scholarly journals Study of morbidity and mortality profile in special care newborn unit at tertiary care teaching institute in Vadodara, Gujarat, India

2018 ◽  
Vol 5 (5) ◽  
pp. 1763 ◽  
Author(s):  
Nimisha K. Pandya ◽  
Kedar G. Mehta
Keyword(s):  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Newborn Care ◽  
Morbidity And Mortality ◽  
Single Digit ◽  
Training Interventions ◽  
Medical College ◽  
Causes Of Mortality ◽  
Area Of Concern

Background: The development of a country is defined by its healthcare status especially the maternal and child health. Neonatal Mortality Rate in India has always been an area of concern again due to logistic issues in implementation of preventive and curative programs in a large and diverse country as ours but has shown a slow but steady fall in the last 2 decades. The current NMR of Gujarat is 25.4/ 1000 live births (2016) which is similar to the national NMR. The goal is to bring down NMR to single digit. Several measures are being taken to address these goals. The objective is to study the morbidity and mortality profile of newborns admitted to the Special Newborn Care Unit at GMERS Medical College and Hospital, Gotri, Vadodara between January 2017 and December 2017.Methods: Retrospective study was carried out at the Special Newborn Care Unit (SNCU), Department of Pediatrics, GMERS Medical College admitted in the period between January 2017 to December 2017. Both inborn and out born admissions were included. Newborns admitted in SCNU were analyzed for causes of morbidity and mortality.Results: 1039 neonates were admitted over a period of 1 year. The gender distribution was 1.5:1 (M: F). 54% admissions were out born. 62% were Low Birth Weight out of which 14% were term SFD vs.86% were premature. Majority of admission in SNCU were Neonatal hyperbilirubinemia 38%, followed by Sepsis in 23%, RDS in 16%, Perinatal asphyxia 15%. Congenital anomalies were reported in 3% newborns. The outcome rates for Survival, LAMA and death were 75%, 06% and 19%. The most common cause for mortality was sepsis (40%) followed by birth asphyxia (21.4%) and RDS (12.2%).Conclusions: The leading cause of morbidity were Sepsis, Birth asphyxia, Respiratory Distress Syndrome and prematurity. Sepsis was the leading causes of mortality in present study followed by Birth asphyxia and RDS. Leading causes of mortality in the study are preventable and curable. Therefore, surveillance and training interventions aimed at management of these causes should be established and strengthened.

MECONIUM STAINED LIQOUR AND ITS IMPACT ON PERINATAL OUTCOME

2021 ◽  
pp. 47-49
Author(s):  
Ranjana Sharma ◽  
Manju Agarwal
Keyword(s):  
Prospective Observational Study ◽  
Perinatal Asphyxia ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
Meconium Aspiration Syndrome ◽  
Morbidity And Mortality ◽  
Medical College ◽  
Increased Risk ◽  
Nicu Admission ◽  
One Year

Background- The occurrence of meconium-stained amniotic uid (MSAF) during labor has long been considered the predictor of adverse fetal outcomes such as meconium aspiration syndrome and perinatal asphyxia, which leads to perinatal and neonatal morbidity and mortality Methods- A Prospective observational study was carried out in Smt. Hira Kunwar Ba Mahila Hospital, Jhalawar attached to Jhalawar Medical College,over one year from January 2020 to January 2021. Total 278 cases taken at random basis having following inclusion criteria Result- MSL is responsible for neonatal morbidity in 15.1% of cases. Rate of neonatal morbidity was higher in thick meconium group (24.9%) as compared to thin meconium group (6.2%) and this difference was statistically signicant. In our study birth asphyxia (5.8%) was the most common complication followed by MAS (4%), Pneumonitis (3.6%) and Sepsis (1.8%). Conclusion- Passage of meconium still remains as an enigma to the obstetrician and equally worries the paediatrician. As shown in the study, thick meconium is associated with increased operative intervention, low apgar score, increased rate of NICU admission and increased risk of neonatal morbidity and mortality as compared to thin meconium.

scholarly journals Pattern of Admission and Outcome in a Neonatal Intensive Care Unit (NICU) of a Tertiary Care Hospital in Dhaka, Bangladesh

2019 ◽  
Vol 10 (2) ◽  
pp. 150-158
Author(s):  
Gule Tajkia ◽  
Syed Khairul Amin ◽  
M Ekhlasur Rahman ◽  
Mumtahina Setu ◽  
Kuntal Roy ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
Medical College ◽  
Disease Pattern

Background: The neonatal period is a highly vulnerable time for an infant completing many of the  physiologic adjustments required for life outside the uterus. As a result, there are high rates of morbidity  and mortality. To reduce morbidity and mortality it is essential to know the neonatal disease pattern.  Neonatal disease pattern changes from time to time and place. Analyzing the neonatal admission pattern  helps the policy makers to make the better strategies and health care givers to serve better. Objectives: This study aimed to determine the disease patterns and outcome of patients admitted to the  Neonatal Intensive Care Unit (NICU) of Anwer khan Modern Medical College Hospital, a tertiary care  hospital in Dhaka, between January 2017 to December 2018. Methods: Retrospective data from the medical records of all neonates admitted during the study period  were reviewed and analyzed for age, weight, sex, reason for admission, duration of hospital stay,  diagnosis and final outcome. Results: The total number of neonates admitted during the study period was 262; 164 were male (62.6%), and  98 were female (37.4%). A total of 223 patients (85.12%) wereborn in the hospital while 39 (12.88%) were  born at home. The majority were admitted during the first 48 hours of life (72.2%). A total of 5 patients (2%)  weighed <1000 gm; 53(20.2%) weighed 1000-1500 gm, and 89 (34%) between 1600-2499 gm. Prematurity  and infection were the main reasons for admission (52.7% and 20%, respectively), followed by birth asphyxia  (12%) and neonatal jaundice (6.8%). A total of 206 patients (78.6%) were improved and discharged, 43 left  against medical advice (16.4%), 3 were referred for urgent cardiac intervention (1.1%) and 10 (3.9%) died. Conclusion: Prematurity, neonatal infection and birth asphyxia were the major causes of neonatal  morbidity and mortality. Anwer Khan Modern Medical College Journal Vol. 10, No. 2: July 2019, P 150-158

scholarly journals Morbidity and mortality profile of neonates admitted in special newborn care unit of a teaching hospital in Uttarakhand, India

2018 ◽  
Vol 7 (1) ◽  
pp. 241 ◽  
Author(s):  
Rakesh Kumar ◽  
Rajlaxmi Mundhra ◽  
Anand Jain ◽  
Suchitra Jain
Keyword(s):  
Tertiary Care ◽  
Medical Science ◽  
Birth Asphyxia ◽  
Newborn Care ◽  
Meconium Aspiration Syndrome ◽  
Study Data ◽  
Morbidity And Mortality ◽  
Treatment Protocols ◽  
Mortality And Morbidity ◽  
Tertiary Care Centers

Background: India accounts for 24% of global neonatal mortality. It is important to study the mortality and morbidity pattern as it helps to implement new treatment protocols, interventions, planning and policy making which helps in better survival and improvement in the quality of life among survivors. The aim of the project study was to determine the causes of morbidity and mortality in neonates admitted in our hospital.Methods: This study was conducted at Special Newborn Care Unit (SNCU) of Veer Chandra Singh Garhwali Government Institute of Medical Science and Research providing level II neonatal care. This is a retrospective hospital based observational study. Data from admission and discharge registers were extracted, compiled and analyzed from March 2016 to February 2018. Neonates taken against medical advice and those referred to tertiary care centers were excluded in calculation of survival outcome. Statistical analysis was done in form of percentage, proportions and chi square test was used to find statistical significance.Results: 1582 neonates were admitted during the study period. 60.80% were inborn and 39.20% were outborn. 59.54% were male and 40.46% were female. Major causes of admission were jaundice (24.72%), sepsis (20.48%), birth asphyxia (18.52%), meconium aspiration syndrome (10.11%). Birth asphyxia was the major cause of mortality, followed by sepsis and prematurity. Mortality was more in outborn babies 14.67% compared to inborn babies 9.80%.Conclusions: Neonatal jaundice, birth asphyxia and sepsis were the commonest causes of morbidity. Common causes of mortality were birth asphyxia and sepsis and prematurity. More deliveries at institutions with SNCU facility, early identification of danger signs and timely referral to tertiary care centers can prevent neonatal deaths.

scholarly journals Morbidity and mortality pattern among babies admitted in special newborn care unit, Nellore, Andhra Pradesh, India

2019 ◽  
Vol 6 (5) ◽  
pp. 1898
Author(s):  
Lakshmi Prasanna Chintha ◽  
Suneetha Bollipo ◽  
Ravi Prabhu Gottumukkala ◽  
Sathya Prakash Palepu
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Neonatal Mortality ◽  
Andhra Pradesh ◽  
Distress Syndrome ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Newborn Care ◽  
Morbidity And Mortality ◽  
Care Teaching

Background: India contributes to 25% of neonatal mortality around the world. In developing countries neonatal mortality is quite high despite of advances in perinatal and neonatal care. The establishment of Special Newborn Care Units (SNCU) has been quite essential in reducing the neonatal morbidity and mortality. This study was conducted to assess the outcome of SNCU at a newly commissioned tertiary care teaching hospital at Nellore District, Andhra Pradesh. Aim of this study the morbidity and mortality patterns in an SNCU at tertiary care teaching hospital.Methods: It was a Retrospective, Hospital based, Descriptive study which was done among neonates admitted to SNCU, Nellore District, Andhra Pradesh for a period of 1 year (January 2015-December 2015). All the neonates admitted to SNCU, Nellore District, Andhra Pradesh during the study period were included in the study. Data was recorded in a predesigned semi-structured proforma. the data was entered into excel-sheet and analyzed using SPSS software version 21.Results: A total of 1015 babies were included in the study. Almost half 592(58.32%) were born in this hospital(inborn) and 423(41.67%) babies were referred from peripheral hospitals and nursing homes (out born). about 3/4th 767(75.5%) of babies were admitted in the first 24 hours of life. Almost half (53.4%) of the study group were male and 46.6% were female. The chief causes of admission in SNCU were Respiratory Distress Syndrome (40.2%) followed by birth asphyxia (19.1%), sepsis (13.3%), Neonatal Jaundice (9.9%) and prematurity (6.6%). In our study 63.0% patients were discharged, 19.3% had left hospital against medical advice, 10.1% died and 7.6% were referred to other institutions for specialized treatment.Conclusion: Respiratory Distress Syndrome, neonatal sepsis, neonatal hyperbilirubinemia, and HIE as the major causes of morbidity. Low Birth Weight and prematurity were the commonest contributors of death, therefore, attempts to prolong the pregnancy each week might improve the neonatal outcome considerably.

scholarly journals Outcomes and analysis of fetomaternal elements and delivery strategies with neonatal respiratory distress

2021 ◽  
Vol 10 (5) ◽  
pp. 2001
Author(s):  
Sambedna . ◽  
Amit Kumar ◽  
Rita Chakore
Keyword(s):  
Gestational Age ◽  
Significant Relationship ◽  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Morbidity And Mortality ◽  
Delivery Mode ◽  
Study Group ◽  
Maternal Factor

Background: Perinatal asphyxia is one of the most important causes of morbidity and mortality in neonates. Perinatal asphyxia occurs in association with different maternal and fetal determinants. However, the relation of associated factors with perinatal asphyxia is not well studied. The aim of this study was to determine the association of maternofetal factors and mode of delivery with perinatal asphyxia in a tertiary care centre.Methods: This was a retrospective comparative study conducted in department of OBG in tertiary care health centre. A total 200 newborns were selected for study out of which100 newborns were with asphyxia at birth as study group and 100 non asphyxiated newborns were taken as control group. Maternal factor like age, parity, gestational age and fetal factor like weight at birth and mode of delivery were studied to established association on perinatal asphyxia.Results: Maternal factor like age, parity, gestational age had not significant relationship with perinatal asphyxia. Maximum number of babies delivered in both control and the study group were in the range of 2.6 to 3kg.In this study birth weight did not have significant relationship with perinatal asphyxia. Proportions of LSCS was comparatively higher in the study group though. The delivery mode did not have any statistically significant influence on the newborns affliction with birth asphyxia (p>0.05).Conclusions: Findings of this study highlight the need for the better obstetrical care and awareness of the possible presence of the risk factors of PNA (perinatal asphyxia) among mothers and fetus, so that the incidence and complications of PNA could be prevented or at least appropriately managed. It can reduce the high incidence of morbidity and mortality due to birth asphyxia. 

MATERNOFETAL OUTCOME IN MECONIUM STAINED LIQUOR AT TERTIARY CARE HOSPITAL

2021 ◽  
pp. 48-50
Author(s):  
Neha Agarwal ◽  
Samta Bali Rathore ◽  
Shivani Baberwal-
Keyword(s):  
Caesarean Section ◽  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
Care Hospital ◽  
Pregnancy Induced Hypertension ◽  
Meconium Aspiration ◽  
Induced Hypertension

BACKGROUND: Occurance of meconium-stained amniotic uid (MSAF) during labour may be considered as a measure for prediction of poor fetal outcomes such as meconium aspiration syndrome and perinatal asphyxia ,resulting in perinatal as well as neonatal morbidity and mortality. It constitutes about 5% of deliveries with meconium stained amniotic uid and death results in about 12% of infants with MAS. METHODS: 40 cases of meconium stained liquor detected after spontaneous or artical rupture of membranes taken during labour from june 2020 to december 2020 and their outcome in terms of mode of delivery(whether vaginal delivery or lower segment caesarean section) and fetal outcome and associated maternal high risk were studied RESULT: Anemia was co existant in around 15%, pregnancy induced hypertension(PIH) in 25%and premature rupture of membrane in 10%.Pregnancies complicated with Pregnancy induced hypertension had signicant higher rate of meconium stained liquor among all cases. Caesarean Section was commonly performed in meconium stained amniotic uid cases and accounted for about 65%of all cases. CONCLUSIONS: Meconium Stained amniotic uid increases the chances of caesarean rates,leading to birth asphyxia ,Meconium Aspiration Syndrome and hence increases the chances of neonatal intensive unit admission.

scholarly journals A prospective case control study of the effects of oligohydramnios on fetomaternal outcome in mothers with term pregnancy in a rural medical college

2018 ◽  
Vol 7 (11) ◽  
pp. 4706
Author(s):  
Dipak Mandi ◽  
Sayantan Sen ◽  
Vasundhara Goswami
Keyword(s):  
Demographic Data ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Case Control ◽  
Control Group ◽  
Case Group ◽  
Perinatal Complications ◽  
Medical College ◽  
Increased Risk ◽  
Nicu Admission

Background: The aim of the current study was to assess the fetomaternal effects of oligohydramnios on term pregnancies in a rural tertiary care setup.Methods: A perspective case control hospital-based trial was conducted at Burdwan Medical College and Hospital for a period of one year. Pregnancies at term (37-42 weeks) were included in the study. 103 patients with sonographically diagnosed oligohydramnios were included in the case group. The control group comprised of 103 mothers at term with normal liquor volume. Demographic data and fetomaternal outcome parameters were assessed and compared.Results: There was increased incidence of fetal and perinatal complications including low birth weight, birth asphyxia and NICU admission. There were more perinatal deaths in the case group compared to the control group. Induction of labour, operative delivery, meconium stained liquor and incidence of preeclampsia were also increased in mothers with low AFI.Conclusions: Oligohydramnios is associated with an increased risk of labour and perinatal complications. Adequate antenatal surveillance and intranatal monitoring coupled with correction of underly-ing factors is the mainstay of management.

scholarly journals A profile on the spectrum of neonatal mortality and morbidity pattern of extramural neonates in the Specialised Neonatal Care Unit (SNCU) in a tertiary care hospital

2018 ◽  
Vol 5 (2) ◽  
pp. 427 ◽  
Author(s):  
Anuradha D. ◽  
Rajesh Kumar S. ◽  
Aravind M. A. ◽  
Jayakumar M. ◽  
J. Ganesh J.
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Respiratory Distress ◽  
Neonatal Mortality ◽  
Low Birthweight ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Newborn Care ◽  
Care Hospital ◽  
Neonatal Deaths

Background: Every year, nearly four million newborn babies die in the first month of life. India carries the single largest share (around 25-30%) of neonatal deaths in the world. Neonatal deaths constitute two thirds of infant deaths in India. 45% of the deaths occur within the first two days of life. It has been estimated that about 70% of neonatal deaths could be prevented if proven interventions are implemented effectively at the appropriate time. It was further estimated that health facility-based interventions can reduce neonatal mortality by 23-50% in different settings. Facility-based newborn care, thus, has a significant potential for improving the survival of newborns in India. This research has been planned with an aim to study the profile of pattern of admissions in a SNCU and their outcomes following admission and management in the unit.Methods: All babies referred for neonatal problems (less than 28 days) and admitted in NICU will be included. Both term and preterm babies will be considered. The criteria for admission includes various causes like low birth weight, preterm, birth asphyxia, respiratory distress, hyperbilirubinemia, congenital anomalies, risk factors (maternal, neonatal, prenatal), infections and outcome will be analysed.Results: Among the 2927 admissions term babies and boys outnumbered. The common causes for admission were birth asphyxia, respiratory distress, low birthweight and preterm. Most babies had an uncomplicated stay. The mortality in the extramural neonates was due to neonatal sepsis, extreme preterm and congenital malformations.Conclusions: Intensive and interventional management, along with good neonatal monitoring and care can reduce the mortality and improve the survival of low birth weight babies and other treatable problems. Thus, a combined effort of management by pediatricians, nursing care, neonatal intensive care unit can improve the survival rates of neonates.

scholarly journals Clinical Profile of Neonates with Perinatal Asphyxia in a Tertiary Care Hospital of Central Nepal

2014 ◽  
Vol 52 (196) ◽  
pp. 1005-1009
Author(s):  
Sweta Kumari Gupta ◽  
Bhawani Kanta Sarmah ◽  
Damodar Tiwari ◽  
Amshu Shakya ◽  
Dipendra Khatiwada
Keyword(s):  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Clinical Information ◽  
Clinical Problem ◽  
Presentation Mode ◽  
Care Hospital ◽  
Central Nepal ◽  
Bag And Mask Ventilation

Introduction: Birth asphyxia is a serious clinical problem worldwide. It claims approximately 9 million deaths each year. It can lead to serious neurological sequaele, such as cerebral palsy, mental retardation, and epilepsy. Methods: All babies admitted in College of Medical Sciences Teaching Hospital, Chiwan, Nepal, NICU from January 2013 to December 2013 with a diagnosis of birth asphyxia (5 min Apgar<7 or those with no spontaneous respirations after birth) were included in the study (n=125). This was a descriptive observational study. Clinical information was collected (gravida, hour at presentation, mode of delivery, sex of baby, gestational age of the baby, requirement of resuscitation). Neonates were admitted to NICU, observed for complications and managed as per hospital protocol. Results: Among the 722 neonates admitted to NICU, 125 had perinatal asphyxia (17.3%). Babies with Hypoxic ischemic encephalopathy(HIE) Grade I had a very good outcome but HIE III was associated with a poor outcome. Outborn neonates had higher grades of perinatal asphyxia as compared to inborns (p=0.018). Term gestation, Males and Multigravida were associated with a higher rate of birth asphyxia. 22.4% neonates were delivered via caesarean section and 74.4% required bag and mask ventilation at birth. Conclusions: Birth asphyxia was one of the commonest causes of admission NICU. Babies with HIE Grade III had a very poor prognosis. Outborn neonates with birth asphyxia had a higher mortality. Males were frequently affected than females.  Keywords: birth asphyxia; HIE; mortality; measurement.

scholarly journals Perinatal Characteristics and Outcome of Neonates at NICU of a Tertiary Level Hospital in Bangladesh

2017 ◽  
Vol 41 (1) ◽  
pp. 34-39
Author(s):  
Mohammod Shahidullah ◽  
M Zahidul Hasan ◽  
Ismat Jahan ◽  
Firoz Ahmed ◽  
Arjun Chandra Dey ◽  
...  
Keyword(s):  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Substantial Reduction ◽  
Birth Asphyxia ◽  
Tertiary Care Centre ◽  
Neonatal Deaths ◽  
Development Goals ◽  
Medical University ◽  
Mdg 4 ◽  
Level Hospital

Background: One of the Millennium Development Goals (MDG-4) is to reduce child mortality up to two-thirds by 2015. In most developing countries, a higher proportion of neonatal deaths are observed. It has been recognized that without a substantial reduction in neonatal deaths, MDG-4 will not be met.Objective: To assess the perinatal characteristics, pattern of admissions and outcome of neonates in a tertiary care centre in Bangladesh.Methods: A retrospective review of consecutive neonatal admissions to Bangabandhu Sheikh Mujib Medical University, between January and December 2013, was conducted. Data were collected from the neonatal admission, discharge and death registers. Standard definitions of the conditions were used to diagnose the clinical conditions.Results: Total 683 neonates were admitted to the NICU. Among them 56.1% were inborn and males were 56.8%. Total 61.3% neonates were low birth weight and 60.3 % were preterm. The overall cesarean section rate was 61.9%. Total 35.3% neonates had sepsis and perinatal asphyxia was present in 16.8% neonates. Congenital anomaly was present in 17.6% neonates. The mean duration of hospital stay was 11.1 days and overall mortality rate was 14.9%.Conclusion: Prematurity, neonatal infections, birth asphyxia and congenital anomalies were the main causes of neonatal hospital admission and neonatal deaths in this study.Bangladesh J Child Health 2017; VOL 41 (1) :34-39

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