scholarly journals Factors Associated with Increased Neonatal Deaths at a Regional Hospital in Namibia

2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Million Bimerew ◽  
Saara K. Hatupopi ◽  
Jennifer Chipps
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Neonatal Sepsis ◽  
Distress Syndrome ◽  
Congenital Abnormalities ◽  
Survey Design ◽  
Birth Asphyxia ◽  
Regional Hospital ◽  
Record Keeping ◽  
Neonatal Deaths

The increased neonatal mortality rate in a regional hospital in Namibia is a concern. According to the 2013 records of the hospital, there were 333 neonatal deaths from 1 January to 31 December 2013. The aim of the study was to investigate the causes of the increased neonatal deaths at this regional hospital in Namibia. A retrospective descriptive survey design was employed to conduct the study. Data were collected from 231 record files of neonates that died from 1 January to 31 December 2013 while admitted at the regional hospital before 28 completed days of life. The results shows that 67.1 per cent (n = 155) neonates that died in the regional hospital were during the first 7 days of life, and 32.9 per cent (n = 76) died after 7 days of life but before 28 completed days of life. Five causes accounted for the early neonatal deaths: respiratory distress syndrome, congenital abnormalities, neonatal sepsis, birth asphyxia, and haemorrhagic diseases of newborns. The late neonatal deaths were mainly caused by neonatal sepsis, followed by respiratory distress syndrome, congenital abnormalities, and birth asphyxia. The results also indicated poor record-keeping as an associated factor in this regional hospital. The study finally concluded that the majority of neonatal deaths that occurred in 2013 at the regional hospital were associated with multiple factors such as respiratory distress syndrome, neonatal sepsis, asphyxia, and congenital abnormalities. However, the majority of these factors could have been avoided.

PHYSIOLOGY OF RESPIRATION IN NEWBORN INFANTS AND IN THE RESPIRATORY DISTRESS SYNDROME

PEDIATRICS ◽  
1959 ◽  
Vol 24 (6) ◽  
pp. 1069-1101
Author(s):  
L. Stanley James
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Newborn Infants ◽  
Clinical Signs ◽  
Birth Asphyxia ◽  
The Body ◽  
Normal Lung ◽  
Term Infants ◽  
Lung Expansion

To improve our understanding of the respiratory distress syndrome, the importance of early examination of the infant, preferably at delivery, cannot be overemphasized. An attempt should be made to estimate clinically the degree of birth asphyxiation by a method such as the Apgar Score. The nature of respirations as well as the rate should be noted, particularly retractions and grunting. Decreased response to stimuli or poor tone, and a low blood pressure are significant signs. In this review, a number of comparisons have been drawn, including evidence from adult medicine or animal experiments. While these may appear unrelated, irrelevant or unduly speculative, they have been introduced for several purposes: to draw attention to aspects of the syndrome other than respiratory distress; to acquaint the general reader with more recent physiology which is deemed pertinent; and to emphasize the importance of relating one system to another, especially respiration to circulation. Many of the studies of respiratory function point to cardiac as well as pulmonary failure, notably the need for oxygen in the presence of a normal tidal and increased minute volume. Other circumstantial evidence of cardiac failure is abundant. Asphyxia appears to play a central role, affecting almost every system in the body and every phase of metabolism. It is probably responsible for the normal or low venous pressures occurring with a failing myocardium. It also accounts for the higher incidence of respiratory distress in the smaller prematures who are unable to achieve and maintain normal lung expansion. The syndrome is uncommon in larger full-term infants and in these instances is associated with obstetrical complications causing more severe degrees of birth asphyxia. The clinical picture includes a number of variations depending upon whether respiratory depression or symptoms relating to the central nervous or gastrointestinal systems predominate. Nevertheless, diagnosis of the respiratory distress syndrome should rely not on the presence or absence of membranes at necropsy, but rather on the history, symptoms and clinical signs. Inasmuch as asphyxia is not a disease, it would seem more logical to regard the syndrome as a failure in adaptation to extrauterine life. Failure to comprehend the many adaptations which newborn infants must make, both cardiopulmonary and biochemical, together with a narrow view centering only around the hyaline membranes, have for so many years cloaked this syndrome with mystery. Physiologic measurements in sick infants are difficult, and many of the determinations and calculations arduous. Some of the studies require confirmation, and others remain to be done, employing new or improved technics which are free from disadvantages of older methods. Because of many variables, caution should be exercised in drawing conclusions from a small number of cases. Early pioneering work has contributed greatly and has paved the way for future investigations. The value of serial studies correlated with careful clinical observations in order that the precise nature of a dynamic process may be more fully revealed has been clearly shown.

scholarly journals Postnatal causes and severity of persistent pulmonary Hypertension of Newborn

2021 ◽  
Vol 37 (5) ◽  
Author(s):  
Muhammad Sohail Arshad ◽  
Mudasser Adnan ◽  
Hafiz Muhammad Anwar-ul-Haq ◽  
Arif Zulqarnain
Keyword(s):  
Pulmonary Hypertension ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Gestational Age ◽  
Distress Syndrome ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
Persistent Pulmonary Hypertension ◽  
High Morbidity ◽  
Meconium Aspiration

Background & Objective: Persistent pulmonary hypertension of the newborn (PPHN) is described as severe respiratory failure along with hypoxaemia. PPHN is known to be linked with high morbidity and mortality around the world. This study was planned to determine the postnatal causes and assess the severity of persistent pulmonary hypertension of newborn in babies presenting to the Children’s Hospital, Multan. Methods: This observational study was conducted at the Department of Paediatric Cardiology, The Children Hospital &Institute of Child Health, Multan, Pakistan from July to December 2019. A total of 122 confirmed cases of PPHN admitted having gestational age above 34 weeks were enrolled. Demographic data of the newborns was recorded along with maternal medical history, pregnancy status and postnatal causes of PPHN. Severity of PPHN was also recorded. Results: Out of a total of 122 cases of PPHN, 81 (66.3%) were male. Majority, 78 (64.0%) had gestational age above 37 weeks. Mode of delivery as cesarean section was noted in 70 (57.4%). Meconium aspiration syndrome 52 (42.6%), birth asphyxia 48 (39.3%), respiratory distress syndrome 23 (18.8%) and sepsis 33 (27.0%) were found to be the commonest causes of PPHN. Severe PPHN was found to be the most frequent, noted among 63 (51.6%) while Moderate PPHN was observed in 40 (32.8%) and Mild PPHN in 19 (15.6%). Morality was noted among 26 (21.3%) of cases. Conclusion: Meconium aspiration syndrome, birth asphyxia and respiratory distress syndrome were the commonest postnatal causes of PPHN. Severe PPHN was found to be the most frequent form of PPHN. doi: https://doi.org/10.12669/pjms.37.5.2218 How to cite this:Arshad MS, Adnan M, Anwar-ul-Haq HM, Zulqarnain A. Postnatal causes and severity of persistent pulmonary Hypertension of Newborn. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.2218 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Descriptive study for neonatal death in neonatal care unit in maternity and children teaching hospital in Aldiwaniah, Iraq

2018 ◽  
Vol 9 (SPL1) ◽  
Author(s):  
Abdulaziz Wannas Abd ◽  
Mahmood Jasim Mohammed
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Premature Infants ◽  
Teaching Hospital ◽  
Neonatal Death ◽  
Distress Syndrome ◽  
Neonatal Care ◽  
Common Cause ◽  
Neonatal Deaths ◽  
Neonatal Care Unit

Of the estimated 130 million infants born each year worldwide,1 4 million die in the first 28 days of life. Three-quarters of neonatal deaths occur in the first week, and more than one-quarter occur in the first 24 hours.1,2 Neonatal deaths account for 40% of deaths under the age of 5 years worldwide. This study was descriptive-analytical prospective one and the population of the study included all infants hospitalized in NICU of maternity and children teaching hospital in aldiwaniah governorate from first of  September 2013  to the end  of august 2014.  About 1644 neonate  patients was  admitted to the neonatal care unit directly either from the labor room or from the operation room and the neonate only in contact with health personnel ; from those we study all  193  hospitalized neonates that  died due to different causes. In this study, of 1466 neonates , were hospitalized in NICU (neonatal intensive care unit ) in maternity and children teaching hospital from first of  September  2013 through  august  2014 ;  from which 193 ( 13.1%  )cases were died . A total of 193infants died in the hospital form which 64.25%  were male and ( 35.75% )of them were female. ; 36.8% of them were full term  and 63.2 % were premature . the most common cause of the neonatal death were the RDS (respiratory distress syndrome) 93 (48.1%) and the second most common cause were the complication of prematurity other than the RDS which form55( 28.4%  ). The birth asphyxia, congenital anomalies and sepsis represent 15 ( 7.7 %  ),  8 (4.1%) , 11 ( 5.6% ) respectively. the meconium aspiration syndrome mainly in postmature infant represent about 9 (4.6 % )and miscellaneous causes( hydrops fetalis and intraventriculer haemorrhage and congenital heart disease ) was 3  ( 1.5 %) .  The common cause of neonatal death was sever immaturity with its complications and mainly the respiratory distress syndrome. Almost the death occur in premature and LBW babies. We can prevent of born these babies by high quality prenatal care. The study proves the relations between certains maternal and neonatal factors and neonatal mortality; since low-weight premature infants are at more risk of dying in infancy, it is suggested that pregnant mothers should be placed under the required cares to avoid the birth of premature infants as possible.

scholarly journals Morbidity profile of infants of mothers with gestational diabetes admitted to a tertiary care centre

2017 ◽  
Vol 4 (3) ◽  
pp. 960
Author(s):  
Devi Meenakshi K. ◽  
Narayana Babu R. ◽  
Srinivasan Padmanaban
Keyword(s):  
Gestational Diabetes ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Tertiary Care Centre ◽  
Insulin Group ◽  
Increased Risk ◽  
Meal Plan

Background: Infants born to mothers with gestational diabetes are at increased risk of neonatal morbidities like birth trauma, hyperbilirubinemia, hypoglycemia, birth asphyxia etc., Maternal glycemic control has been one of the parameters that determines the occurrence of these problems.Methods: A retrospective study done by analysing the case records of babies born to mothers with gestational diabetes and admitted to the NICU of Govt Kilpauk Medical college from January 2015 to December 2015. The morbidity profile of infants born to mothers with gestational diabetes was analysed and comparison was made between the two groups namely mothers who were managed by meal plan and those who were managed by insulin.Results: About 198 babies were analysed majority were delivered by caesarean section (83%). Only 2 babies (1%) weighed more than 4000gms. The commonest morbidity observed was hyperbilirubinemia (24.2%) which was 27.7% in the insulin group as against 19% in the group on meal plan. The next common morbidity was sepsis (15.2%). This was also common in insulin group 18.5% as against 10.1% in the meal group. Others were hypoglycemia (4%), congenital heart disease (2.5 %) and respiratory distress syndrome (1.5 %).Conclusions: Babies born to mothers with gestational diabetes were found to have morbidities like hyperbilirubinemia and sepsis. Less commonly found morbidities were hypoglycemia, birth asphyxia, respiratory distress syndrome etc., Though the morbidities were more common among insulin group as compared to the group on meal plan this difference was not statistically significant. 

scholarly journals Causes of Preterm and Low Birth Weight Neonatal Mortality in a Rural Community in Kenya: Evidence From Verbal and Social Autopsy

2020 ◽  
Author(s):  
Beatrice Olack ◽  
Nicole Santos ◽  
Mary Inziani ◽  
Vincent Moshi ◽  
Polycarp Oyoo ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Neonatal Mortality ◽  
Distress Syndrome ◽  
Neonatal Period ◽  
Preterm Neonates ◽  
Neonatal Deaths ◽  
Social Autopsy

Abstract BackgroundUnder-five mortality in Kenya has declined over the past two decades. However, the reduction in the neonatal mortality rate has remained stagnant. In a country with weak civil registration and vital statistics systems, there is an evident gap in documentation of mortality and its causes among low birth weight (LBW) and preterm neonates. We aimed to establish causes of neonatal LBW and preterm mortality in Migori County, among participants of the PTBI-K (Preterm Birth Initiative-Kenya) study.MethodsThis was a cross sectional study whereby Verbal and social autopsy (VASA) interviews were conducted with caregivers of deceased LBW and preterm neonates delivered within selected 17 health facilities in Migori County, Kenya. The probable cause of death was assigned using the WHO International Classification of Diseases (ICD-10). ResultsBetween January 2017 to December 2018, 3175 babies were born preterm or LBW, and 162 (5.1%) died in the first 28 days of life in 17 participating health facilities in the PTBI-K project. VASA was conducted among 88 (53.7%) neonatal deaths. Almost half (38, 43.2%) of the deaths occurred within the first 24 hours of life. Birth asphyxia (45.5%), neonatal sepsis (26.1%), respiratory distress syndrome (12.5%) and hypothermia (11.0%) were the leading causes of death. In the early neonatal period, majority (54.3%) of the neonates succumbed to asphyxia while in the late neonatal period majority (66.7%) succumbed to sepsis. Delay in seeking medical care was reported for 4 (5.8%) of the neonatal deaths. ConclusionDeaths among LBW and preterm neonates occur early in life due to preventable causes. This calls for enhanced intrapartum and immediate postpartum care interventions targeting asphyxia, sepsis, respiratory distress syndrome and hypothermia.

scholarly journals Causes of preterm and low birth weight neonatal mortality in a rural community in Kenya: evidence from verbal and social autopsy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Beatrice Olack ◽  
Nicole Santos ◽  
Mary Inziani ◽  
Vincent Moshi ◽  
Polycarp Oyoo ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Neonatal Mortality ◽  
Distress Syndrome ◽  
Neonatal Period ◽  
Preterm Neonates ◽  
Neonatal Deaths ◽  
Social Autopsy

Abstract Background Under-five mortality in Kenya has declined over the past two decades. However, the reduction in the neonatal mortality rate has remained stagnant. In a country with weak civil registration and vital statistics systems, there is an evident gap in documentation of mortality and its causes among low birth weight (LBW) and preterm neonates. We aimed to establish causes of neonatal LBW and preterm mortality in Migori County, among participants of the PTBI-K (Preterm Birth Initiative-Kenya) study. Methods Verbal and social autopsy (VASA) interviews were conducted with caregivers of deceased LBW and preterm neonates delivered within selected 17 health facilities in Migori County, Kenya. The probable cause of death was assigned using the WHO International Classification of Diseases (ICD-10). Results Between January 2017 to December 2018, 3175 babies were born preterm or LBW, and 164 (5.1%) died in the first 28 days of life. VASA was conducted among 88 (53.7%) of the neonatal deaths. Almost half (38, 43.2%) of the deaths occurred within the first 24 h of life. Birth asphyxia (45.5%), neonatal sepsis (26.1%), respiratory distress syndrome (12.5%) and hypothermia (11.0%) were the leading causes of death. In the early neonatal period, majority (54.3%) of the neonates succumbed to asphyxia while in the late neonatal period majority (66.7%) succumbed to sepsis. Delay in seeking medical care was reported for 4 (5.8%) of the neonatal deaths. Conclusion Deaths among LBW and preterm neonates occur early in life due to preventable causes. This calls for enhanced implementation of existing facility-based intrapartum and immediate postpartum care interventions, targeting asphyxia, sepsis, respiratory distress syndrome and hypothermia.

scholarly journals Pattern, Causes, and Treatment Outcome of Neonates Admitted at Hiwot Fana Specialized University Hospital, Eastern Ethiopia.

2021 ◽  
Author(s):  
Addis Eyebru ◽  
Tamirat Getachew ◽  
Adera Debela ◽  
Meron Degefa ◽  
Daniel Kebede ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Neonatal Sepsis ◽  
Neonatal Death ◽  
Distress Syndrome ◽  
Outcome Variable ◽  
Factors Associated

Abstract Background: Neonatal period is the most the vulnerable time for survival of newborns. In Ethiopia, neonatal death remains increasing and requires extraordinary efforts and a novel intervention to reduced neonatal death as those deaths continue to occur in even hospital settings where there are the best neonatal care services. Despite many efforts done to improve the outcome of neonates admitted to hospitals; neonates continue dying in those settings. The causes of neonatal death in Ethiopia varies from place to place. So, identifying the causes of death in the study area is very important for prevention and treatment. The study aimed to assess the causes and factors associated with treatment outcomes. Methods: Institution-based cross-sectional study design was conducted among 707 randomly selected neonates from March 1 to 31, 2020. Data were extracted from medical records using a checklist adapted from WHO and neonatal registration book. The data were inserted into Epi-data version 3.1 and then exported into SPSS window version 22 for analysis. Bivariate and multivariate analyses were done to identify the association between independent variables and the outcome variable. Results: From 698 admitted neonates during 2 years period, 594 of them were improved and 104 of them were died. The proportion of neonatal death was 14.9% (95% CI:12.3,17.9). Neonatal sepsis, low birth weight and prematurity were the leading cause of neonatal death. Residency [ AOR=2.30, 95%CI: (1.3, 4.12)], low birth weight [AOR=2.52, 95%CI: (1.24,5.13))], respiratory distress syndrome [AOR =2.86, 95%CI:(1.11.7.35)], neonatal sepsis [AOR= 2.48, 95%CI: (1.40, 4.38)], and Neonates treated with phototherapy and oxygen [ AOR=0.22, 95%CI:(0.088,0.54)], [AOR= 0.47,95%CI:(0.22,0.99)] were factors associated with poor treatment outcome.Conclusion: The causes of neonatal death were mainly from preventable and treatable causes like neonatal sepsis, low birth weight, and prematurity in the study setting. Residency, low birth weight, respiratory distress syndrome, having neonatal sepsis, treatment with phototherapy, and treatment with oxygen were independent factors. The concerned bodies should give attention to neonates admitted to intensive care units by strengthening the quality of care given at the unit and strengthening early detection and prevention of neonatal problems during post-partum periods.

scholarly journals Pregnancy outcomes, Newborn complications and Maternal-Fetal Transmission of SARS-CoV-2 in women with COVID-19: A systematic review of 441 cases

2020 ◽  
Author(s):  
Rahul K Gajbhiye ◽  
Deepak N Modi ◽  
Smita D Mahale
Keyword(s):  
Systematic Review ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Distress Syndrome ◽  
Neonatal Deaths ◽  
Hypertensive Disorders ◽  
Still Births ◽  
Maternal Fetal Transmission

ABSTRACTObjectiveThe aim of this systematic review was to examine the maternal and fetal outcomes in pregnant women with COVID-19 and also assess the incidence of maternal-fetal transmission of SARS CO-V-2 infection.Data sourcesWe searched PUMBED. Medline, Embase, MedRxiv and bioRxiv databases upto 3rd May 2020 utilizing combinations of word variants for “coronavirus” or “COVID-19” or “severe acute respiratory syndrome” or “SARS-COV-2” and “pregnancy”. We also included data from preprint articles.Study eligibility criteriaOriginal case reports and case series on pregnant women with diagnosis of SARS-CoV-2 infection.Study appraisal and synthesis methodsWe included 50 studies reporting the information on 441 pregnant women and 391 neonates. The primary outcome measures were maternal health characteristics and adverse pregnancy outcomes, neonatal outcomes and SARS-CoV-2 infection in neonates was extracted. Treatments given to pregnant women with COVID-19 were also recorded.ResultsOut of 441 women affected by COVID-19 in pregnancy, 387 women have delivered. There are nine maternal deaths reported. In pregnant women with COVID-19, the most common symptoms were fever (56%), cough (43%), myalgia (19%), dyspnea (18%) and diarrhea (6%). Pneumonia was diagnosed by CT scan imaging in 96 % of COVID-19 pregnant women. Pregnancy complications included delivery by cesarean section (80%), preterm labor (26%), fetal distress (8%) and premature rupture of membranes (9%). Six still births (2%) are reported. The most common co-morbidities associated with pregnant women with COVID-19 were hypertensive disorders (10%), diabetes (9%), placental disorders (2%), co-infections (3%), scarred uterus (3%) and hypothyroidism (3%). Amongst the neonates of COVID-19 mothers, preterm birth (25%), respiratory distress syndrome (8%), pneumonia (8%) were reported. There were four neonatal deaths reported. Vertical transmission rate of SARS-CoV-2 is estimated to be 8%.ConclusionIn pregnant women with COVID-19, hypertensive disorders and diabetes are common comorbidities and there is a risk of preterm delivery and maternal death. Amongst the neonates born to mothers with COVID-19, respiratory distress syndrome and pneumonia are common occurrence. There are reports of still births and neonatal deaths. There is an evidence of vertical transmission of SARS-CoV-2 infection in women with COVID-19.

Pulmonary Hyaline Membranes: Killer or Protector

PEDIATRICS ◽  
1972 ◽  
Vol 49 (4) ◽  
pp. 639-640
Author(s):  
Toshio Fujikura
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Clinical Significance ◽  
Cause Of Death ◽  
Distress Syndrome ◽  
Postmortem Examination ◽  
Fibrinolytic Enzymes ◽  
Definite Evidence ◽  
Neonatal Deaths ◽  
Hyaline Membranes

It is unfortunate that the clinical significance of hyaline membranes has been overempha-sized in the respiratory distress syndrome. Membranes are confirmed always in neonatal deaths at postmortem examination and there is very little information regarding the membranes among surviving infants who have suffered from the syndrome. Although some investigators have tried to dissolve the membranes with fibrinolytic enzymes, there is no definite evidence that the membranes are responsible for the direct cause of death and the syndrome.

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