scholarly journals Evaluation of perinatal factors in neonatal sepsis at tertiary centre

2017 ◽  
Vol 6 (11) ◽  
pp. 4981 ◽  
Author(s):  
Raju Kumar ◽  
Anita Kumari ◽  
Anjili Kumari ◽  
Neelam Verma
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Neonatal Mortality ◽  
Neonatal Sepsis ◽  
Clinical Signs ◽  
High Index ◽  
Major Health Problem ◽  
Maternal Risk ◽  
Neonatal Septicaemia ◽  
High Index Of Suspicion

Background: Neonatal mortality in India continues to remain a major health problem. Neonatal infections are one of the major contributor to neonatal mortality causing approximately one-quarter of the deaths. The signs of neonatal sepsis may be non-specific and easily missed, especially in the early stages. A high index of suspicion and identification of both maternal and neonatal risk factors is an important for early identification and prompt treatment.Methods: This is prospective study done at Patna medical college and hospital Patna from February 2014 to January 2015 in department of paediatrics. All inborn and out born neonates who had clinical signs of sepsis were included in the study.Results: During the 1-year study period, there were a total of 910 admissions in the NICU, out of which 175 were admitted due to neonatal septicaemia. Incidence of neonatal septicaemia was approximately 20%. Mean age at presentation was 4.8±6.38). Low birth weight (60%), preter delivery (60.57%), male gender (66.85%) and low APGAR score at1 minute were common foetal risk factor and prolonged labour (41.14%) and multiple vaginal examination (36.57%), PROM in 28%, MSL (25.71%) were common maternal risk factors. Present study documented a culture positivity rate of 42.28%. E. coli (37.83%) was the most common isolated organism in early as well as LOS. Staphylococcus aureus (20.27%) was the most common isolated Gram-positive bacterium. Mortality rate was 45.14%. Mortality was more in preterm babies (57.54%) which was statically significant p value <0.001.Conclusions: Neonatal septicemia is common and serious condition with high mortality rate. Since the condition starts with vague clinical signs, one has to keep very high index of suspicion to diagnose neonatal sepsis. Diagnosis and treatment at the early stage is very important for favorable outcome. Proper antenatal care, and institutional delivery may decrease neonatal sepsis.

scholarly journals Clinical and bacteriological study of neonatal septicaemia in a tertiary care hospital

2017 ◽  
Vol 5 (10) ◽  
pp. 4455
Author(s):  
Sneha V. Khante ◽  
Sharmila S. Raut
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Mortality Rate ◽  
Blood Culture ◽  
Neonatal Sepsis ◽  
Care Hospital ◽  
Bacteriological Study ◽  
Female Ratio ◽  
Maternal Risk ◽  
Neonatal Septicaemia

Background: Neonatal sepsis is a clinical syndrome of bacteraemia characterized by systemic signs and symptoms in the first month of life. It is the leading causes of neonatal mortality and morbidity. Early diagnosis and treatment with appropriate antibiotics is important to improve the prognosis of neonatal sepsis. Our objectives were to study the organisms causing neonatal septicaemia, associated risk factors, to correlate CRP with blood culture and to study mortality rate in neonatal septicaemia.Methods: The study of 2 years included clinically suspected cases of neonatal septicaemia admitted in NICU. 566 blood samples were collected, processed and isolates were identified. Maternal and neonatal risk factors were studied. CRP test was done by slide agglutination test.Results: Blood culture was positive in 205 (36.22%) cases. Among the culture positive cases, 128 (62.44%) were males and 77 (37.56%) females with male to female ratio of 1.66:1. Early onset sepsis was present in 137 (66.83%) and late onset sepsis in 68 (33.17%) cases. 107 (52.20%) were low birth weight babies. The most common neonatal risk factor was prematurity 75 (36.58%) and maternal risk factor was prolonged rupture of membrane 65 (31.71%). gram negative bacilli 144 (70.24%) were found to be common cause of sepsis than gram positive cocci 61 (29.76%), Klebsiella pneumoniae 54 (26.34%) being most common pathogen. Out of 566, CRP test was positive in 244 (43.10%) cases. Mortality rate was 23.41%.Conclusions: Neonatal septicaemia is a life-threatening emergency. The study of etiological profile and CRP test plays a significant role.

scholarly journals Maternal Risk Factors for Perinatal Mortality

2013 ◽  
Vol 26 (2) ◽  
pp. 86-91
Author(s):  
Nusrat Ara Yousuf ◽  
Ismat Ara Yousuf ◽  
Noor Uddin Talukder ◽  
Afroza Kutubi ◽  
Parveen Akhter Shamsun Nahar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Neonatal Mortality ◽  
Perinatal Mortality ◽  
Prospective Clinical Study ◽  
Maternal Risk Factors ◽  
Neonatal Mortality Rate ◽  
College Hospital ◽  
Total Birth ◽  
Maternal Risk

Objective: This prospective clinical study was designed on maternal risk factors for perinatal  mortality.Material and Methods: This is cross sectional study conducted in the Department of Obstetrics  & Gynae and Department of pediatrics Sylhet M A G Osmani Medical College Hospital, Sylhet, during the period from 1st July 2008 – 30th June 2009. Here study population were all fresh & macerated stillborn & early neonatal death cases during the study period. For  convenience sampling total 100 cases were studied for this study during the study period.Results: During this period 8398 deliveries were done & there were 715 perinatal deaths. In Sylhet region neonatal mortality rate is higher (53 /1000 total birth) than our national neonatal  mortality rate (37/1000 total birth) (BDHS, 2007). From this study it was revealed that most  important maternal risk factor for perinatal mortality was pre-eclampsia, eclampsia and obstructed labour.Conclusion: Perinatal mortality rate serves as the most sensitive index of maternal and neonatal care. DOI: http://dx.doi.org/10.3329/bjog.v26i2.13786 Bangladesh J Obstet Gynaecol, 2011; Vol. 26(2) : 86-91  

NEONATAL SEPSIS AND IDENTIFICATION OF RISK FACTORS: STUDY IN AVBRH HOSPITAL SAWANGI

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Pramod P. Singhavi
Keyword(s):  
Risk Factors ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Late Onset ◽  
Signs And Symptoms ◽  
Premature Rupture ◽  
Maternal Risk ◽  
Late Onset Sepsis ◽  
Early Onset Sepsis ◽  
Meconium Stained Amniotic Fluid

Introduction: India has the highest incidence of clinical sepsis i.e.17,000/ 1,00,000 live births. In Neonatal sepsis septicaemia, pneumonia, meningitis, osteomyelitis, arthritis and urinary tract infections can be included. Mortality in the neonatal period each year account for 41% (3.6 million) of all deaths in children under 5 years and most of these deaths occur in low income countries and about one million of these deaths are due to infectious causes including neonatal sepsis, meningitis, and pneumonia. In early onset neonatal sepsis (EOS) Clinical features are non-specific and are inefficient for identifying neonates with early-onset sepsis. Culture results take up to 48 hours and may give false-positive or low-yield results because of the antenatal antibiotic exposure. Reviews of risk factors has been used globally to guide the development of management guidelines for neonatal sepsis, and it is similarly recommended that such evidence be used to inform guideline development for management of neonatal sepsis. Material and Methods: This study was carried out using institution based cross section study . The total number neonates admitted in the hospital in given study period was 644, of which 234 were diagnosed for neonatal sepsis by the treating pediatrician based on the signs and symptoms during admission. The data was collected: Sociodemographic characteristics; maternal information; and neonatal information for neonatal sepsis like neonatal age on admission, sex, gestational age, birth weight, crying immediately at birth, and resuscitation at birth. Results: Out of 644 neonates admitted 234 (36.34%) were diagnosed for neonatal sepsis by the paediatrician based on the signs and symptoms during admission. Of the 234 neonates, 189 (80.77%) infants were in the age range of 0 to 7 days (Early onset sepsis) while 45 (19.23%) were aged between 8 and 28 days (Late onset sepsis). Male to female ratio in our study was 53.8% and 46% respectively. Out of total 126 male neonates 91(72.2%) were having early onset sepsis while 35 (27.8%) were late onset type. Out of total 108 female neonates 89(82.4%) were having early onset sepsis while 19 (17.6%) were late onset type. Maternal risk factors were identified in 103(57.2%) of early onset sepsis cases while in late onset sepsis cases were 11(20.4%). Foul smelling liquor in early onset sepsis and in late onset sepsis was 10(5.56%) and 2 (3.70%) respectively. In early onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 21(11.67%), 19 (10.56%), 20(11.11%) and 33 (18.33%) cases respectively. In late onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 2 (3.70%), 1(1.85%), 3 (5.56%) and 3 (5.56%) cases respectively. Conclusion: Maternal risk identification may help in the early identification and empirical antibiotic treatment in neonatal sepsis and thus mortality and morbidity can be reduced.

Risk factors for perinatal mortality: a case control study from Thiruvananthapuram, Kerala, India

2017 ◽  
Vol 6 (6) ◽  
pp. 2452 ◽  
Author(s):  
Mayadevi Brahmanandan ◽  
Lekshmi Murukesan ◽  
Bindu Nambisan ◽  
Shaila Salmabeevi
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Perinatal Mortality ◽  
Case Control Study ◽  
Gestational Hypertension ◽  
Significant Risk ◽  
Case Control ◽  
Maternal Risk ◽  
Perinatal Mortality Rate ◽  
Control Study

Background: The greatest risks to life are in its very beginning. Although a good start in life begins well before birth, it is just before, during, and in the very first hours and days after birth that life is most at risk. This prospective case control study was designed on maternal risk factors for perinatal mortality.Methods: This was a case control study conducted in the Department of Obstetrics and Gynecology and Department of Paediatrics, Medical College Trivandrum for one year period in 2004-2005. The cases were all the fresh and macerated still births and early neonatal death cases during the study period. The controls were chosen as the next delivery entry in the OR register.Results: During this period, the total number of deliveries was 14,796 and there were 431 perinatal deaths. The perinatal mortality rate was 29.12. This was much higher compared to Kerala’s perinatal mortality rate of 10, the reason being that the study is conducted in a tertiary referral hospital with one of the best new born care nurseries and a large number of referrals. The most significant risk factors for perinatal mortality were low socio-economic status, referrals, late registration, prematurity, low birth weight, intra-uterine growth restriction, maternal diseases like gestational hypertension and gestational diabetes and intrapartum complications like abruption.Conclusions: Perinatal mortality rate serves as the most sensitive index of maternal and neonatal care. Good antenatal care and prevention of preterm birth may play a key role in further reduction of PMR.

scholarly journals Early neonatal mortality and risk factors: a case-control study in Paraná State

2018 ◽  
Vol 71 (5) ◽  
pp. 2527-2534 ◽  
Author(s):  
Michelle Thais Migoto ◽  
Rafael Pallisser de Oliveira ◽  
Ana Maria Rigo Silva ◽  
Márcia Helena de Souza Freire
Keyword(s):  
Risk Factors ◽  
Neonatal Mortality ◽  
Neonatal Death ◽  
Secondary Data ◽  
Case Control ◽  
Management Tool ◽  
Early Neonatal Death ◽  
Maternal Risk ◽  
Early Neonatal Mortality ◽  
Technological Management

ABSTRACT Objective: to analyze the Early Neonatal Mortality risk factors according to the risk stratification criteria of the Guideline of the Rede Mãe Paranaense Program. Method: a case-control epidemiological study with secondary data from the Mortality and Live Birth Information System in 2014. The crude analysis was performed by the Odds Ratio association measure, followed by the adjusted analysis, considering risk factors as independent variables, and early neonatal death as dependent variable. Results: were considered as maternal risk factors: absence of partner and miscarriages; neonatal: male, low birth weight, prematurity, Apgar less than seven in the fifth minute, presence of congenital anomaly; and care: up to six prenatal appointments. Conclusion: an innovative study of risk factors for early neonatal death from the Guideline's perspective, a technological management tool for maternal and child health, in search of its qualification and greater sensitivity.

scholarly journals Infant mortality: comparison between two birth cohorts from Southeast and Northeast, Brazil

2004 ◽  
Vol 38 (6) ◽  
pp. 773-779 ◽  
Author(s):  
Valdinar S Ribeiro ◽  
Antônio A M Silva ◽  
Marco A Barbieri ◽  
Heloisa Bettiol ◽  
Vânia M F Aragão ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Infant Mortality ◽  
Neonatal Mortality ◽  
Protective Factor ◽  
Infant Mortality Rate ◽  
Northeast Brazil ◽  
Birth Cohorts ◽  
Neonatal Mortality Rate ◽  
Live Births

OBJECTIVE: To obtain population estimates and profile risk factors for infant mortality in two birth cohorts and compare them among cities of different regions in Brazil. METHODS: In Ribeirão Preto, southeast Brazil, infant mortality was determined in a third of hospital live births (2,846 singleton deliveries) in 1994. In São Luís, northeast Brazil, data were obtained using systematic sampling of births stratified by maternity unit (2,443 singleton deliveries) in 1997-1998. Mothers answered standardized questionnaires shortly after delivery and information on infant deaths was retrieved from hospitals, registries and the States Health Secretarys' Office. The relative risk (RR) was estimated by Poisson regression. RESULTS: In São Luís, the infant mortality rate was 26.6/1,000 live births, the neonatal mortality rate was 18.4/1,000 and the post-neonatal mortality rate was 8.2/1,000, all higher than those observed in Ribeirão Preto (16.9, 10.9 and 6.0 per 1,000, respectively). Adjusted analysis revealed that previous stillbirths (RR=3.67 vs 4.13) and maternal age <18 years (RR=2.62 vs 2.59) were risk factors for infant mortality in the two cities. Inadequate prenatal care (RR=2.00) and male sex (RR=1.79) were risk factors in São Luís only, and a dwelling with 5 or more residents was a protective factor (RR=0.53). In Ribeirão Preto, maternal smoking was associated with infant mortality (RR=2.64). CONCLUSIONS: In addition to socioeconomic inequalities, differences in access to and quality of medical care between cities had an impact on infant mortality rates.

scholarly journals Neonatal Sepsis: A Profile of a Changing Spectrum

2015 ◽  
Vol 34 (3) ◽  
pp. 207-214
Author(s):  
K Venkatnarayan ◽  
PK Bej ◽  
RK Thapar
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Clinical Diagnosis ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Maternal Risk Factors ◽  
Maternal Risk ◽  
Clinical Criteria ◽  
Common Organism ◽  
Sepsis Screen

Introduction: The clinical features of neonatal sepsis are protean and are based on variety of clinical, demographic and laboratory profile of suspected cases. Objectives: To describe the aforementioned profiles in neonates presenting with clinically suspected sepsis based on pre-defined clinical criteria. Material and Methods: Design: Cross-Sectional Study; Setting: Level-2 NICU, Tertiary Care Hospital; Duration: Jan 2011 to Jul 2012. Subjects: 50 consecutive neonates presenting with any of the predefined clinical criteria were assessed for presence of maternal risk factors and studied with respect to: Gestational age, sepsis screen, clinical profile and antibiotic sensitivity of the organisms cultured. Results: Out of the fifty neonates, 38 (76%) were early onset sepsis. The sepsis screen showed an overall sensitivity of 73%, specificity of 54%; with a positive predictive value of 41% and a negative predictive value of 83%. The most common organism cultured was Staphylococcus aureus followed by E Coli, Pseudomonas, Coagulase Negative Staphylococcus and Group B Streptococcus. Ampicillin and Amikacin fared better than Cefotaxime and Gentamicin for Gram positive and Gram negative organisms, respectively. Overall, 37 babies responded to first line antibiotics and 11 required a change of antibiotics. One required addition of inotropes and two of the neonates died. Conclusion: A clinical diagnosis of sepsis based on predefined clinical criteria along with maternal risk factors, over- treated 27 babies (71%) with EONS and 8 babies (66.6%) with LONS. However, such a clinical diagnosis was supported by a septic screen almost twice as frequently (50% Vs 26.3%) in LONS. Staphylococcus aureus was the most common organism isolated. J Nepal Paediatr Soc 2014;34(3):207-214 DOI: http://dx.doi.org/10.3126/jnps.v34i3.11236  

scholarly journals Gestational Diabetes Insipidus Associated with HELLP Syndrome: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Renela Gambito ◽  
Michael Chan ◽  
Mohamed Sheta ◽  
Precious Ramirez-Arao ◽  
Harmeet Gurm ◽  
...  
Keyword(s):  
Risk Factors ◽  
Enzyme Activity ◽  
Case Report ◽  
Gestational Diabetes ◽  
Diabetes Insipidus ◽  
Clinical Setting ◽  
Hellp Syndrome ◽  
High Index ◽  
High Index Of Suspicion ◽  
Twin Pregnancies

Gestational diabetes insipidus is a rare, but well recognized, complication of pregnancy. It is related to excess vasopressinase enzyme activity which is metabolized in the liver. A high index of suspicion of gestational diabetes insipidus is required in a correct clinical setting especially in the presence of other risk factors such as preeclampsia, HELLP syndrome, and twin pregnancies. We are presenting a case of gestational diabetes insipidus in a patient with HELLP syndrome. The newborn in this case also had hypernatremia thereby raising possibilities of vasopressinase crossing the placenta.

scholarly journals Early neonatal mortality rate and the risk factors in Wangaya hospital

2016 ◽  
Vol 48 (5) ◽  
pp. 306
Author(s):  
Made Lndah Nastiti Utami Budha ◽  
Wayan Retayasa ◽  
Made Kardana
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Mortality Rate ◽  
Neonatal Mortality ◽  
Gestational Age ◽  
Neonatal Death ◽  
Early Neonatal Death ◽  
Neonatal Mortality Rate ◽  
Early Neonatal Mortality ◽  
Early Neonatal Mortality Rate

Background The first week of life of a neonate is a critical period.In Asia, early neonatal mortality rate remains high.Objective To investigate early neonatal mortality rate and the riskfactors in Wangaya Hospital.Methods A cross sectional study was carried out retrospectivelyon neonates registered at Perinatology Unit, Wangaya HospitalDenpasar, Bali since January 2006. The study was done fromOctober to November 2007. Data was obtained from medicalrecord, analyzed as univariate using chi-square test or Fisher'sexact test and multivariate logistic regression analysis model.Results Early neonatal mortality rate in Wangaya Hospital was 38.7per 1000 livebirths. Univariate analyses showed that there werefive significant risk factors of early neonatal death, i.e., respiratorydistress, asphyxia, birth weight less than 2500 grams, sepsis, andgestational age less than 3 7 weeks. Multivariate analysis showedthat those five variables were significant as risk factors of earlyneonatal death i.e., OR (95% confidence interval) for respiratorydistress: 16.8 (3.7 to 76.6)], asphyxia: 13.5 (6.1 to 29.9)], birthweight <2500 grams: 8.1 (3.3 to 19.9)], sepsis: 7.3 (3.1 to 17.1),and gestational age <37 weeks: 3.5 (1.6 to 7.8)].Conclusions Early neonatal mortality rate in Wangaya Hospitalremains high. Respiratory distress, asphyxia, birth weight <2500gram, sepsis, and gestational age <37 weeks were independent riskfactors of early neonatal death.

scholarly journals COVID Toes: Concurrent Lower Limb Arterial and Venous Thromboembolism in a Patient with COVID-19 Pneumonitis Presenting with Foot Ischaemia

2021 ◽  
pp. 153857442110456
Author(s):  
Kathryn A. Lee ◽  
Richard S. McBride ◽  
Ranjeet Narlawar ◽  
Rebecca Myers ◽  
George A. Antoniou
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Venous Thromboembolism ◽  
Peripheral Arterial Disease ◽  
Lower Limb ◽  
Respiratory Symptoms ◽  
Arterial Disease ◽  
High Index ◽  
Peripheral Arterial ◽  
High Index Of Suspicion

We present a 74-year-old gentleman, who presented with foot ischaemia requiring bilateral amputation in the absence of radiological signs of occlusive peripheral arterial disease. He was found to have COVID-19 pneumonitis and concurrent arterial and venous thromboemboli despite no initial respiratory symptoms or signs, nor pre-existing risk factors for cardiovascular disease. Patients who present with foot ischaemia with or without respiratory symptoms or signs warrant a high index of suspicion for COVID-19 infection, particularly in those with no predisposing risk factors.

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