scholarly journals A study on status of neonatal transport to a level III neonatal intensive care unit

2018 ◽  
Vol 5 (3) ◽  
pp. 1040
Author(s):  
P. Sampathkumar Sampathkumar ◽  
S. Gobinathan
Keyword(s):  
Neonatal Intensive Care ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Current Status ◽  
Delivery Mode ◽  
Low Oxygen ◽  
Cross Sectional ◽  
Neonatal Transport ◽  
Mode Of Transport ◽  
Interfacility Transport

Background: In the past decade, great advancements in Neonatal care contributed to a fall in IMR. A further fall in IMR can only be achieved by improving the neonatal transport facilities. Hence to assess the current status of neonatal transport we undertook this study.Methods: This is a cross-sectional study of 75 neonates transported to our NICU. For all the babies, data regarding the place of birth, mode of delivery, mode of transport, etc. were collected. On admission parameters like blood glucose, temperature, CRT, SPO2, the presence of cyanosis, shock was assessed.Results: In the present study 64% of neonates came to our NICU on their conveyance. 67% of referrals from PHCs did not utilize ambulance facility. 30% of neonates had hypothermia on arrival. 35%had hypoglycemia on arrival. 15% had a low oxygen saturation on arrival. 15% had prolonged CRT on arrival. Only 8% of neonates received prior treatment. 11% babies did not have any referral slip. Only a very few had complete and proper referral advice.Conclusions: To further reduce the neonatal mortality rate, the neonatal transport facilities should be upgraded. A standard protocol should be formulated for interfacility transport. A separate fleet of neonatal ambulances well equipped and manned by trained personnel is the need of the hour.

scholarly journals Fetal malposition and malpresentation: Mode of delivery and perinatal outcomes at Maternity Teaching Hospital in Erbil city

2020 ◽  
Vol 24 (3) ◽  
pp. 367-375
Author(s):  
Shahen Kak Hussein ◽  
Shahla Alalaf
Keyword(s):  
Cesarean Section ◽  
Teaching Hospital ◽  
Neonatal Intensive Care ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Breech Presentation ◽  
Neonatal Morbidity ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Neonatal Deaths

Background and objective: Delivering a malpositioned and malpresenting fetus remains uncertainty, despite advances in obstetric practice. This study aimed to determine the mode of delivery and neonatal outcome in cases of fetal malposition and malpresentation. Methods: A cross-sectional study of women delivering malpositioned and malpresenting fetuses was conducted at Maternity Teaching Hospital, Erbil city, Kurdistan Region, Iraq, from the 1st of June, to the 30th of November, 2018. Three hundred women and their newborns were followed for seven days of life. Results: The total rate of malposition and malpresentation was 4.8%. Most women (87.3%) delivered by cesarean section, 25% of the neonates were admitted to the neonatal intensive care unit, where 69.3% of these infants stayed for seven days. There were three early neonatal deaths (1.0%), all of them were in occipito-posterior, or occipito-transverse position and were delivered abdominally. Among occipito-posterior and occipito-transverse deliveries, 2.2% ended with the death of the fetus (P = 0.360). An Apgar score of 7 was recorded after 5 minutes for 97.7% of the infants. Around 11% of the women had postpartum hemorrhage. Conclusion: Fetal malpresentation and malposition are not uncommon during labor, and most cases are delivered by cesarean section. Neonatal morbidity and mortality are dependent on the type of presentation and the mode of delivery. Keywords: Malposition; Malpresentation; Perinatal outcome; Breech presentation.

scholarly journals Frequency of common factors leading to primary postpartum haemorrhage in patients presenting at Nishtar Hospital Multan.

2019 ◽  
Vol 26 (10) ◽  
pp. 1799-1804
Author(s):  
Hajira Masood ◽  
Sobia Mazhar ◽  
Syed Muhammad Ali ◽  
Muhammad Sajjad Masood ◽  
Saima Yasmin Qadir ◽  
...  
Keyword(s):  
Postpartum Haemorrhage ◽  
Mode Of Delivery ◽  
Significant Risk ◽  
Common Factors ◽  
Numerical Data ◽  
Cross Sectional Study ◽  
Uterine Atony ◽  
Delivery Mode ◽  
Cross Sectional ◽  
Maternal Deaths

Objectives: The objective was to determine the frequency of common factors leading to Primary postpartum hemorrhage. Study Design: Cross-sectional study. Setting: Study was conducted in obstetrics and Gynaecology ward of Nishtar Hospital Multan. Period: From 15-9-2017 to 14-03-2018. Material and Methods: Total 2119 deliveries were done in hospital during study period. Patients with loss of blood greater than 500 ml in vaginal delivery and 1000 ml in abdominal delivery were included. Main variables of study were age, paity, duration of delivery, mode of delivery. analysis was done by using SPSS for Window (version 10.0) Mean and stranded deviation was calculated for numerical data like ages of the patients and parity, while frequencies and percentages was calculated for qualitative data like mode of delivery. Results: 61.07% of the patients delivered vaginally and duration of labour was prolonged in 27.51% of cases. The single most frequent factor leading to primary postpartum haemorrhage was uterine atony i.e. in 48.99% of cases. Conclusion: Uterine atony was the most significant risk factors of primary postpartum haemorrhage. Our findings confirm the importance of previously recognized factors. Timely identification & management of these factors can help in reducing the incidence of maternal deaths.

scholarly journals Risk Assessment of Morbidity and Mortality in the Neonatal Transport

10.3823/2294 ◽  
2017 ◽  
Vol 10 ◽  
Author(s):  
Geane Estevam Da Silva ◽  
Nilba Lima De Souza ◽  
Cecília Olívia Paraguay de Oliveira Saraiva ◽  
Edualeide Jeane Pereira Bulhões Da Nóbrega ◽  
Maria de Lourdes Costa Da Silva ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Rio Grande ◽  
Neonatal Morbidity ◽  
Cross Sectional Study ◽  
Morbidity And Mortality ◽  
Sectional Study ◽  
Cross Sectional ◽  
Neonatal Transport ◽  
Hospital Transport ◽  
Descriptive Statistical Analysis

Neonatal transport is related to risk, which destabilizes the clinical condition of the newborn. This study aimed to present the assessment of risk of morbidity and mortality of the NB during the inter- and intra-hospital transport in accordance with the TRIPS and ERTIH-Neo scores. Cross-sectional study, descriptive and retrospective, held in the year 2014 in a maternity School, located in Rio Grande do Norte. The data were from the record of 57 transports performed with newborns in the Neonatal Intensive Care Unit. The collected data were submitted to descriptive statistical analysis through absolute and relative frequencies. The results of the TRIPS was possible in only 26% of the population, the majority of the scores were higher than 10. As for intra-hospital transport, there was a predominance of newborns who had obtained a score between 16 and 20. It was concluded that the realization of transport involved risks of neonatal morbidity and mortality.

scholarly journals Delivery Mode Preference and Associated Factors among Pregnant Mothers in Harar Regional State, Eastern Ethiopia: A Cross-Sectional Study

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Fissaha Tekulu Welay ◽  
Berhanu Gebresilassie ◽  
Guesh Gebreayezgi Asefa ◽  
Meresa Berwo Mengesha
Keyword(s):  
Caesarean Section ◽  
Antenatal Care ◽  
Associated Factors ◽  
Caesarean Delivery ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Delivery Mode ◽  
Sectional Study ◽  
Cross Sectional ◽  
Pregnant Mothers

Background. The right to prefer mode of delivery is a crucial component of compassionate and respectful care that fosters both maternal and neonatal well-being as the failure to respect the mother’s interest increases to the risk of maternal depression and posttraumatic stress. Thus, the aim of the study was to assess delivery mode preference and associated factors among pregnant women. Methods and Materials. The study was conducted in two hospitals and two health centers. We used a cross-sectional study design incorporating 398 pregnant mothers attending an antenatal care follow-up from February to May 2018. The study excluded pregnant mothers with any previous uterine surgery including caesarean delivery from participation due to their restricted chance to prefer their mode of delivery. Data were collected by using a pretested questionnaire. Data were entered to EpiData Manager version 3.1 and exported to Statistical Package for the Social Sciences version 22 for analysis. Besides, the analysis included both the bivariate and multivariable analyses to check the association between dependent and independent variables. Finally, level of statistical significance was declared at P value < 0.05. Result. The participant’s level of response was 100% (398). The age of the mothers ranges from 15 to 45 years old. The delivery mode preference of the caesarean section (C/S) and spontaneous vertex delivery (SVD) was 115 (28.9%) and 283 (71.1%), respectively. The study revealed that planned 47 pregnancy [AOR, 1.76; CI: 0.89-3.47], young age [AOR, 12.9; CI: 0.23-7.1], and primigravida [AOR, 1.24; CI: 0.29-5.2] were among the variables associated with maternal preference of caesarean section. Conclusion and Recommendation. Nearly one-third of the mothers preferred caesarean delivery as their mode of delivery due to fear of labor pain and repeated vaginal examination by the care providers. This is particularly seen in women who had received higher education level, claim their pregnancy as planned, their choice of delivery at hospital, young aged, pregnant for the first time, and those who had visited antenatal care repeatedly. This implies that policy makers and stakeholders should exert due emphasis to ongoing desire of caesarean delivery as the procedure is not without risk, if it is done without indication. For researchers, we recommend to investigate the preference of mode of delivery in a much broader aspect.

scholarly journals The Transport and Outcome of Sick Outborn Neonates Admitted to a Regional and District Hospital in the Upper West Region of Ghana: A Cross-Sectional Study

Children ◽  
2020 ◽  
Vol 7 (3) ◽  
pp. 22 ◽  
Author(s):  
Edem M. A. Tette ◽  
Benjamin D. Nuertey ◽  
Dominic Akaateba ◽  
Naa Barnabas Gandau
Keyword(s):  
District Hospital ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Levels Of Care ◽  
Neonatal Transport ◽  
West Region ◽  
Mode Of Transport ◽  
Different Levels ◽  
Travel Distances

Optimum care of sick neonates often involves transporting them across different levels of care. Since their condition may deteriorate over time, attention needs to be paid to travel distances and how they are transferred. We examined the mode of transport, distances travelled, condition on arrival and outcome of outborn neonates admitted to a district and a regional hospital in Ghana using a cross-sectional study involving caregivers of neonates admitted to these hospitals. Information on referral characteristics and outcome were obtained from questionnaires and the child’s case notes. Overall, 153 caregivers and babies were studied. Twelve deaths, 7.8%, occurred. Neonates who died spent a median duration of 120 min at the first health facility they visited compared with 30 min spent by survivors; they travelled mostly by public buses, (41.7%), compared with 36.0% of survivors who used taxis. Majority of survivors, 70.2%, had normal heart rates on arrival compared with only 41.7% of neonates who died; hypothermia was present in 66.7% compared with 47.6% of survivors. These findings indicate that the logistics for neonatal transport were inadequate to keep the neonates stable during the transfer process, thus many of them were compromised especially those who died. Further studies are warranted.

scholarly journals Fetal Outcome in Cesarean Versus Normal Deliveries in Pregnancy with Meconium-stained Liquor: A Cross-sectional Study

2021 ◽  
Vol 19 (1) ◽  
pp. 107-110
Author(s):  
Umesh Chandra Jha ◽  
Ganesh Dangal
Keyword(s):  
Vaginal Delivery ◽  
Neonatal Death ◽  
Neonatal Intensive Care ◽  
Perinatal Asphyxia ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Cross Sectional Study ◽  
Meconium Aspiration Syndrome ◽  
Sectional Study ◽  
Cross Sectional

Background: Intrauterine meconium passage in near term or term fetuses has been associated with feto-maternal stress factors and/or infection and is contributing to the increased rate of cesarean section. This study aimed to evaluate effect of mode of delivery on fetal outcome in pregnancy with meconium-stained liquor.Methods: A cross sectional study was done in 2019 at a tertiary care center. Data was collected from women in labor, in whom meconium was seen after rupture of membrane. Out of these, 115 cases, who underwent cesarean delivery for meconium-stained liquor were enrolled in one group; while in another group 115 cases who delivered vaginally were enrolled and the fetal outcome was compared in between these two groups.Results: Out of 230 cases, most participants were from 21 to 25 years age group. Most of patients were primigravida accounting for 63%, and with mean gestational age of 39.4 weeks. Low Apgar score at one and 5 minutes, percentage of respiratory distress, perinatal asphyxia, need of bag and mask ventilation as mode of resuscitation were associated more with vaginal deliveries. Incidence of Neonatal Intensive Care Unit admission, meconium aspiration syndrome, and neonatal death were seen more in vaginal delivery in comparison to cesarean delivery.Conclusions: There was no much difference in Apgar score at 5 minutes in either mode of delivery. Incidence of respiratory distress, perinatal asphyxia, Neonatal Intensive Care Unit admission, meconium aspiration syndrome and neonatal death were higher in vaginal delivery. Fetal morbidity and mortality were seen more in moderate to thick meconium-stained liquor.Keywords: Cesarean section; fetal outcome; meconium-stained liquor; vaginal delivery

Role of Sildenafil in the Treatment of Persistent Pulmonary Hypertension of Newborn (PPHN) - Should it Be Withdrawn from Market of Bangladesh due to Threat of being Misuses

2020 ◽  
Vol 35 (2) ◽  
pp. 100-104
Author(s):  
Maksudur Rahman ◽  
Mohammad Abdullah Al Mamun ◽  
MAK Azad Chowdhury ◽  
Abu Sayeed Munsi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cardiac Intensive Care Unit ◽  
Cross Sectional ◽  
Cardiac Intensive Care ◽  
Hospital Protocol

Background: Recently it has been apprehended that sildenafil, a drug which has been successfully using in the treatment of PPHN and erectile dysfunction in adult, is going to be withdrawn from the market of Bangladesh due to threat of its misuses. Objective: The aim of this study was to see the extent of uses of sildenafil in the treatment of PPHN and importance of availability of this drugs in the market inspite of its probable misuses. Methods: This cross sectional study was conducted in neonatal intensive care unit (NICU), special baby care unit (SCABU) and cardiac intensive care unit (CICU) of Dhaka Shishu (Children) Hospital from June, 2017 to May 2018. Neonates with PPHN were enrolled in the study. All cases were treated with oral sildenefil for PPHN along with others management according to hospital protocol. Data along with other parameters were collected and analyzed. Results: Total 320 patients with suspected PPHN were admitted during the study period. Among them 92 (29%) cases had PPHN. Male were 49(53 %) cases and female were 43(47%) cases. Mean age at hospital admission was 29.7±13.4 hours. Based on echocardiography,13(14%) cases had mild, 38 (41%) cases moderate and 41(45%) cases severe PPHN. Mean duration of sildenafil therapy was 11.9±7.1 days. Improved from PPHN were 83 (90%) cases. Mortality was 10% (9). Conclusion: In this study it was found that the incidence of PPHN is 29% among the suspected newborns. Sildenafil is successfull in improving the oxygenation of PPHN and to decrease the mortality of neonates. DS (Child) H J 2019; 35(2) : 100-104

Phototherapy Induced Hypocalcemia in Neonates with Unconjugated Hyperbilirubinemia

2021 ◽  
Vol 11 (1) ◽  
pp. 4-8
Author(s):  
Amna Khan ◽  
Anila Farhat ◽  
Hamayun Anwar ◽  
Sajid Shamim ◽  
Mujeeb Ur Rehman ◽  
...  
Keyword(s):  
Serum Calcium ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Neonatal Intensive Care ◽  
Cross Sectional Study ◽  
Categorical Variables ◽  
P Value ◽  
Cross Sectional ◽  
Unconjugated Hyperbilirubinemia ◽  
Before And After

Objective: To determine the frequency of hypocalcemia in neonates with unconjugated hyperbilirubinemia receivingphototherapy.Study design and setting: Cross sectional study conducted at neonatal intensive care unit, King Abdullah Teaching Hospital,Mansehra for one year from December 2017 to November 2018.Methodology: Total 213 full term stable neonates of either gender with jaundice were studied in this study. Out of which,143 with unconjugated hyperbilirubinemia were exposed to phototherapy while 70 neonates with exaggerated physiologicalhyperbilirubinemia taken as control were not exposed to phototherapy. Serum calcium level was determined through bloodtest before and after 24 hours of phototherapy. SPSS version 22 was used to analyze the data. Frequency and percentageswere used to describe categorical variables like gender and hypocalcemia. Hypocalcemia was stratified by age and genderto see effect modifiers. Post stratified chi-square test was applied in which p value = 0.05 was considered as significancevalue.Results: In study group, 143 neonates who received phototherapy had mean age of 7 days ± 2.62 SD. Total 65% neonateswere male and 35% neonates were female. Mean serum calcium level of neonates before and after provision of phototherapywas 9.28 mg/dl ± 0.23 and 8.54 mg/dl ± 0.68 respectively, which is statistically significant. The frequency of hypocalcemiawas 40% in neonates with unconjugated hyperbilirubinemia after 24 hours of phototherapy.Conclusion: Hypocalcemia is an important complication in neonates with unconjugated hyperbilirubinemia after continuousphototherapy. Hypocalcemia has clinical impact and adds to morbidity, and if left untreated, can lead to mortality.

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