scholarly journals Clinical Profile and Outcome of Asphyxiated Newborn in a Medical College Teaching Hospital

2016 ◽  
Vol 4 (1) ◽  
pp. 1
Author(s):  
Kiran Panthee ◽  
Kiran Sharma ◽  
Balkrishna Kalakheti ◽  
Kul Thapa

Introduction: Perinatal asphyxia, a major topic in neonatology, is a severe condition which has a high impact on neonatal mortality and morbidity and neurological and intellectual development of the infant. It is defined by WHO as "failure to initiate and sustain breathing at birth". It is estimated that around four million babies are born asphyxiated and among those one million die and an equal number of babies develop serious neurological consequences ranging from cerebral palsy and mental retardation to epilepsy. This study was done to identify the occurrence, clinical profile and, immediate outcome of perinatal asphyxia in Lumbini Medical College Teaching Hospital.   Methods: It was a retrospective study where 82 cases who fulfilled the inclusion criteria were included between December 2014 to November 2015. Inclusion criteria included newborns with: a) Apgar score equal to or less than six at five minutes, b) requirement of  more than one minute of positive pressure ventilation, c) signs of fetal distress (heart rate of less than 100 beats per minute, late decelerations).   Results: Out of total 425 neonatal intensive care unit (NICU) admissions, 82 (19.3%) cases were of asphyxia among which 56 were inborn and 26 were referred from outside. Of those 82 cases, 47 (57.3%) cases developed hypoxic ischemic encephalopathy (HIE); HIE stage I had good outcome with survival rate of 95% and HIE stage III had poor outcome with survival rate of only 25%.   Conclusion: Despite advances in management of neonates, perinatal asphyxia is still the leading cause of neonatal intensive care unit admission and mortality and morbidity in neonates.

2019 ◽  
Vol 57 (216) ◽  
Author(s):  
Sunil Raja Manandhar

Introduction: Respiratory distress is one of the commonest problem seen in neonates during admission in Neonatal Intensive Care Unit. Hyaline Membrane disease, Meconium Aspiration Syndrome, septicemia, congenital pneumonia, Transient Tachypnea of Newborn are the major causes of respiratory distress in neonates. Bubble Continuous Positive Airway Pressure is a non-invasive respiratory support delivered to a spontaneously breathing newborn to maintain lung volume during expiration. The main objective of this study was to observe the outcome of respiratory distress in neonates with Bubble Continuous Positive Airway Pressure. Methods: This was a descriptive cross-sectional study conducted at Kathmandu Medical College Teaching Hospital over six months (October 2018 – March 2019) period. All preterm, term and post term babies with respiratory distress were included. Ethical clearance was received from Institutional Review Committee of Kathmandu Medical College and statistical analysis was done with SPSS 19 version. Results: Sixty three babies with respiratory distress were included in this study with 45 (71%) male predominance. The mean birth weight receiving Bubble Continuous Positive Airway Pressure was 2661.75±84 gms and gestational age was 36.67±3.4 wks. The Bubble Continuous Positive Airway Pressure was started at 8.05±2 hr of life and duration of Bubble Continuous Positive Airway Pressure required for settling respiratory distress was 95.71±3 hrs. Out of 63 babies, improvement of respiratory distress in neonates with Bubble Continuous Positive Airway Pressure was 39 (61%) with confidence interval of (38-62) whereas 24 (39%) babies required mechanical ventilation and other modalities. Conclusions: This study concludes usefulness of Bubble Continuous Positive Airway Pressure in neonates with respiratory distress.


2021 ◽  
Vol 14 (1) ◽  
pp. 24-28
Author(s):  
Namrata K.C. ◽  
Bandana Shrestha ◽  
Arjun Bhattarai ◽  
Shankar Paudel ◽  
Nabraj Subedi

Background: The objective of this study was to determine the disease pattern and outcome of diseases in neonatal intensive care unit (NICU) as the common causes of mortality and morbidity in our region are preventable. Methods: The retrospective study was carried out in 1041 newborns admitted from 1st August 2019 to 30th July 2020 in Gandaki Medical College Teaching Hospital in Western Nepal. Age, sex, gestational age, diagnosis at admission, outcome of admitted newborns were the main variables under study. Data was entered and analyzed using SPSS 20 version. Result: Among 1041 newborns, 599 (57.54%) were male and 442(42.46%) were female. 1028(98.75%) were born in hospital while 8(0.77%) were born at home and 5(0.48%) in ambulance. The majority 610 newborns were admitted during the first 24 hours of life. Infection and hyperbilirubinemia were the main reasons for admission (44.96% and 23.15 % respectively), followed by prematurity (9.51%) and Birth Asphyxia (9.13%). A total of 831patients (79.83%) were improved and discharged, 79(7.59%) were discharged on request, 61(7.59%) left against medical advice, 34 (3.26) were referred and 36 (3.46%) expired. The major causes for neonatal mortality were prematurity (44.45%), Sepsis (27.78%), and Birth Asphyxia (13.89%) respectively. Among the expired neonates, 24(66.67%) were outborns and 12(33.33%) were inborns and majority 27(75%) expired at the age between 24-48 hours of life. Conclusions: Infection was the leading cause of morbidity and prematurity the leading cause of mortality in the neonatal care unit. This is preventable with antenatal care, training of manpower and procurement of necessary equipments.


2015 ◽  
Vol 69 (1) ◽  
pp. 20-25
Author(s):  
Silvana Naunova-Timovska

Abstract Introduction. Acute kidney injury is a serious condition which damages the kidney as a central mediator of the homeostasis of bodily fluids and electrolytes. It is not a rare problem in the intensive care units, particularly in the neonatal population. Perinatal asphyxia is a common predisposing factor associated with neonatal kidney injury. The aim of this study was to determine the characteristics of acute kidney injury in newborns from neonatal intensive care unit and to explore the association with perinatal asphyxia. Methods. The study was conducted at the Children’s University Hospital in Skopje, R. Macedonia. It was a clinical, prospective study. In the period of two years (January 2013 to December 2014) 29 patients hospitalized at the Neonatal Intensive Care Unit (NICU) with documented neonatal kidney injury were analyzed. Medical data records of admitted neonates with kidney injury were analyzed. The material was statistically analyzed using methods of descriptive statistics. Results. We evaluated 29 neonates with documented acute kidney injury who at the period of 2 years were treated in NICU. The prevalence of kidney injury was 6.4%. Most of involved neonates were born at term (66%). Prerenal injury was evaluated in 80% of cases. Perinatal asphyxia was the most common predisposing factors for kidney injury in our study, revealed in 56% of cases with predominance of term-infants and male gender. Sepsis was present in 44% of cases, prematurity in 34%, and congenital malformation in 27% of cases. Mortality rate was 27.5% and it was higher in patients with assisted ventilation and sepsis. Conclusion. Perinatal asphyxia is a dominant predisposing factor associated with neonatal kidney injury. Often, the occurrence of kidney damage in the neonatal population is multifactorial (more than 40%) and caused by several associated comorbidities


2013 ◽  
Vol 33 (3) ◽  
pp. 177-181 ◽  
Author(s):  
Gauri Shankar Shah ◽  
Satish Yadav ◽  
Anil Thapa ◽  
Lokraj Shah

Introduction: Neonatal period is the most susceptible period of life due to different causes, which in most cases are preventable. Every year millions of neonates are born and a large proportion of them are admitted to the neonatal intensive care unit (NICU) for various indications. One of the Millennium Development Goals is to reduce under five mortality by two thirds by 2015. Therefore, this study was conducted to identify the clinical profile, pattern of diseases and common causes of mortality and morbidity in neonates admitted to NICU. Materials and Methods: A retrospective study was conducted at level III Neonatal NICU of a tertiary -care teaching hospital from January, 2012 to December, 2012. Results: Total of 361 neonates were admitted in NICU. Eighty six neonates (23.8%) were admitted due to prematurity and 73 (20.2%) with birth asphyxia. Among birth asphyxia, 40(54.8%)were in HIE III, 27.4% and 17.8% in HIE II and HIE I, respectively. One hundred eighteen (32.6%) cases were diagnosed as sepsis. The overall mortality was 20.2% during hospital stay. Conclusions: Sepsis, prematurity and birth asphyxia were major causes for admission in NICU. All these etiologies are preventable up to some extent and, if detected earlier, can be effectively treated in order to reduce morbidity and mortality. DOI: http://dx.doi.org/10.3126/jnps.v33i3.8447   J. Nepal Paediatr. Soc. 2013;33(3):177-181


PEDIATRICS ◽  
2008 ◽  
Vol 122 (5) ◽  
pp. e1048-e1052 ◽  
Author(s):  
T. D. Soltau ◽  
W. A. Carlo ◽  
J. Gee ◽  
J. Gould ◽  
N. Ambalavanan

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