scholarly journals Study of congenital malformations in newborns: a hospital based prospective study

2017 ◽  
Vol 4 (4) ◽  
pp. 1409
Author(s):  
Kinjal G. Patel ◽  
Chintu Chaudhary

Background: Congenital malformations represent a defect in the morphogenesis during fetal life. Since the introduction of primary health care and immunization programme, congenital malformations have emerged as one of the commonest cause of perinatal mortality. The objective was to study the incidence, systemic distribution, various maternal risk factors and immediate outcome of congenital malformations in hospital delivered neonates.Methods: This study was conducted at a tertiary care hospital for a period of 2 years. All the hospital delivered live neonates and stillbirth babies with congenital malformations are included in this study. Detailed history, examinations and investigations are carried out to identify etiological factors. Their outcome in form of morbidity and mortality are taken up to their hospital stay.Results: Out of 9600 babies with malformations 171(1.88%) having single malformation and 23(0.25%) having multiple malformations. Incidence of malformations was higher in stillbirths (24.25/1000 livebirths) against than in live births (19.96/1000 livebirths).  The cardiovascular system was involved in 23.4% of babies, followed by musculoskeletal system (22.3%) then gastrointestinal (15.9%) and genitourinary system (15.4%).   Multiple malformations were seen in 11.8% cases. Maternal risk factors associated with malformations were oligohydramnios in 4.12%, previous abortion in 2.5%, eclampsia in 2.5%, polyhydramnios in 1.54%, maternal diabetes in 1.54% and consanguinity in 1.03%. Maximum mortality occurred in babies with gastrointestinal system malformations (56.5%) followed by cardiovascular system malformations (21.7%).  Majority of babies with malformations discharged (78.9%) only 11.8% of babies expired and 2.6% of babies left against medical advice (LAMA).Conclusions: Congenital malformations represent one of the causes of neonatal mortality.  Stillborn babies have higher incidence of malformations. Antenatal ultrasonography and maternal risk factors has important role to identify malformations. Early detection and timely management required to decrease the mortality. 

2019 ◽  
Vol 39 (3) ◽  
pp. 135-141
Author(s):  
Yuba Nidhi Basaula ◽  
Radha Kumari Paudel ◽  
Ram Hari Chapagain

Introduction: Congenital anomalies account for 7.0% of neonatal deaths in Nepal. The present study was carried out to determine the overall rate of congenital malformations, incidence and prevalence in live births, still birth and incidence affecting various organ systems, at Bharatpur Hospital, Nepal. Methods: All the intramural deliveries between Jan 2015 to Dec 2019 were included in the study. All the newborns were looked for congenital malformations after birth within seven days. Antenatal ultrasonography findings were noted. 2D echocardiography was also used for all congenital heart diseases, along with routine X-ray chest. A total of 131 babies with congenital problem were studied and the information was recorded in WHO NBBD Proforma. Data were recorded in MS Excel and SPSS 16 version was used for analysis. Results: Out of the total 60160 deliveries, 131 (0.21% of total birth) were with congenital malformations, sex wise distribution was 65 (49.5%) females and 63 (48.7%) males and three (1.8%) were ambiguous. Oro-facial malformation (49, 37.4%) was the commonest form of malformation followed by the musculoskeletal system (31, 23.6 %), centre nervous system (31, 23.6%) and congenital malformations of genital organs (8, 6.0%). Conclusions: The incidence of congenital malformation in this study was 0.21%. Females were more common than males and oro-facial malformation was the commonest type of malformation. Lack of antenatal visit, lack of folic acid during pre-conception period and low socioeconomic status were the commonest risk factors.


2020 ◽  
Vol 7 (10) ◽  
pp. 1952
Author(s):  
Somashekhar Chikkanna ◽  
Kavya S. ◽  
Saravanan P. ◽  
Nagaraj M. V.

Background: Perinatal asphyxia is an insult to fetus or newborn due to lack of oxygen (hypoxia) or lack of perfusion (ischemia) to various organs of sufficient magnitude and duration. Prenatal asphyxia is one of the major causes of early neonatal mortality in India. Our goal was to evaluate risk factors of perinatal asphyxia.Methods: Observational prospective study on 100 babies delivered in our hospital consecutively and requiring resuscitation were included.Results: The mean age of mothers was 23.5 years. 54% neonates were born to primiparous mothers. Anaemia was widely prevalent in the mothers of neonates requiring resuscitation. The major maternal risk factors for newborns requiring resuscitation were pregnancy-induced hypertension (PIH) (46%), oligohydramnios (41%), polyhydramnios (30%) and meconium stained liquor (28%). The fetal factors associated with resuscitation of newborns were intrauterine growth restriction (IUGR) (30%), prematurity (25%), meconium aspiration syndrome (MAS) (20%), and neonatal seizures (36%). Mortality was highest in hypoxic ischemic encephalopathy (HIE) stage 3 with 11%.Conclusions: The most common maternal risk factors for newborns requiring resuscitation was PIH followed by oligohydramnios, polyhydramnios and meconium stained liquor. IUGR was the most common fetal risk factor followed by, prematurity, MAS and neonatal seizures.


2021 ◽  
Vol 8 (6) ◽  
pp. 1027
Author(s):  
Ujjwala S. Keskar ◽  
Anjali H. Parekh

Background: Very low birth weight babies with respiratory complications are the commonest reason for admission in NICU. We wanted to identify maternal risk factors associated with it and ways to prevent it. The objective of the current study was to study the prevalence of maternal risk factors, morbidity and mortality in VLBW babies admitted in tertiary care hospital NICU.Methods: Cross sectional observational study performed on all very low birth weight (VLBW) neonates admitted in neonatal intensive care unit of tertiary care hospital attached with Smt. Kashibai Navale medical college, Pune from January 2019 to March 2020.Results: In our study VLBW babies were 2.2% (78/3545). Mean gestational age was 31.15±3.21 weeks; mean birth weight was 1226.24±250.95 grams. Small for gestational age (SGA) babies were 41% and 96% were preterm. Maternal risk factors were present in 61.53% of deliveries, commonest were anaemia in 30.06 % and preeclampsia in 24.35%. Resuscitation at birth was required in 30.76% babies. Morbidity profile showed respiratory distress syndrome in 46.15%, neonatal sepsis in 19.23% and patent ductus arteriosus in 16.66% babies. Overall survival was 74.35%. Prematurity and its complications like RDS requiring surfactant therapy and mechanical ventilation were significant contributors for mortality but only 23.07% mothers were found to have received antenatal steroids in the hospital .Conclusions: Anaemia and preeclampsia were commonly found risk factors present in 61.53% of mothers of VLBW babies. Use of antenatal steroids in mothers should be made compulsory to decrease mortality in VLBW preterm newborns.


Author(s):  
Vinitha Wills ◽  
Jacob Abraham ◽  
N. S. Sreedevi

Background: To study the system-wise occurrence of congenital anomalies in newborns admitted in a tertiary hospital and to study the associated maternal factors.Methods: This is a retrospective study of all the mothers and their newborn babies with congenital anomalies who were delivered or referred to the Obstetrical Department / Neonatology unit during a two-year study period. The maternal risk factors and associated Obstetric complications were studied.Results: Among the babies born with congenital anomalies, the systems most involved were Genito-urinary System (28.5%) and Cardiovascular System (20.5%). Among the maternal risk factors, Diabetes (14.01%), previous abortions (12.7%) and hypothyroidism (8.7%) were the most significant associated factors. Intrauterine growth restriction (17.4%) was noted to be more common in these babies.Conclusions: The incidence of anomalies was most involving the Genito-urinary System and Cardiovascular System. The major risk factor identified was maternal Diabetes. Prevention by public awareness during adolescence, pre-conceptional counseling and antenatal screening is stressed. Availability of Pediatric surgery and Rehabilitative facilities to improve the quality of life would be warranted.


2021 ◽  
Vol 8 (2) ◽  
pp. 341
Author(s):  
Sayooj Somanathan ◽  
Sriram Pothapregada ◽  
Anuradha Varadhan ◽  
Ruth Ann Mathew

Background: This study was conducted to study the clinical profile of hypoglycemia in newborn and to determine the prevalence of hypoglycemia among neonates admitted in NICU.Methods: All newborns admitted in NICU were examined and those with hypoglycemia (GMR<45 mg/dl) were included in the study and observed. In neonates with risk factors blood sugar was screened at 2, 6, 12, 24, 48 and 72 hours of life or whenever symptoms suggestive of hypoglycemia developed in any neonates and for critically sick neonates blood sugar was screened in every 6 hour in active phase of illness. Any neonates with blood glucose level less than 45 mg/dl were analysed for maternal risk factors, neonatal risk factors and course in the NICU.Results: The prevalence of neonatal hypoglycemia was 14.9% among NICU admissions. The maternal risk factors were GDM, PIH, and PROM. The neonatal risk factors were prematurity, SGA, LGA and comorbid conditions which include perinatal asphyxia, sepsis, polycythemia, shock. The common symptoms were poor feeding, lethargy, jitteriness, convulsions, irritability, hypotonia and cyanosis. Majority of the neonates required only oral feeds for correction of hypoglycemia.Conclusions: Blood glucose screening in neonates with this risk factor is mandatory as many of the neonates were asymptomatic. The importance of early initiation of breast feeding to prevent hypoglycemia should be emphasized. 


2019 ◽  
Vol 2 (1) ◽  
pp. 77-82
Author(s):  
Abha Shrestha ◽  
N Pradhan ◽  
B Kayastha

Background: Intrauterine growth restricted (IUGR) fetuses are at higher risk of developing neonatal complications and also known to develop metabolic syndrome in adult life. So, an early antenatal detection, choosing the optimal time and method of delivery and intervention when required could minimize the risk significantly. Objective: To find out the prenatal outcome and the maternal and placental risk factors. Methods: A prospective study was conducted from January 2010 to January 2019, at a Teaching Hospital. A singleton pregnancy, above 28 weeks of gestation with clinical diagnosis of IUGR and confirmed by ultrasonography were included in the study. The statistical analysis was performed by Statistical Package of Social Sciences (SPSS) 23.0 software. Results: Maternal risk factors like low pregnancy body mass index, preeclampsia, anaemia, hypothyroidism and placental factors like retro placental hemorrhage were mainly responsible for intrauterine growth restriction. Conclusions: The early identification of risk factors and management of the same antenatal is an important issue to prevent adverse prenatal outcomes associated with IUGR.


2019 ◽  
Vol 6 (5) ◽  
pp. 1859
Author(s):  
Najia Hassan ◽  
Sujaya Mukhopadhyay ◽  
Sneha Mohan

Background: Preterm birth is a major cause of mortality and morbidity for newborns. Complications of prematurity are becoming more common as more survivors are spending time in Neonatal intensive care unit.Methods: A retrospective hospital based clinical observational study was conducted in NICU in Sharda hospital, a tertiary care centre in Greater Noida. Data regarding neonates′ age, sex, clinical presentation, maternal risk factors, complications and outcome were recorded.Results: A total of 133 preterm neonates were enrolled in the study. Maternal risk factors like Pregnancy induced hypertension (PIH) was seen in 19.5% cases, Urinary tract infection in 15% and Antepartum haemorrhage in 14.2% cases. Among the complications of prematurity, RDS was noted in 38.3% cases, Hyperbilirubinemia in 16.5% and feed intolerance in 15% cases. Sepsis was present in 3% of the preterm. Mortality rate was 7.5%. Most common cause of death was RDS.Conclusions: Pregnancy induced hypertension and Antepartum haemorrhage were important maternal risk factors for prematurity. Respiratory distress syndrome and perinatal asphyxia were the important causes of mortality in the present study.


2020 ◽  
Vol 27 (03) ◽  
pp. 613-617
Author(s):  
Humaira Tabassum ◽  
Memoona Faiyaz ◽  
Aasma Hanif ◽  
Uzma Fahim ◽  
Areeba Aftab

Abruption placentae are a major cause of maternal and perinatal morbidity and mortality. Placental abruption is due to the rupture of the uterine spiral artery. Bleeding into decidua leads to separation of the placenta. There are many major maternal and fetal complications associated with placental abruption. Objectives: To assess the maternal risk factors, perinatal mortality and morbidity in relation to the severity of placental abruption. Study Design: Descriptive case series. Setting: Department of Obstetrics and Gynecology, Jinnah Hospital, Lahore for one year. Period: From Jan 2016 to Dec 2016. Material & Methods: Hundred females were included with placental abruption and were followed-up till delivery. At the time of delivery maternal and fetal complications were noted. Results: Mean age of females was 29.24 + 3.58years. The mean gestational age at delivery was 32.95+3.12 weeks. About 64% underwent vaginal delivery while 36% underwent cesarean section. Among pre-disposing factors increased risk of anemia i.e. 46%, hypertension was found in 28%, multiple pregnancies with 18% and polyhydromnias were found in 8%. The incidence of fetal mortality was 58% and only 42% were born alive at time of delivery. Fetal morbidity is analyzed, 95.23% were in need of resuscitation, admission to nursery was done in 95.23%, neonatal jaundice was seen in 80.95%, anemia in 71.42% and respiratory problems were found in 85.71%. APGAR score at 5 minutes among 21 alive born fetuses was <8 in 85.71%. Conclusion: Resultantly maternal morbidity and perinatal mortality is significant, and this calls for early detection, regular visits, and special surveillance. There should be timely referral to tertiary care center where antenatal care plays an important role in decreasing the incidence of abruption placenta.


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