scholarly journals Clinical Pattern of Neonatal Infections

2014 ◽  
Vol 1 (3) ◽  
pp. 5-13
Author(s):  
MN Islam ◽  
Abdul Hannan ◽  
S Zahid Hossain ◽  
Md. Habibur Rahman ◽  
SA Razzaque

Neonatal infection is an important cause of morbidity and mortality among infants. Clinical pattern of neonatal infection in the neonatal unit of Institute of Post Graduate Medicine & Research (IPGM&R), Dhaka has been reported. Out of total 2160 Neonatal admission from July 1991 to June 1993, 320 (14.8%) cases of neonatal infections were found. Septicemia was the commonest type found in 118 (5.5%) cases. Other infections included umbilical sepsis (14.7%), Skin infections (1.6%), Meningitis (1.2%). Tetanus neonatorum were not included. Out of 320 cases, 20 patients died (6.2%). Preterm low birth weight and birth asphyxia were the common risk factors.DOI: http://dx.doi.org/10.3329.bjms.v1i3.17909

2018 ◽  
Vol 30 (1) ◽  
pp. 19-22
Author(s):  
Ummay Salma ◽  
Mahe Jabeen ◽  
Sabiha Shimul ◽  
Dilruba Akhter

Less fetal movement affects perinatal outcome. To examine association between antenatal CTG findings and perinatal outcome in women with less fetal movement. This prospective observational study was conducted in the department of Obstetrics and Gynecology, Kumudini Women's Medical College and Hospital, Mirzapur, Tangail over a period of six months from January 2015 to June 2015. It included 100 pregnant women after 34 weeks of gestation. They underwent a cardiotocogram (CTG) test. Data were collected by face-to-face interview, observation and document review. The mean age of the women was 24.37±4.62 (SD) years and mean gestational age was 38.48±2.15 weeks. In this study, 82.0% of the cases presented at term pregnancy, 42.0% of the women were primi gravida and rest falls between 2nd to 4th gravida. Normal vaginal delivery was in 59.0% cases and rest were undergone caesarean sections (41.0%). Late deceleration with decreased variability was (23.5%) most common. Incidence of low birth weight was 16.0% & macrosomia was 5.0%. Birth asphyxia was found in 52.0% cases, 49.0% needed immediate resuscitation, 35.0% were admitted into neonatal unit and early neonatal death was 8.0%. Birth asphyxia was significantly higher in non-reassuring [37(72.5%)] than reassuring [15(30.6%)] on CTG. Incidence of low birth weight was higher in non-reassuring [11(21.6%)] than in reassuring [5(10.2%)] on CTG (p>0.05). Early neonatal death was more in respondents with non-reassuring [5(9.8%)] on CTG than reassuring [3(6.1%)] on CTG (p>0.05). Twenty six (51.0%) neonatal of the non-reassuring were admitted into neonatal unit whereas only 9 (18.4%) neonatal of the reassuring were admitted into neonatal unit. It can be concluded that CTG may be the first line investigation for ante and intrapartum fetal assessment.Medicine Today 2018 Vol.30(1): 19-22


2018 ◽  
Vol 14 (2) ◽  
pp. 56-59
Author(s):  
Jyoti Adhikari ◽  
Shristi Kharel ◽  
Lalita Bahl ◽  
Deepal Poudel ◽  
Rajesh K.C.

Background: Teenage pregnancy is a common public health problem worldwide which is detrimental to the health of mother and child and has long been considered a high-risk situation. The risk of low birth weight (LBW) and preterm delivery is particularly high among teenagers.Methods: A comparative study was conducted in Nepalgunj Medical College Teaching Hospital, Kohalpur during the period of July 2015 to June 2016. The study was carried out to compare the immediate neonatal outcome and morbidity pattern in neonates of 50 adolescent and 50 adult mothers.Results: In the present study, 84% belonged to adolescent mother group (17-19 years) whereas 50% belonged to adult mother group (20-23 years). Illiteracy was seen more in adolescent mothers (62%) and most were from rural areas (68%). The common immediate neonatal outcome found in adolescent and adult mothers were preterm delivery (96% vs. 52%; p value 0.001), low birth weight (LBW) (70% vs. 38%; p value 0.001). The common neonatal morbidities seen significantly high in neonates of adolescent mothers, viz: Neonatal sepsis (NNS)(54% vs. 20% p value <0.02), apnea (30% vs. 14% P value <0.02), neonatal jaundice(NNJ)(44% vs. 30% p value <0.01) while the other morbidities found were birth asphyxia (20% vs. 14%; p value <0.1), Respiratory distress syndrome (RDS) (36% vs. 24% p value<0.1), anemia (16% vs. 8%; p value <0.1), seizure (10% vs. 8%; p value <0.1), meconium aspiration syndrome (MAS) (6% vs. 18%; p value<0.1) and intrauterine growth retardation(IUGR)(22% vs. 20%; p value <0.5). Similarly mortality was found to be more in neonates of adolescent mothers (14% vs. 8%; p value <0.1).Conclusion: Adolescent pregnant mothers are at risk of having poor neonatal outcome and morbidities like NNS, NNJ, RDS, apnea, IUGR, birth asphyxia, anemia and seizure. JNGMC,  Vol. 14 No. 2 December 2016, Page: 56-59


2020 ◽  
pp. 32-34
Author(s):  
Prabodh Chandra Mondal ◽  
Dhruba Kumar Mahata ◽  
Rincy Mathew ◽  
Debarshi Jana

INTRODUCTION Newborns receiving intensive care require frequent determination of hematologic status, blood chemistry and arterial gas analysis. Anemia of prematurity (AoP) is common in preterm very low birth weight babies (<1.5 kg body weight).Nearly all extremely preterm infants develop AoP and up to 90% require atleast one red blood cell transfusion during their NICU stay. However, anotherim[ortant cause for AoP seems to be related to iatrogenic blood loss due to frequent laboratory investigations. Recently, several small studies reported that newborns especially preterm VLBW infants may lose more than half of their blood volume due to cumulative laboratory blood sampling in the first weeks after birth. OBJECTIVES To determine the total amount of blood sampled in VLBW new-borns during the stay in the neonatal unit (SNCU& NICU). The number and total amount of blood transfused in VLBW new-borns during the stay. The relationship between blood loss due to blood sampling and blood transfusion in VLBW. MATERIALS AND METHODS A prospective observational study is being planned to perform in all VLBW new-borns admitted in the neonatal unit of a tertiary care centre in eastern India. This study will be conducted for 6 months in all VLBW. Subjects will be subdivided into 1000gm (500gm to 999gm) and >- 1000gm- < 1500gm. Each group will be subdivided into critically ill or not. Babies with RDS requiring surfactant and/or ventilator treatment, birth asphyxia with HIE and/or in whom infection is strongly suspected or verified by blood investigation and culture will be considered as critically ill. Those babies with duration of stay more than 5 days will be considered for the study. RESULTS Our study showed that total of 214 babies (both VLBW, ELBW) admitted from 1/11/2019 to 30/4/2020.Among these, 130 babies admitted in the SNCU for more than 5 days. Out of this, 86 babies were eligible in the study satisfying all inclusion criteria. Baseline characteristics are mentioned in table 1.Table 2 presents the comorbidities like respiratory distress, birth asphyxia, sepsis. The total iatrogenic blood loss was 3ml (0.90- 11.89). The average blood loss was 3.4 ml/kg. CONCLUSION From our study we found that sampling related blood loss is higher among lower birth weight babies. As birth weight decreases, sampling related blood loss increases and further need for transfusion increase.


Author(s):  
K. Famra ◽  
P. Barta ◽  
A. Aggarwal ◽  
B.D. Banerjee

OBJECTIVES: Neonatal seizures are significant cause of neonatal mortality and morbidity. Current study was planned to study prevalence of adverse outcomes in neonatal seizures and identify its predictors. METHODS: This observational descriptive study was carried out on 220 neonates with seizures. Neonates who succumbed to illness/ death before investigations, or whose maternal records were incomplete were excluded. Blood sugar, serum calcium, serum electrolytes, and USG skull were done in all patients. CT scan, MRI and inborn errors of metabolism profile were done as and when indicated. Adverse outcomes were defined as death, phenobarbitone non responders, or abnormal examination at discharge. Antenatal, perinatal and neonatal predictors of adverse outcomes in neonatal seizures were evaluated. RESULTS: Out of 220 neonates with seizures 76(34.5%) had adverse outcomes. Very low birth weight babies (≤1500 gm) [OR 1.27(CI 0.57–2.84)], microcephaly [OR 5.93 (CI 0.55–64.41)], Apgar score≤3 at 5 minutes [OR 11.28(CI 14.18–30.45)], seizure onset within 24 hours [OR 5.99(CI 12.43–14.78)], meningitis [OR 2.63(CI 0.08–6.39)], septicemia [OR1.22(CI 0.45–3.31)] and abnormal cranial USG [OR 7.95(CI 12.61–24.22)] were significant predictors of adverse outcomes in neonates with seizures. CONCLUSION: Prematurity, very low birth weight, birth asphyxia, meningitis, septicemia and abnormal USG could predict adverse outcomes in neonatal seizures. Improved antenatal and neonatal clinical practices may help reduce adverse outcomes in these patients.


2016 ◽  
Vol 15 (2) ◽  
Author(s):  
Keline Soraya Santana Nobre ◽  
Maria Vera Lúcia Moreira Leitão Cardoso ◽  
Juliana Lopes Teixeira ◽  
Márcia Maria Coelho Oliveira Lopes ◽  
Fernanda Cavalcante Fontenele

Aim:  analyze  the  use  of  peripherally  inserted  central  catheter  in terms of the aspects of technique, positioning and maintenance, as well as the influence on the number of venous dissections in hospitalized infants in a neonatal unit. Method: descriptive,  retrospective,  quantitative  study,  in  reference  maternity  unit  of  a  city  in northeastern  Brazil.  Sample  composed  of  1,599  peripherally  inserted  central  catheter insertions in 1,204 infants during the years 2006 to 2013. Instruments were used that recorded  aspects  of  the  insertion  of  peripherally  inserted  central  catheter  and  venous dissection.  Results:  most  babies  were  premature,  of  low  birth  weight  and  male.  The veins  of  the  cubital  region  were  the  most  punctured  with  insertion  success  until  the fourth  puncture.  The  central  positioning  of  the  catheter  tip predominated,  with  a permanency  time  between  11  and  20  days,  removing  it  at  the  end  of  the  treatment. Over  the  years,  the  number  of  venous  dissections  was  inversely  proportional  to  the insertion  of  peripherally  inserted  central  catheter.  Conclusion:  this  transvenous  device was  shown  to  be  important  for  the  treatment  of  hospitalized  newborns,  favoring reduction of venous dissections.


2020 ◽  
Vol 8 (1) ◽  
pp. 92
Author(s):  
B. C. Yelamali ◽  
Gangadhar S. Mirji ◽  
Mirnalini Rajput

Background: Persistent pulmonary hypertension in newborns (PPHN) remains a significant cause of perinatal morbidity and mortality. Early recognition of factors that increase the risk of PPHN is of great importance in either to prevent or to treat PPHN optimally. Aim was to study the neonatal predisposing factors, profile and outcome of PPHN.Methods: This retrospective study was conducted in level III neonatal care unit, a rural referral centre of North Karnataka, India from January 2018 to April 2020.Results: During the study period a total of 50 infants with PPHN were identified with the incidence of 5.43/1000 live births. Mean gestation age (±SD) was 38.28±2.49 weeks and mean birth weight (±SD) was 2624±512 gm. The most noted risk factors were meconium aspiration syndrome (42%), birth asphyxia (16%), RDS (10%), positive pressure ventilation at birth (52%) and male gender (62%). Out of 50 infants with PPHN, high mortality was seen in low birth weight babies (66.6%). Use of sildenafil showed increased mortality (56.2%) whereas use of surfactant scored better with decreased mortality of 42.8%.Conclusions: Major risk factors for PPHN are MAS, birth asphyxia, RDS and low birth weight. Poor prognosis is seen in male gender, prematurity and CDH with increased risk of mortality. The use of systemic pulmonary vasodilators can be considered with caution and use of surfactant has a role in management of PPHN.


2018 ◽  
Vol 5 (2) ◽  
pp. 427 ◽  
Author(s):  
Anuradha D. ◽  
Rajesh Kumar S. ◽  
Aravind M. A. ◽  
Jayakumar M. ◽  
J. Ganesh J.

Background: Every year, nearly four million newborn babies die in the first month of life. India carries the single largest share (around 25-30%) of neonatal deaths in the world. Neonatal deaths constitute two thirds of infant deaths in India. 45% of the deaths occur within the first two days of life. It has been estimated that about 70% of neonatal deaths could be prevented if proven interventions are implemented effectively at the appropriate time. It was further estimated that health facility-based interventions can reduce neonatal mortality by 23-50% in different settings. Facility-based newborn care, thus, has a significant potential for improving the survival of newborns in India. This research has been planned with an aim to study the profile of pattern of admissions in a SNCU and their outcomes following admission and management in the unit.Methods: All babies referred for neonatal problems (less than 28 days) and admitted in NICU will be included. Both term and preterm babies will be considered. The criteria for admission includes various causes like low birth weight, preterm, birth asphyxia, respiratory distress, hyperbilirubinemia, congenital anomalies, risk factors (maternal, neonatal, prenatal), infections and outcome will be analysed.Results: Among the 2927 admissions term babies and boys outnumbered. The common causes for admission were birth asphyxia, respiratory distress, low birthweight and preterm. Most babies had an uncomplicated stay. The mortality in the extramural neonates was due to neonatal sepsis, extreme preterm and congenital malformations.Conclusions: Intensive and interventional management, along with good neonatal monitoring and care can reduce the mortality and improve the survival of low birth weight babies and other treatable problems. Thus, a combined effort of management by pediatricians, nursing care, neonatal intensive care unit can improve the survival rates of neonates.


2019 ◽  
Author(s):  
Alemwork Desta Meshesha ◽  
Muluken Azage ◽  
Endalkachew Worku ◽  
Getahun Gebre Bogale

Abstract Background Globally, every year, 2.5 million infants die within their first month of life. Neonatal asphyxia is the leading specific cause of neonatal mortality in low- and middle-income countries, including Ethiopia. Therefore, the aim of this study was to identify the determinants of birth asphyxia among newborns admitted in Amhara region referral hospitals, Ethiopia. Methods Facility-based unmatched case-control study was employed among 193 cases and 193 controls of newborns. Newborns admitted to neonatal intensive care units with admission criteria of birth asphyxia and without birth asphyxia were considered as cases (Apgar score<7) and controls (Apgar score>=7) respectively. Data were collected using a structured questionnaire by systematic random sampling technique with proportional allocation, and entered in to Epi-Info version 7 and exported to SPSS version 20 for statistical analysis. Bivariate and multivariable logistic regression models were fitted to identify determinants of birth asphyxia. Results Newborns with low birth weight (<2.5kg) had 8.94 higher odds of birth asphyxia than those whose weight at birth was >=2.5kg at birth (AOR: 8.94, 95% CI: 4.08, 19.56). Newborns born at health centers were 7.36 times more likely to develop birth asphyxia than those born at hospitals (AOR: 7.36, 95% CI: 2.44, 22.13). Newborns born using instrumental delivery were 3.03 times more likely to develop birth asphyxia than those delivered by vaginally (AOR: 3.03, 95% CI: 1.41, 6.49). Newborns from mothers with prolonged labor were 2 times more likely to suffer from birth asphyxia as compared to their counterparts (AOR: 2.00, 95% CI: 1.20, 3.36). Conclusion This study identified prolonged labor, instrumental delivery, delivered at health centers, and low birth weight were identified as determinants of birth asphyxia. Thus, intervention planning towards the identified determinants may be needed to reduce neonatal birth asphyxia.


2020 ◽  
Vol 32 (2) ◽  
pp. 26-31
Author(s):  
Fatima Zohra ◽  
Md Faruq Alam ◽  
Mekhala Sarkar ◽  
Shahriar Faruque ◽  
Mohammad Waliul Hasnat Sajib

Neurodevelopmental disorders (NDD) are public health burden worldwide. NDD causes disabilities and reduces the quality of life. Perinatal factors like maternal age, stress, maternal physical illnesses, birth complications, preterm birth, low birth weight and neonatal infections are the important risk factors for NDD. The objectives of the study were to determine the proportion of perinatal factors among children with neurodevelopmental disorders attending tertiary care hospitals in Dhaka city. This was a cross-sectional study conducted in outpatient department of National Institute of Mental Health (NIMH), Dhaka and Institute of Paediatric Neurodisorder and Autism (IPNA), Bangabandhu Sheikh Mujib Medical University (BSMMU) from January 2017 to July 2018. Among 115 children with NDD aged 0-17 years satisfying inclusion and exclusion criteria who were conveniently selected as sample. After diagnosing NDD using DSM- 5 criteria by psychiatrists and paediatric neurologists, a semi structured questionnaire was applied by researcher herself that included socio-demographic and perinatal factors as well. Results showed that majority of the respondents (29.6%) were 5-8 years with male predominance (78.3%). The most common perinatal factors were maternal factors like maternal stress (68.7%), maternal physical illness (66.1 %), inadequate food/rest intake (53.9%) and inadequate weight gain during pregnancy (50.4%). Fetal and neonatal factors like birth complication (82.6%), preterm birth (80%), low birth weight (75.6%), neonatal illness (69.6%) and birth asphyxia (61.7%). Most common neonatal illness were pneumonia (30.0 %) followed by neonatal Jaundice (20%). Early identification of possible perinatal factors and providing safe perinatal period can give a positive impact in prevention of NDD in children. Bang J Psychiatry 2018;32(2): 26-31


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