scholarly journals Clinical Profile and Outcome of Neonates Admitted to the Neonatal Care Unit in a Rural Teaching Hospital

2018 ◽  
Vol 1 (2) ◽  
pp. 23-27 ◽  
Author(s):  
Sandeep Shrestha ◽  
N. Sindan ◽  
N. Kayastha ◽  
D.B. Karki ◽  
K. Jha ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Neonatal Morbidity ◽  
Meconium Aspiration Syndrome ◽  
Clinical Profile ◽  
Morbidity And Mortality ◽  
Mortality And Morbidity ◽  
Period 2 ◽  
Neonatal Care Unit ◽  
One Year ◽  
Rural Teaching

Introduction: Neonatal morbidity and mortality rates reflect efficiency of health services of a country. This study was conducted to identify the clinical profile, pattern of diseases and common causes of mortality and morbidity in neonates admitted to neonatology unit. Methods: The study was conducted in Neonatal Unit of Karnali Academy of Health Sciences, Jumla for a period of one year from 1st May 2017 to 30th April 2018. Data of all admitted patients were reviewed and analyzed in terms of gender, gestational age, age at presentation, weight, cause of admission and their outcome. Diagnosis was made on clinical examination, radiological findings and laboratory investigations. Data were analyzed using SPSS version 20. Results: Out of 153 neonates admitted during the study period, 2 were excluded because of deficient record. Full-term neonates were 122(80.7%) while preterm were 29 (19.3%). Low birth weight (LBW) babies were 32 (21.18%). Neonatal sepsis 91 (60.26%) was the most common cause of hospital admissions followed by meconium aspiration syndrome 21(13.9%) and prematurity 10(6.62%). Out of 151 newborns, 112 babies (74.1%) were discharged after improvement, 15(9.93%) left against medical advice, 13(8.6%) babies were referred to higher centers for intensive care and there were 9 (5.9%) mortalities and 2(1.3%) got absconded. Conclusions: The majority of neonatal morbidity is due to sepsis, prematurity and respiratory causes. All these causes are preventable to some extent and, can be effectively treated in order to reduce morbidity and mortality.

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.

Efetividade do Método Canguru em Relação à Redução da Mortalidade e Morbidade Neonatal

2018 ◽  
Vol 22 (3) ◽  
pp. 186
Author(s):  
Dayane Cristina Da Silva Santos ◽  
Mirian Dos Santos Pereira
Keyword(s):  
Low Income ◽  
Neonatal Morbidity ◽  
Neonatal Care ◽  
Morbidity And Mortality ◽  
Low Income Countries ◽  
Middle Income ◽  
Mortality And Morbidity ◽  
Premature Newborn ◽  
Middle Income Countries ◽  
Low Weight

O Método Mãe Canguru (MC) é destinado ao atendimento do recém-nascido prematuro de baixo peso, e visa fortalecer o vínculo mãe-filho, aumentar a competência e a confiança dos pais no cuidado do bebê e incentivar a prática da amamentação. O objetivo do estudo foi demonstrar as evidências que apontam o uso de Método Canguru (MC) como uma alternativa aos cuidados neonatais, enfocando seus benefícios e avaliando se o método reduz a morbidade e mortalidade em neonatos de baixo peso. Trata-se de uma pesquisa descritiva, realizada a partir de um levantamento bibliográfico nas bases de dados BDEnf, Lilacs, SciELO e BIREME, considerando o período de 2000 a 2016. Foram analisados artigos sobre o Método Canguru (MC) e a redução da morbimortalidade neonatal. O estudo evidenciou que o Método Mãe Canguru (MC) reduz as taxas tanto de mortalidade como morbidade neonatal, porém demonstrou que existem poucos estudos referentes a este tema. O Método Mãe Canguru (MC) demonstrou ser mais que uma alternativa para países de baixa renda, nos quais faltam incubadoras ou salas de atendimento neonatal, constituindo-se, também, uma estratégia com múltiplas vantagens para o recém-nascido, tanto o prematuro quanto o nascido a termo. Destacou-se a eficácia do método na diminuição da morbimortalidade do neonato com baixo peso. Os estudos sobre mortalidade e morbidade do Método Mãe-Canguru (MC), em países de baixa e média renda, concluíram que o Método Mãe Canguru (MC) reduz, substancialmente, a mortalidade neonatal em bebês nascidos antes do termo com baixo peso em hospitais. Palavras-chave: Morbimortalidade Neonatal. Método Canguru. Recém-Nascido de Baixo Peso. Abstract: The Kangaroo Mother Method is intended for the care of the low weight premature newborn and aims to strengthen the mother-child bond, increase the parents’ competence and trust in the baby care and encourage the breastfeeding practice. The objective was  demonstrating the evidence supporting the use of KMM as an alternative to neonatal care, focusing on its benefits and evaluating whether the method reduces morbidity and mortality in low weight premature newborn. This is a descriptive research, based on a bibliographic survey in the databases BDEnf, Lilacs, SciELO and BIREME, considering the period from 2000 to 2016.  Articles were analyzed on the Kangaroo Method and the reduction of neonatal morbidity and mortality, the study showed that the Kangaroo Mother Method reduces the rates of both mortality and neonatal morbidity, but has shown that there are few studies related to this topic. The Kangaroo Mother Method has proven to be more than an alternative for low-income countries, where incubators or neonatal care rooms are lacking. It is also a strategy with multiple advantages for the newborn, both premature and full-term. The method efficacy in reducing neonatal morbidity and mortality and low weight was emphasized. Mortality and morbidity studies of the Kangaroo Method in low- and middle-income countries have concluded that the Kangaroo Mother Method substantially reduces neonatal mortality in preterm infants in hospitals and underweight. Keywords: Morbidity and Mortality Neonatal. Kangaroo Method. Low Birth Newborn. 

scholarly journals Morbidities and mortality among infants of HIV-1-infected mothers with bacterial vaginosis in Kenya

2020 ◽  
Author(s):  
Ngugi Mwenda ◽  
Ruth Nduati ◽  
Mathew Kosgey ◽  
Gregory Kerich
Keyword(s):  
Bacterial Vaginosis ◽  
Hospital Admissions ◽  
Controlled Trial ◽  
Neonatal Morbidity ◽  
Estimating Equation ◽  
Morbidity And Mortality ◽  
Bloody Stool ◽  
Maternal Condition ◽  
Cumulative Hazard ◽  
Hazard Curve

Abstract Background: This study aimed to assess the effects of maternal bacterial vaginosis (BV) on the morbidity and mortality of HIV-exposed infants of women enrolled in a randomized controlled trial (pre-dating antiretroviral therapy) at birth, 6 months, and 12 months. Methods: Four hundred and twenty-five HIV-positive pregnant women were enrolled in this trial and were categorized as exposed if they had a laboratory-based diagnosis of BV (Nugent method). We compared the morbidity and mortality of infants of the mothers at birth, 6 months, and 12 months. We assessed morbidities from the mother’s history and clinical examination during scheduled and non-scheduled visits. The data that were collected longitudinally were then analyzed via multiple logistic regression with the generalized estimating equation. An independent correlation structure was assumed to evaluate the specific morbidity risks to infants associated with exposure to BV. We used the Kaplan–Meier method to generate the cumulative hazard curve, to determine mortalities at different stages between the two groups. Overall, only data for 328 infants were complete and used in the analysis.Results: Data were available for 159 and 171 BV exposed and non-exposed mothers, respectively. Exposure to BV was not associated with any neonatal morbidity at birth, but was associated with adverse maternal condition (unadjusted odds ratio [OR], 2.93; 95% confidence interval [CI], 1.19–7.20, P=0.02) and maternal hospital admissions (unadjusted OR, 1.95; 95% CI, 1.08–3.51, P=0.02). At 6 months, infants of BV exposed mothers had higher odds of bloody stool (adjusted OR, 3.08; 95% CI, 1.11–10.00, P=0.04), dehydration (adjusted OR, 2.94; 95% CI, 1.44–6.37, P=0.01), vomiting (adjusted OR, 1.64; 95% CI, 1.06–2.56, P=0.03), and mouth ulcers (adjusted OR, 12.8; 95% CI, 2.27–241.21, P=0.02). At 12 months, exposure to BV was associated with dehydration (adjusted OR, 1.81; 95% CI, 1.05–3.19, P=0.03) and vomiting (adjusted OR, 1.39; 95% CI, 1.01–1.92, P=0.04). Kaplan­–Meier survival analysis showed no association of BV with infant mortality (P=0.65); however, the cumulative hazard curve showed a higher trend toward deaths among BV exposed infants.Conclusion: Our findings demonstrate that BV is a good predictor of maternal and infant morbidities. Infants of both HIV and BV exposed mothers can manifest these symptoms at any stage within a year of growth. Adverse maternal condition and hospitalization of mothers after birth could indicate exposure to BV. Bloody stool, dehydration, vomiting, and mouth ulcers could indicate exposure to BV among infants.

scholarly journals Meconium stained liquor and fetal outcome: a hospital based follow up study

2019 ◽  
Vol 8 (6) ◽  
pp. 2434
Author(s):  
P. Kalpana ◽  
A. Kavitha
Keyword(s):  
Amniotic Fluid ◽  
Apgar Score ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Meconium Aspiration Syndrome ◽  
Chi Square ◽  
Mortality And Morbidity ◽  
Meconium Staining ◽  
Meconium Stained Amniotic Fluid

Background: Meconium staining of the amniotic fluid is a common problem occurring in 10-22% of all deliveries. Meconium aspiration syndrome complicates approximately 1.5% of these deliveries with a reported mortality rate as high as 40%. Objectives of the study were to determine whether meconium stained liquor during labour is associated with fetal distress and to check if there is any correlation in between the degree of meconium staining liquor and fetal outcome.Methods: A clinical study of 200 cases of meconium stained amniotic fluid in cephalic presentation was undertaken among patients who were admitted in labour room were examined in detail and investigations were done. Fetal heart rate and its pattern were noted every fifteen min. Total APGAR score at one minute and five minute was noted down. Odds ratio with 95% confidence interval was calculated. Proportions were analyzed using chi square value.Results: Majority of the study subjects belonged to the age group of 21-30 years. Majority i.e. 54.5% were multigravida. Majority had toxemia in 24% of the cases. Fetal distress and the incidence of forceps delivery or LSCS was significantly more in those with thick meconium compared to those with thin meconium (p<0.05). But fetal asphyxia was not associated with type of stained meconium. It is seen that as the duration of the meconium staining increased, the proportion of babies with low APGAR score, perinatal mortality and morbidity increased.Conclusions: Thick meconium stained amniotic fluid was associated with increased rate of interventions, neonatal morbidity and mortality compared to thin meconium stained meconium fluid.

LO02: Heart failure and palliative care in the emergency department

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S27-S28
Author(s):  
M. Lipinski ◽  
D. Eagles ◽  
L.M. Fischer ◽  
L. Mielneczuk ◽  
I.G. Stiell
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
High Risk ◽  
Mortality Rate ◽  
Hospital Admissions ◽  
Mortality And Morbidity ◽  
Early Palliative Care ◽  
Icd 10 ◽  
Ed Visits ◽  
One Year

Introduction: Heart failure (HF) is a common ED presentation that is associated with significant morbidity and mortality. Despite recent evidence and recommendations for early palliative care (PC) involvement in these patients, they are still significantly under-served by PC services, often resulting in multiple ED visits. We sought to evaluate use of PC services in patients with HF presenting to the ED. Secondary objectives of the study were to investigate: 1) one year mortality, ED visits, and admissions; 2) application of a novel palliative care referral score. Methods: We conducted a health records review of 500 consecutive HF patients who presented to two academic hospital EDs. We included patients aged 65 years or older who were diagnosed as having a HF exacerbation by the emergency physician (ICD-10 code 150.-). Our primary outcome was PC involvement. Secondary outcomes included one year mortality rates, ED visits, admissions to hospital, as well as the application of a novel PC referral score developed by the institutional cardiac Palliative Care Committee. The score consisted of 6 different aspects of the patient’s illness, including laboratory tests, hospital usage, and markers of decompensation. We conducted appropriate univariate analyses. Results: Patients were mean age 80.7 years, women (53.2%), and had significant comorbidities (atrial fibrillation (51.2%), diabetes (40.4%) and COPD (20.8%)). Compared to those with no PC, the 79 (15.8%) patients with PC involvement had a higher one year mortality rate (70.9% vs. 18.8%, p&lt;0.0001), more ED visits/year for HF (0.82 vs. 0.52, p&lt;0.0001), and more hospital admissions/year for HF (1.4 vs. 0.85, p&lt;0.0001). Using the heart failure palliative care score criteria, 60 patients had scores &gt;=2. Compared to those with scores &lt;2, these patients had a higher 1-year mortality rate (50% vs. 24%, p&lt;0.0001) and more ED visits/year for HF (0.83 vs. 0.54, p&lt;0.01). Only 40.0% of these high risk patients had any PC involvement. Conclusion: We found that few HF patients had PC services involved in their care. Using this novel HF palliative care referral score, we were able to identify patients with a significantly greater risk of mortality and morbidity. This study provides evidence that the ED is an appropriate setting to identify and refer high risk HF patients who would likely benefit from earlier PC involvement and may be a future avenue for PC access for these patients.

scholarly journals Meconium aspiration syndrome: clinical profile, risk factors and outcome in central India

2018 ◽  
Vol 6 (1) ◽  
pp. 144 ◽  
Author(s):  
Milind B. Kamble ◽  
Poonam Jain
Keyword(s):  
Risk Factors ◽  
Central India ◽  
Sampling Technique ◽  
Meconium Aspiration Syndrome ◽  
Clinical Profile ◽  
Cross Sectional ◽  
Meconium Aspiration ◽  
Life Threatening ◽  
One Year ◽  
Meconium Stained Amniotic Fluid

Background: Meconium aspiration syndrome (MAS) is a life-threatening respiratory disease affecting some neonates born through meconium-stained amniotic fluid (MSAF). MSAF complicates delivery in approximately 8% to 25% of live births, of which nearly 5% of the neonates born through MSAF develop MAS. The present study was undertaken to find out the prevalence of MSAF and MAS and to study the etiology, risk factors, clinical profile and outcome of MAS.Methods: By purposive sampling technique, all newborns, fulfilling the inclusion criteria during one year of study period were enrolled in this hospital based cross-sectional observational study. Risk factors and clinical profile were compared between those who died and survived.Results: Out of 8765 deliveries in hospital 1220 neonates were born with MSAF of which 94 neonates had MAS. Thereby, incidence of MSAF was 13.9% and incidence of MAS out of MSAF was 7.7 %. Of the 94 neonates who had MAS 13.82% died. Almost 3/4th of the MAS neonates were term and AGA. MAS were more common in primigravida mother (68%) and LSCS deliveries (53.2%). Of the total MAS 54.2% had thick meconium in whom mortality was 92.3%. The mortality in MAS cases was significant in low 5-minute APGAR score and non-vigorous baby.Conclusions: Since MSAF is associated with higher morbidity and mortality, if the knowledge of risk factors is known to health care personnel then timely referral or intervention can help in decreasing MAS and its complications.

scholarly journals Prognostic Value of Procalcitonin for Morbidity and Mortality in Patients after Cardiac Surgery

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Ahmad Amouzeshi ◽  
Farshid Abedi ◽  
Mahmoud Zardast ◽  
Yaser Rezaeian Bilondi ◽  
Zahra Amouzeshi
Keyword(s):  
Mortality Rate ◽  
Wound Infection ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Early Mortality ◽  
Morbidity And Mortality ◽  
Mortality And Morbidity ◽  
Cabg Surgery ◽  
One Year ◽  
Cabg Patients

Background. The increased serum procalcitonin (PCT) level in cardiac patients is known as a sign of postoperative complications. Objective. Considering the importance of predicting the incidence of both complications and mortality caused by coronary artery bypass graft (CABG) surgery, this study was conducted to determine the serum PCT level and its relationship with one-year morbidity and mortality among CABG patients. Methods. This descriptive-analytical study was performed on 100 patients who underwent CABG surgery in Vali-e-Asr Hospital of Birjand, Iran. They were selected by a census sampling method from March 2014 to March 2015. The Elecsys BRAHMS PCT kit (Roche Company) was then used to measure the patients’ serum PCT level. The required data were collected using the patients’ medical records and telephone interviews with the patient or his/her relatives by passing one year from their discharge. The outcomes of this study comprised of mortality and morbidity causes (e.g., dysrhythmia, infection, and stroke). The data were then analyzed in SPSS version 16 by Mann–Whitney, chi-squared, and Fisher exact tests. Results. The postoperative serum PCT level is significantly correlated with sternum wound infection ( p = 0.001 ), packed cells (PC) transfusion ( p = 0.003 ), and death ( p = 0.003 ). In addition, a significant relationship was found between dyslipidemia and hypertension and early mortality rate in patients with high levels of PCT. Of note, risk-adjusted death did not differ significantly between the serum PCT levels after one year (RR, 0.068; 95% CI 0.008–0.566). Conclusion. Higher PCT serum levels in CABG patients are associated with the increased early mortality rate, sternum wound infection, and PC transfusion. Additionally, the other factors associated with mortality in the patients under study included dyslipidemia and hypertension.

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.

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