Abstract

This study aimed to evaluate cord blood haematological parameters in pregnant mothers with high risk factors in predicting early onset neonatal sepsis. Methods: This is hospital based study done at Department of Obstetrics and Gynaecology, Siddhartha Medical College, Vijayawada.All examinations were done 24 hours after birth. Neonatal sepsis (NS) was characterized as a positive blood culture with symptoms of infection. All smears were examined by the pathologist blinded to the clinical findings. Platelet count & WBC, Differential leucocyte count ,Nucleated RBC (for correction of leucocyte count),Neutrophil morphology for assessing degenerative changes.e A complete blood count, included TLC, platelet count, total neutrophil count (TNC). Absolute neutrophil counts (ANC) were calculated from the observed values. Results: Out of 100 high risk cases of neonatal septicaemia 56 culture positive cases 39 (69.64%) were males and 17 (30.36%) were females.Among the culture positive cases Klebsiella were the commonest isolates i.e, Klebsiella 23(41.07%), Staphylococci 12(21.43%), Pseudomonas6(10.71%), Enterobacter 5(8.93%), E.coli 4(7.14), Providencia 4(7.14%)And Acinetobacter 2(3.57%). 14. Haematological scoring system at score ≥2 was reliable since it had sensitivity & NPV of 100% but specificity and PPV of 54.7.A score of Haematological score of ≥5 had specificity and PPV of 100%. With increase in the score, the specificity and Positive predictive value increased. Among the different screening parameters assessed, total neutrophil count had highest sensitivity and Negative predictive value. Immature neutrophil count had highest Specificity and Positive predictive value. Conclusion:Neonatal septicemia is still a leading cause of mortality and morbidity in developing countries like India. Gram negative organisms are the predominant causative agents in neonatal septicemia with Klebsiella pneumonia leading the list. Blood culture is considered “Gold standard” for the diagnosis of septicemia in neonates. A hematological score of 0 and 1 suggested sepsis was unlikely, 2-3 – sepsis possible and score 4 and 5 indicated very likely. The study found that the higher the score the greater the certainty that sepsis occurs.

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