of women in Asia have haemoglobins below 10 g per 100 mi.

5 per cent of pregnant women have bacteriuria. Despite adequate therapy, birth weights of infants of such mothers are lower compared with those without any bacteriuria. If such infection is persistent or refractory to treatment the rate of foetal loss also tends to be high. PROTECTION OF THE FOETUS Since the aim of prenatal care is protection of the mother and the foetus, one ought to consider positive steps to achieve it. Immunisation of the mother against tetanus in the last trimester produces antibodies in her blood which reach the foetus in sufficient quantities to protect it from neonatal tetanus.

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