scholarly journals Outcome of neonates requiring mechanical ventilation in a tertiary hospital

2018 ◽  
Vol 8 (3) ◽  
pp. 24-30
Author(s):  
Shanti Regmi ◽  
Santosh Pathak ◽  
Pusp Raj Awasti ◽  
Subhash Bhattarai ◽  
Rajan Poudel
Keyword(s):  
Mechanical Ventilation ◽  
Birth Asphyxia ◽  
Hyaline Membrane Disease ◽  
Tertiary Hospital ◽  
Meconium Aspiration Syndrome ◽  
Therapeutic Modality ◽  
Mechanically Ventilated ◽  
Medical College ◽  
Nicu Admission ◽  
Organ Dysfunctions

Mechanical ventilation is a key therapeutic modality in treatment of sick neonates. Our hospital based retro­spective study conducted at Chitwan Medical College (CMC), Nepal over the duration of 2 years, from February 2015 to January 2017, with aims to study the clinical profile, indications, complications and outcome in terms of survival in mechanically ventilated neonates. Total of 119 mechanically ventilated neonates were included in the study. Along with admission and discharge register record, all the patient’s record files were retrieved from the medical record section, necessary details were entered in a predesigned proforma and statistical analysis was done using IBM SPSS 20 software. Out of 1306 total NICU admission, total 130 were mechanically ventilat­ed, among them only 119 (9.1%) were included in the study. Majority (71.4%) were male. More than half were Preterm (51.3%) and outborn (58%). Most common indication of mechanical ventilation was sepsis followed by Birth asphyxia (BA), respiratory distress syndrome/hyaline membrane disease (RDS/HMD) and Meconium Aspiration Syndrome (MAS). Overall survival was 45(37.8%). Among the indications during the study period, the best survival observed was in birth asphyxia. Shock and Disseminated intravascular coagulation (DIC) were the two most common complications encountered during the course of ventilation. Increasing birth weight, higher gestational age and Downes Score at intubation of 6 or < 6 was associated with a better outcome. Shock, multi organ dysfunctions (MODS), and ventilator associated pneumonia (VAP) were the statistically proven individual predictors of outcome.

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 Short-Term Outcome of Mechanical Ventilation in Neonates

2011 ◽  
Vol 31 (1) ◽  
pp. 35-38 ◽  
Author(s):  
SM Gurubacharya ◽  
DR Aryal ◽  
M Misra ◽  
R Gurung
Keyword(s):  
Mechanical Ventilation ◽  
Survival Rate ◽  
Birth Asphyxia ◽  
Hyaline Membrane Disease ◽  
Meconium Aspiration Syndrome ◽  
Western World ◽  
Term Outcome ◽  
Level Ii ◽  
Neonatal Ventilation ◽  
Hyaline Membrane

Mechanical ventilation of newborn has been practiced for several years with several advances made in the way. As compared to the Western world and our neighbouring countries, neonatal ventilation in our country is still in its infancy. Objectives: To analyze the common indications and outcome of neonates requiring mechanical ventilation. Methods: This was a prospective observational study conducted on neonates requiring mechanical ventilation within first 24 hours of birth over a period of nine months. Results: Birth asphyxia was the commonest indication for ventilation (59.67%) followed by asphyxia with meconium aspiration syndrome (MAS) (17.74%), hyaline membrane disease (HMD) (8.06%), MAS (6.45%) and intrauterine pneumonia (6.45%). Out of 62 babies, 22 (35.48%) survived. Babies with asphyxia had highest survival rate (51.35%). Neonates with HMD did not survive. Term babies and babies weighing ≥2500g had higher survival rate of 40.47% and 41.46% respectively, while babies less than 32 weeks had survival rate of 16.66% only. Conclusions: Mechanical ventilation reduces the neonatal mortality; hence, facilities for neonatal ventilation should be included in the regional and central hospitals providing level II neonatal care. Key words: neonatal ventilation; hyaline membrane disease; low birth weight DOI: 10.3126/jnps.v31i1.3463J Nep Paedtr Soc 2010;31(1):35-38

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 study of mechanical ventilation in children

2017 ◽  
Vol 4 (6) ◽  
pp. 2088 ◽  
Author(s):  
Nilofer S. Bhori ◽  
Sunil V. Ghate ◽  
Punit S. Chhajed
Keyword(s):  
Mechanical Ventilation ◽  
Hospital Stay ◽  
Health Care Cost ◽  
Management Strategies ◽  
Laryngeal Edema ◽  
Mechanically Ventilated ◽  
Medical College ◽  
Diseased State ◽  
Hospital Protocols ◽  
State Infrastructure

Background: Mechanical ventilation (MV) is one of the most commonly performed procedures in PICU. The indications of MV are multiple. The management strategies also vary depending upon the diseased state, infrastructure and hospital protocols. Although benefits of MV are unquestionable, its use can also cause harm. This study was done to assess the frequency, indications, complications and immediate outcome of mechanically ventilated children, with an aim to improve management protocols and outcome.Methods: A prospective observational study of children (1 month to 13 years), needing invasive MV in PICU of a medical college. MV was initiated after assessment of indication/s. All patients were ventilated with pressure support modes. Complications and outcome were assessed. Results: Of 452 patients admitted to PICU, 72 (15.93%) needed MV. Most common indication was respiratory failure (20.83%). Mean duration of MV was 4.2±4.32 days. Mean hospital stay was 11.89±12.8 days. Of 72, 24 (33.33%) developed complication/s, commonest being laryngeal edema (11.11%). Mean duration of ventilation and hospital stay were significantly higher (p <0.01) in those who developed complication/s. The mortality rate of mechanically ventilated children was 38.89%. Initial mode of MV used was significantly associated (p <0.05) with mortality. Conclusion: Complications prolong the duration of mechanical ventilation and hospital stay. They increase mortality and health care cost in a developing country. Alternatives should be tried before starting invasive MV in children. 

scholarly journals Neonatal Outcome in Meconium Stained Amniotic Fluid (MSAF): A Study in a Neonatal High Dependency Unit (NHDU) of a Medical College Hospital

Mediscope ◽  
2019 ◽  
Vol 6 (2) ◽  
pp. 65-71
Author(s):  
MB Ali ◽  
AA Maruf ◽  
N Naher ◽  
S Islam
Keyword(s):  
Amniotic Fluid ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
Maternal Risk Factors ◽  
College Hospital ◽  
Maternal Risk ◽  
Medical College ◽  
High Dependency ◽  
Meconium Stained Amniotic Fluid ◽  
Ischemic Encephalopathy

Background: Meconium-stained amniotic fluid (MSAF) is a potential sign of fetal hypoxia as well as a potential toxin if the fetus aspirates with a gasping breath in utero or when it takes its first breaths following birth. Objective: To evaluate the outcome of neonates with meconium-stained amniotic fluid (MSAF). Material and Methods: This prospective observational study was carried out in the department of pediatrics of Gazi medical college Hospital, Khulna during one calendar year from 01 July 2016 to 30 June 2017. Maternal risk factors for MSAF, modes of delivery of neonates were recorded. All neonates born with MSAF were included in this study: they were shifted to neonatal high dependency unit for observation and monitoring as per the pediatrician’s advice. Neonatal outcomes like birth asphyxia, neonatal jaundice, aspiration pneumonia, septicemia, meconium aspiration syndrome (MAS), hypoxic-ischemic encephalopathy (HIE) and death were observed and recorded. Result: A total of 157 babies were included during the study period. Modes of delivery of babies were: normal delivery 86(54.78%), caesarean section 48(30.57%) and instrumental delivery 23(14.65%). Maternal risk factors were postdated pregnancy 51(32.48%), previous caesarian section 20(12.74%), pregnancy-induced hypertension (PIH) 20(12.74%), premature rupture of membranes 18(11.46%), gestational diabetes mellitus (GDM) 17(10.83%), intrauterine growth retardation (IUGR) 14 (8.92%), cephalopelvic disproportion 9(5.73%) and anemia 8(5.10%). Outcome of babies were: 118(75.16%) babies were discharged without any complications, 10(6.37%) developed neonatal jaundice, 10(6.37%) meconium aspiration syndrome (MAS), 8(5.10%) birth asphyxia, 4(2.55%), aspiration pneumonia, 3(1.91%) hypoxic-ischemic encephalopathy (HIE), 2(1.27%) septicemia and 2(1.27%) baby died in early neonatal period. Mediscope Vol. 6, No. 2: Jul 2019, Page 65-71

TO COMPARE THE FETOMATERNAL OUTCOME OF ORAL MISOPROSTOL SOLUTION AND VAGINAL MISOPROSTOL TABLET FOR INDUCTION OF LABOUR AT TERM IN THE DEPARTMENT OF OBSTETRICS & GYNAECOLOGY, SMS MEDICAL COLLEGE, JAIPUR

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Neelam Bhardwaj ◽  
Parveen . ◽  
Prerna . ◽  
Neeta Meena ◽  
Prem .
Keyword(s):  
Controlled Trial ◽  
Meconium Aspiration Syndrome ◽  
Induction Of Labour ◽  
Medical College ◽  
Oral Misoprostol ◽  
Misoprostol Group ◽  
Group A ◽  
Nicu Admission ◽  
Vaginal Misoprostol ◽  
Group B

Background: Induction of labour is a common intervention, required in situations where continuation of pregnancy may be lifethreatening for the mother and/or fetus. In industrialized countries, the induction rate ranges from 10-25%. Methods: Randomized controlled trial was conducted at Department of Obstetrics and Gynaecology, SMS Medical College, Jaipur. Results: APGAR score at 1 min and 5 minutes was 6.64 and 6.84 in oral misoprostol and vaginal misoprostol group respectively, while at 5 minutes it is 6.7 oral group and 7 of vaginal misoprostol group. 34% of cases need NICU admission in Group-A (Oral misoprostol) and 14% in Group-B (Vaginal misoprostol) group. Meconium aspiration syndrome which is present 10% of patients in Group-A (Oral Misoprostol) while it is present in 6% of patients in Group-B (Vaginal misoprostol). Conclusion: The lesser incidence of meconium-stained liquor and NICU admissions and fewer caesareans with better neonatal outcome in women induced with oral misoprostol outweigh its advantages over the vaginal misoprostol Keywords: Misoprostol, Labor, Induction, Fetomaternal outcome.

scholarly journals Profile Of Neonatal Admission At Chitwan Medical College

2014 ◽  
Vol 3 (4) ◽  
pp. 13-16
Author(s):  
SP Shrestha ◽  
AK Shah ◽  
R Prajapati ◽  
YR Sharma
Keyword(s):  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Birth Asphyxia ◽  
Normal Vaginal Delivery ◽  
Neonatal Hypoglycemia ◽  
Lower Section ◽  
Clinical Sepsis ◽  
Medical College ◽  
Common Causes ◽  
Nicu Admission

In Nepal, three most common causes of newborn (NB) admission in the neonatal intensive care unit (NICU) are birth asphyxia, neonatal sepsis and prematurity and they are the leading causes of death too. A study previously done in Nepal shows asphyxia as a leading cause of hospital admission accounting 22% followed by prematurity 20% and neonatal sepsis 17% with mortality due to these three causes being 7%, 3% and 5% respectively. Reasons of NICU admission in Chitwan Medical College (CMC) are clinical sepsis in 50% of cases followed by birth asphyxia 17.6%, and prematurity in 6.7% cases. Respiratory distress syndromes (RDS), neonatal jaundice, congenital hydrocephalus, meningitis are other reasons of NICU admission. Most of the babies were delivered by normal vaginal delivery at health facility 53%, and 47% of NB was delivered through lower section Caesarean section (LSCS). Only 6% of NB was having birth weight of less than 1.5 kg and majority of them were above that. There were 65% NB who was born at term and remaining 35% were preterm. Majority of NB were admitted within 72 hours of birth with 79% of the total admission. Hypoglycemia was observed in 83 out of 202 newborns accounting 41% neonatal hypoglycemia at birth. Journal of Chitwan Medical College 2013; 3(4); 13-16 DOI: http://dx.doi.org/10.3126/jcmc.v3i4.9547

scholarly journals Meconium stained liquor and perinatal outcome

2018 ◽  
Vol 7 (12) ◽  
pp. 5056
Author(s):  
Aruna Biradar ◽  
Shreedevi Kori ◽  
Neelamma Patil ◽  
S. R. Mudanur
Keyword(s):  
Apgar Score ◽  
Fetal Heart Rate ◽  
Neonatal Intensive Care ◽  
Fetal Heart ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
P Value ◽  
Operative Interference ◽  
Nicu Admission ◽  
Meconium Stained Amniotic Fluid

Background: The aim of this study is to know the association between the meconium stained amniotic fluid and its association with the perinatal outcome.Methods: All the patients coming to present hospital for delivery with meconium stained liquor during the study period were included in the study.Results: 163 cases with meconium stained liquor (MSAF) were included in the study, 124(76.1%) and 39(23.9%) had thin and thick MSAF respectively. Among these cases, thick MSAF was more associated with high fetal heart rate (FHR) variability (p value- 0.030), associated with increased rate of operative interference (64.1%; p value- 0.001), abnormal Apgar score (p value-0.003 at 1min and 0.001 at 5min) and increased neonatal intensive care unit (NICU) admission (33.3%; p value - <0.001).Conclusions: Present study showed that thick meconium is associated with more complications like increased operative interference, birth asphyxia, meconium aspiration syndrome, low Apgar score, prolonged NICU stay and overall increased perinatal mortality compared to thin meconium stained liquor. As the gestational age increased the incidence of meconium increased and a greater number of thick meconium had abnormal CTG.

scholarly journals The study of maternal and perinatal outcome in prolonged pregnancy

2017 ◽  
Vol 6 (3) ◽  
pp. 1067 ◽  
Author(s):  
Shivani Singh ◽  
Hem Prabha Gupta ◽  
Urvashi Verma ◽  
Gunjan Yadav
Keyword(s):  
Perinatal Outcome ◽  
Birth Asphyxia ◽  
Uttar Pradesh ◽  
Well Being ◽  
Normal Pregnancy ◽  
Control Group ◽  
Medical College ◽  
Prolonged Pregnancy ◽  
Nicu Admission ◽  
Control Study

Background: Prolonged pregnancy or post-dated pregnancy is that pregnancy which has exceeded duration considered to be upper limit of normal pregnancy that is above 40 completed weeks or 280 days from the first day of last menstrual period. The objective was to evaluate the maternal and perinatal outcome of post-dated pregnancy.Methods: A prospective case control study was conducted on antenatal women for 18 months period from May 2014- October 2015 admitted to the Obstetrics and Gynecology Department, Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India. The study group was comprised of antenatal women having pregnancy beyond 40 weeks, and the control group was represented with antenatal women between 37-40 weeks admitted for delivery during this period.Results: The prevalence of post-dated pregnancy was found to be 17.6% and of post-term was 5.69%. Among post-dated subjects LSCS rate was 56.50% and in term (37-40 weeks) patient it was 34.18%. The NICU admission for birth asphyxia was 6.09% among term (37-40 weeks) patients and 17.6% in post-dated pregnancies.Conclusions: Any pregnancy that crosses expected date of delivery, Foetal well-being must be assessed and induction of labour should be considered to decrease the risk of perinatal morbidity and mortality.

scholarly journals Clinical study of babies born through meconium stained amniotic fluid

2019 ◽  
Vol 6 (2) ◽  
pp. 491 ◽  
Author(s):  
Shilpasri Y. M. ◽  
Madhurya B.
Keyword(s):  
Amniotic Fluid ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Fetal Monitoring ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Meconium Aspiration Syndrome ◽  
Meconium Aspiration ◽  
Medical College ◽  
Meconium Stained Amniotic Fluid

Background: Meconium stained amniotic fluid has been considered a sign of fetal distress and associated with poor fetal outcome, but others considered meconium passage by fetus is physiological phenomena and produce environmental hazards to fetus before birth. Such magnitude of different opinion was the object behind taking up of this study and aim was to find out incidence and effect of meconium in terms of morbidity and mortality.Methods: Two hundred babies born with meconium stained amniotic fluid considering the inclusion and exclusion criteria from December 2012 to June 2013 in the Department of Paediatrics, Cheluvamba hospital attached to Mysore Medical College and Research Institute, Mysore. Fetal monitoring, mode of delivery, Apgar score, birth weight, resuscitation of baby are noted. All babies followed-up up to 1st week of neonatal life.Results: In present study 200 babies born through meconium stained amniotic fluid was randomly selected-thin 37% and thick 63%. Major complications like birth asphyxia, meconium aspiration syndrome, early neonatal death seen in 5.5% (11 cases), morbidity in 37%, 12.5% in thin and 24.5% in thick MSAF. Causes of death were meconium aspiration syndrome in 3 cases, sepsis in 1 case, pneumonia in 1 case and birth asphyxia in 6 cases.Conclusions: Immediate airway management, need for suction and intubation should be guided by state of newborn rather than presence of meconium. Timely diagnosis and management of meconium stained amniotic fluid may improve fetal outcome. From present study authors conclude that MSAF adversely affect fetal outcome mostly by thick meconium.

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