scholarly journals Evaluation of risk factors for perinatal asphyxia in a tertiary care hospital in Bangalore: an observational prospective study

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 (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. 


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.


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. 


2021 ◽  
pp. 48-50
Author(s):  
Neha Agarwal ◽  
Samta Bali Rathore ◽  
Shivani Baberwal-

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.


2006 ◽  
Vol 21 (9) ◽  
pp. 795-798 ◽  
Author(s):  
Deborah A. Hall ◽  
R. Paul Wadwa ◽  
Neil A. Goldenberg ◽  
Jill M. Norris

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.


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