scholarly journals Clinical Profile of Neonates with Perinatal Asphyxia in a Tertiary Care Hospital of Central Nepal

2014 ◽  
Vol 52 (196) ◽  
pp. 1005-1009
Author(s):  
Sweta Kumari Gupta ◽  
Bhawani Kanta Sarmah ◽  
Damodar Tiwari ◽  
Amshu Shakya ◽  
Dipendra Khatiwada
Keyword(s):  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Clinical Information ◽  
Clinical Problem ◽  
Presentation Mode ◽  
Care Hospital ◽  
Central Nepal ◽  
Bag And Mask Ventilation

Introduction: Birth asphyxia is a serious clinical problem worldwide. It claims approximately 9 million deaths each year. It can lead to serious neurological sequaele, such as cerebral palsy, mental retardation, and epilepsy. Methods: All babies admitted in College of Medical Sciences Teaching Hospital, Chiwan, Nepal, NICU from January 2013 to December 2013 with a diagnosis of birth asphyxia (5 min Apgar<7 or those with no spontaneous respirations after birth) were included in the study (n=125). This was a descriptive observational study. Clinical information was collected (gravida, hour at presentation, mode of delivery, sex of baby, gestational age of the baby, requirement of resuscitation). Neonates were admitted to NICU, observed for complications and managed as per hospital protocol. Results: Among the 722 neonates admitted to NICU, 125 had perinatal asphyxia (17.3%). Babies with Hypoxic ischemic encephalopathy(HIE) Grade I had a very good outcome but HIE III was associated with a poor outcome. Outborn neonates had higher grades of perinatal asphyxia as compared to inborns (p=0.018). Term gestation, Males and Multigravida were associated with a higher rate of birth asphyxia. 22.4% neonates were delivered via caesarean section and 74.4% required bag and mask ventilation at birth. Conclusions: Birth asphyxia was one of the commonest causes of admission NICU. Babies with HIE Grade III had a very poor prognosis. Outborn neonates with birth asphyxia had a higher mortality. Males were frequently affected than females.  Keywords: birth asphyxia; HIE; mortality; measurement.

MATERNOFETAL OUTCOME IN MECONIUM STAINED LIQUOR AT TERTIARY CARE HOSPITAL

2021 ◽  
pp. 48-50
Author(s):  
Neha Agarwal ◽  
Samta Bali Rathore ◽  
Shivani Baberwal-
Keyword(s):  
Caesarean Section ◽  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
Care Hospital ◽  
Pregnancy Induced Hypertension ◽  
Meconium Aspiration ◽  
Induced Hypertension

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.

scholarly journals Morbidity Pattern and Hospital Outcome of Neonates Admitted in Tertiary Care Hospital, Nepal

2020 ◽  
Vol 40 (2) ◽  
pp. 107-113
Author(s):  
Deepeshwara Nepal ◽  
Sumit Agrawal ◽  
Sushan Shrestha ◽  
Ajit Rayamajhi
Keyword(s):  
Birth Weight ◽  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Extremely Low Birth Weight ◽  
P Value ◽  
Care Hospital ◽  
Hospital Outcome ◽  
Poor Outcome

Introduction: The first 28 days of life, neonatal period is crucial as neonates are susceptible to sepsis, birth asphyxia, hypoxic injuries and its consequences which may lead to lifelong morbidity. Knowing the causes of morbidity and mortality is an essential step to improve neonatal health. The aim of this study is to describe the pattern and causes of neonatal admission, immediate hospital outcome in the form of improved, died or left against medical advice  and factors associated with its outcome. Methods: This was a retrospective hospital based study carried out in Neonatal Intensive Care Unit (NICU) of Kanti Children’s Hospital, Kathmandu, Nepal over a period of six months (February 2019 to July 2019 AD). Neonatal details including age, sex, gestational age, birth weight, and maternal age and parity, mode of delivery, place of delivery, neonatal morbidities and neonatal outcomes were recorded in a predesigned performa. Results were expressed as mean, percentage and p value. P- value was calculated by using chi-square test. Results: A total of 163 neonates were admitted during the study period, among which 106 (65%) were males. The mean birth weight was 2483.96 ± 812.63 gm. Among admitted newborns 130 (79.8%) had good outcome, babies born to young mothers (< 20 years of age) had poor outcome which is statistically significant with p value of 0.002. Neonates whose birth weight were < 1000 gram had significantly poor outcome (0.001). Conclusion: Common causes of NICU admission were neonatal sepsis, neonatal hyperbilirubinemia, prematurity and perinatal asphyxia. Babies born to young primipara mothers, extremely low birth weight, extremely premature babies and babies undergoing mechanical ventilation had poor outcome.

scholarly journals Clinico-radiological Observations in Meconium Aspiration Syndrome

2018 ◽  
Vol 56 (209) ◽  
pp. 510-515 ◽  
Author(s):  
Susana Lama ◽  
Shyam Kumar Mahato ◽  
Nagendra Chaudhary ◽  
Nikhil Agrawal ◽  
Santosh Pathak ◽  
...  
Keyword(s):  
Apgar Score ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
Care Hospital ◽  
Radiological Findings ◽  
Female Ratio ◽  
Meconium Aspiration ◽  
Significant Difference

Introduction: To understand and report the prevalence of meconium aspiration syndrome and the clinico-radiological features in a tertiary care hospital of western Nepal. Methods: An observational study carried out for a year in 2014-15 in all babies with MAS. Clinical and radiological profiles of MAS in relation to gender, gestational age, mode of delivery, birth weight, Apgar score, thickness of meconium, age at admission and the immediate outcome were studied. Results: Out of 584 admitted newborns (male=389; female=186) during the study period, 78 (13.4%) had meconium aspiration syndrome with male: female ratio of 1.2:1. Majority of babies admitted to NICU had thick meconium [n=52 (66.7%)]. There was no statistical significant difference in various parameters such as Apgar score at 1 and 5 minutes, respiratory distress, birth asphyxia, duration of oxygen use, MAS severity and chest x-ray in those with thick MAS compared to thin. Among all newborns with MAS, 59% (n=46) had abnormal radiological findings with over two-folds in those with thick MAS (71.7%)] compared to thin (28%). Hyperinflation (47.8%), diffuse patchy infiltration (37%), consolidation (21.7%) collapse (8.7%), right lung fissure (6.5%) and pneumothorax (8.7%) were the abnormal radiological findings seen in MAS babies. The odds of having APGAR score at 1 minute at least 7 or more was twice unlikely in those having thick meconium compared to thin (P=0.02) Conclusions: Thick meconium is relatively common with more significant abnormal radiological findings and low Apgar score.

scholarly journals A study of clinical profile of intractable epilepsy in children

2020 ◽  
Vol 7 (3) ◽  
pp. 664
Author(s):  
C. Bhanu Sree ◽  
Gangadhar B. Belavadi
Keyword(s):  
Febrile Seizure ◽  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Intractable Epilepsy ◽  
Birth Asphyxia ◽  
Good Control ◽  
Care Hospital ◽  
Number Of Children ◽  
Risk Pregnancy ◽  
History Of

Background: This study was undertaken to find out the prevalence and clinical features of intractable epilepsy (IE) in a tertiary referral center.Methods: Study was conducted in a tertiary care hospital on 60 children with intractable epilepsy. Cases includes  intractable epilepsy is when seizures continue to occur despite maximally tolerated doses of more than two antiepileptics, occurrence of an average of one seizure per month for 18 months with no more than a 3 month seizure free period during these 18 months. Controls: epileptic children who had good control of seizures for the previous 18 months.Results: The prevalence of intractable seizures was 10% with maximum number of children 25 (41.6%) belonged to the 5-12 years. 15 (50%) children had daily seizures. Myoclonic seizures proved to be an important predictor of intractability. 4 children among the cases had history of family seizures, 6 children in cases had history febrile seizure, whereas, 6 children among the controls had history of family seizures, 8 children in controls had history febrile seizure.  23.3% of children presented with Status epilepticus in the cases and 16.6% of the children in the controls. Remote symptomatic etiology 12(40%) is the commonest cause of seizure. 13 (43.3%) children in cases and 3 (10%) children among the controls had a history suggestive of birth asphyxia. EEG was abnormal in 17 (56.6%) cases when compared to 11 (36.6%) children in the controls. CT scan was abnormal in 14 (46.6%) cases and 10 (33.3%) controls. MRI was abnormal in 16 (53.3%) children of the cases and 8 (26.6%) children of the controls.Conclusions: The commonest cause of intractable epilepsy was perinatal asphyxia. Perinatal asphyxia can be prevented by good nutrition during pregnancy, regular antenatal check ups with detection of high risk pregnancy, promoting hospital deliveries and prompt resuscitation of newborn when required. 

ASSESSMENT OF BURDEN OF ASPHYXIATED BABIES ACCORDING TOMETHOD OF RESUSCITATION AT TERTIARY CARE HOSPITAL

2019 ◽  
Vol 3 (10) ◽  
Author(s):  
Dr. Satya Narayan Bijarnia ◽  
Dr. Deveshwar Dev ◽  
Dr. R K Gupta
Keyword(s):  
Clinical Symptoms ◽  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Control Group ◽  
Care Hospital ◽  
Term Infants ◽  
Female Ratio ◽  
New Born ◽  
Male Female Ratio

Background: Perinatal asphyxia is characterized among the fetus or new born due to deficiency of perfusion to the various organs of the fetus or new born. Birth asphyxia is the single most important perinatal cause of brain damage in term infants. When asphyxia is followed by an abnormal neonatal behavior a syndrome has been described known as hypoxic ischemic encephalopathy. Material & Methods: The new born with congenital malformation of CNS were excluded from the study. Each selected newborn was subjected to Apgar scoring at birth and assessment of gestational age. The Apgar scoring was done at one and five minutes after births and infants were categorized into mild, moderate and severe birth asphyxia according to Apgar score at 1 minute of age after birth Results: In the present study, on the basis of clinical symptoms we found that asphyxiated group males comprised 62% cases and females 38% cases male female ratio was 1.63:1.0 it is statistically in significant. as compared to control group where male female ratio was 2.59:1. In Mild and moderate asphyxia male preponderance was seen while in severe asphyxia the difference was not marked There was no statistically significant sex difference in birth asphyxia. Conclusion: We concluded from the present study that in resuscitation of mild and moderately asphyxiated babies Bag and Mask was used more frequently (40% and 82.5% respectively) and endotracheal tube with Ambubag was used more (75%) frequently for severely asphyxiated babes. Key words: asphyxia, resuscitation, Ambubag.

scholarly journals Evaluation of the immediate outcomes of perinatally asphyxiated newborns in a tertiary care hospital in rural Bangalore: a retrospective study

2020 ◽  
Vol 7 (11) ◽  
pp. 2133
Author(s):  
Somashekhar Chikkanna ◽  
Saravanan P. ◽  
Nagaraj M. V. ◽  
Kavya S.
Keyword(s):  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Care Hospital ◽  
Female Ratio ◽  
Early Neonatal Mortality ◽  
Lower Segment Caesarean Section ◽  
Duration Of Hospitalization ◽  
Medical Advances ◽  
Male To Female

Background: Perinatal asphyxia is a condition resulting from deprivation of oxygen to a neonate that lasts long enough to cause damage to the brain. Perinatal asphyxia is one of the major causes of early neonatal mortality in India. The goal was to evaluate outcomes of asphyxiated babies. Methods: One hundred consecutive neonates with birth asphyxia (Apgar 0-3 at 5-minute of age) were studied. Data from medical records of all babies with perinatal asphyxia admitted were retrieved and documented for the study.Results: Majority of the neonates are inborn (57%). Male to female ratio was 1.5:1. Spontaneous vaginal delivery constitute 32% and lower segment caesarean section (LSCS) 36%. Mortality was highest in hypoxic ischemic encephalopathy (HIE) stage 3 with 11%. Mean duration of hospitalization is directly related to Sarnat and Sarnat staging of HIE. 22% babies were having neurological sequelae and discharged on anti-convulsant. 21% mortality, majority were outborn.Conclusions: Despite advances in the management of neonates, perinatal asphyxia is still the leading cause of morbidity and mortality. Perinatal asphyxia is still prevalent despite medical advances. Babies with HIE stage III had poor outcome. Appropriate strategies required to minimize the neuro-developmental sequelae.

scholarly journals Outcomes and analysis of fetomaternal elements and delivery strategies with neonatal respiratory distress

2021 ◽  
Vol 10 (5) ◽  
pp. 2001
Author(s):  
Sambedna . ◽  
Amit Kumar ◽  
Rita Chakore
Keyword(s):  
Gestational Age ◽  
Significant Relationship ◽  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Morbidity And Mortality ◽  
Delivery Mode ◽  
Study Group ◽  
Maternal Factor

Background: Perinatal asphyxia is one of the most important causes of morbidity and mortality in neonates. Perinatal asphyxia occurs in association with different maternal and fetal determinants. However, the relation of associated factors with perinatal asphyxia is not well studied. The aim of this study was to determine the association of maternofetal factors and mode of delivery with perinatal asphyxia in a tertiary care centre.Methods: This was a retrospective comparative study conducted in department of OBG in tertiary care health centre. A total 200 newborns were selected for study out of which100 newborns were with asphyxia at birth as study group and 100 non asphyxiated newborns were taken as control group. Maternal factor like age, parity, gestational age and fetal factor like weight at birth and mode of delivery were studied to established association on perinatal asphyxia.Results: Maternal factor like age, parity, gestational age had not significant relationship with perinatal asphyxia. Maximum number of babies delivered in both control and the study group were in the range of 2.6 to 3kg.In this study birth weight did not have significant relationship with perinatal asphyxia. Proportions of LSCS was comparatively higher in the study group though. The delivery mode did not have any statistically significant influence on the newborns affliction with birth asphyxia (p>0.05).Conclusions: Findings of this study highlight the need for the better obstetrical care and awareness of the possible presence of the risk factors of PNA (perinatal asphyxia) among mothers and fetus, so that the incidence and complications of PNA could be prevented or at least appropriately managed. It can reduce the high incidence of morbidity and mortality due to birth asphyxia. 

scholarly journals Audit of Neonatal Morbidity and Mortality in A Tertiary Care Hospital, Sylhet

2017 ◽  
Vol 15 (2) ◽  
pp. 45-48
Author(s):  
Farzana Hamid ◽  
Syed Moosa MA Quaium ◽  
Azizur Rahman ◽  
AT Reza Ahmad ◽  
Shahariar Khan ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Perinatal Asphyxia ◽  
Perinatal Care ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Neonatal Morbidity ◽  
Meconium Aspiration Syndrome ◽  
Neonatal Unit ◽  
Care Hospital ◽  
Disease Pattern

Background: To know the disease pattern and causes of morbidity & mortality of patients admitted to the neonatal unit in a tertiary care hospital in Sylhet, Bangladesh.Methods: This retrospective study was conducted in the neonatal unit from December 2014 to November 2015. Data of all the patients admitted to the neonatal unit during study period was analyzed for, age, sex, weight, gestational age, place and mode of delivery, maternal antenatal events, disease pattern and their outcome.Results: A total of 985 patients were admitted during study period. Among 985 cases 566(57.5%) were male and 419(42.5%) were female. 450(45.6%) were admitted at the age of less than 24 hours. 122 (12.4%) were preterm babies. 202(20.5%) were low birth weight. 693(70.4%) were delivered in hospital. Main causes of admission were perinatal asphyxia 398(40.4%), neonatal sepsis164 (16.6%), preterm LBW 122(12.4%), Meconium Stained Baby (MSB) 88(8.9%), Intrauterine Growth Retardation (IUGR) 80(8.1%), neonatal jaundice 62(6.2%), Infant of Diabetic Mother (IDM) 30(3.0%), Transient Tachypnoea of Newborn (TTN) 15(1.5%), Meconium Aspiration Syndrome (MAS) 10(1.1%), Respiratory Distress Syndrome (RDS) 6(0.6%) and congenital anomaly 10(1.1%). Most of the deaths were associated with preterm LBW (6.5%), perinatal asphyxia with Hypoxic Ischaemic Encephalopathy (HIE) (4.5%), sepsis (2.4%), RDS (16.7%), MAS (10%).Conclusion: Preterm LBW, perinatal asphyxia and neonatal sepsis were the three leading cause of neonatal morbidity & mortality. These findings could be important in identifying the areas requiring attention to improve the perinatal care and also to manage the problems associated with them.Chatt Maa Shi Hosp Med Coll J; Vol.15 (2); Jul 2016; Page 45-48

Maternal and neonatal outcome in pregnancy bbeyond 41 Weeks of Gestation: Observational study

2021 ◽  
Vol 8 (2) ◽  
pp. 53-57
Author(s):  
Dr. Asmita Misal ◽  
Dr. Urmila Gavali ◽  
Dr. Gautam S. Aher
Keyword(s):  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Maternal Morbidity ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Labour Induction ◽  
Care Hospital ◽  
Perinatal Complications ◽  
Perineal Tear ◽  
Meconium Stained Amniotic Fluid

Background: Pregnancy beyond term is associated with adverse maternal and perinatal outcome. The aim of the study the maternal and perinatal outcome in pregnancies at and beyond 41 week of gestation. Methods: This is a prospective study of 140 patients with pregnancy beyond 41 weeks fulfilling the eligibility criteria and admitted and delivered in department of obstetrics and gynaecology at a tertiary care hospital. We examined its association with following outcomes: age, parity, genetic factors, bishop’s score at admission, mode of delivery, induction rate, meconium stained amniotic fluid, oligohydramnios, Perinatal and neonatal morbidity, Perineal tear, postpartum haemorrhage, maternal morbidity and mortality etc. Results: Out of 140 patients, majority in the age group of 21-25 years, 68 (48.6%) patients were primigravida while 72 (51.4%) patients were multigravida. Maximum patients 65% were not in labour whereas 35% were in labour. In 51 (36.4%) patients mode of delivery was caesarean section, in which most common indication being foetal distress in 25.5% followed by meconium stained amniotic fluid in 17.6%. In present study perinatal morbidity like stillbirth, RDS were 2.86% & 25.8% respectively. Maternal morbidity like PPH, tear and wound infection were 4.31%, 6.4%, 0.7%respectively. Conclusions: With Regular antenatal check-up, incidence of post term pregnancy can be decreased and Labour induction should be considered at 41weeks to prevent lot of maternal and perinatal complications.

scholarly journals MODE OF DELIVERY AND ITS IMPACT ON NEONATAL OUTCOMES IN PRETERM INFANTS

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e27-e27
Author(s):  
Sarah McKnight ◽  
Bishal Gautam ◽  
Michael Miller ◽  
Bryan S Richardson ◽  
Orlando da Silva
Keyword(s):  
Caesarean Section ◽  
Preterm Infants ◽  
Periventricular Leukomalacia ◽  
Ductus Arteriosus ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Neonatal Outcomes ◽  
Care Hospital ◽  
Significant Difference

Abstract BACKGROUND The optimal mode of delivery for preterm infants remains controversial, and routine Caesarean sections (C/S) are not recommended, except for maternal indications. Nonetheless, many preterm infants are delivered by C/S, particularly those in breech presentation, and recent retrospective data have suggested that these infants may have improved outcomes. OBJECTIVES To examine whether C/S as the mode of preterm delivery is associated with decreased mortality and improved short term outcomes. DESIGN/METHODS This retrospective, population-based cohort study examined infants with a gestational age between 23 0/7 weeks and 32 6/7 weeks, born between January 1, 2007 and December 31, 2016, and admitted to the Neonatal Intensive Care Unit at a single Canadian Tertiary Care hospital. Infants with major congenital anomalies were excluded. Data were abstracted from the local Neonatal-Perinatal database for all infants. Two groups, those delivered vaginally and those delivered by C/S, were compared for major neonatal outcomes including the primary outcomes of death and severe intraventricular hemorrhage (IVH), defined as grade 3 or higher. RESULTS A total of 1442 infants met inclusion criteria (784 born by C/S and 658 vaginally). There was no significant difference in neonatal mortality (7.0% vs 7.1%, p=0.925) or severe IVH (6.1% vs 7.4%, p=0.317). There was, however, a significant difference in the incidence of IVH, any grade (19.9% vs 27.5%, p=0.001), which remained after controlling for other significant predictors. There were no other significant differences in the secondary outcomes examined including need for extensive resuscitation, respiratory distress syndrome, bronchopulmonary dysplasia, patent ductus arteriosus, necrotizing enterocolitis, periventricular leukomalacia, or retinopathy of prematurity. CONCLUSION Caesarean section was not associated with decreased mortality in preterm infants, relative to vaginal births. Caesarean section was associated with a reduced rate of IVH (any grade) and there was a trend towards decreased severe IVH which may warrant further study.

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