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 ◽  
...  

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

2021 ◽  
pp. 48-50
Author(s):  
Neha Agarwal ◽  
Samta Bali Rathore ◽  
Shivani Baberwal-

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.


2014 ◽  
Vol 52 (196) ◽  
pp. 1005-1009
Author(s):  
Sweta Kumari Gupta ◽  
Bhawani Kanta Sarmah ◽  
Damodar Tiwari ◽  
Amshu Shakya ◽  
Dipendra Khatiwada

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.


Author(s):  
Pravinkumar A. Jadav ◽  
Palak M. Dabhi ◽  
Dhruti A. Rathod

Background: Caesarean section (CS) performed in the second stage of labour has many implications for maternal and neonatal morbidity as well as for subsequent pregnancies. The objectives of this study were to determine the rates of CS at full dilatation, their indications, associated maternal and neonatal complications.Methods: This retrospective study assessed all the women with a singleton fetus in cephalic presentation at term (≥37 weeks) who underwent CS in the second stage of labor between 1 August 2019 and 31 March 2020 at a tertiary care hospital. Maternal demographics, labour and delivery details as well as neonatal outcomes were collected.Results: During the study period, 2124 (36%) babies were born by CS. Of these, 49 (2.3%) were performed in the second stage of labour at ≥37 weeks of gestation. The most common indication of CS was non-descent of head in 38 (77.55%) of cases. The majority of women 38 (77.55%) delivered by CS in the second stage of labor were primiparous. The 27 (55.10%) women were in the age group of 20-25 years. Most common intraoperative complication was blood-stained urine in 20 (40.81%) women. Overall transfusion rate was 18.36%. Maximum number of babies born 44 (89.79%) were having birth weight between 2.5-3.5 kg. Out of 65 babies born, 17 (34.69%) were admitted to neonatal intensive care unit.Conclusions: Formulation of an institutional protocol and training and supervision of trainees to improve the skill of operative vaginal delivery and second stage cesarean is needed.


2018 ◽  
Vol 56 (209) ◽  
pp. 510-515 ◽  
Author(s):  
Susana Lama ◽  
Shyam Kumar Mahato ◽  
Nagendra Chaudhary ◽  
Nikhil Agrawal ◽  
Santosh Pathak ◽  
...  

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.


Author(s):  
Merin Baby ◽  
Sruthi M. V.

Background: Caesarean section is a surgical procedure done when vaginal delivery is contraindicated. The prevalence of caesarean section in Kerala showing an increasing trend. Even though the caesarean section is an emergency lifesaving procedure, various other factors like socio-demographic determinants, economic factors and patient’s or clinician’s preferences also influence this increasing trend. The present study was undertaken to compare the various determinants of caesarean section with normal delivery from a tertiary care hospital in Thrissur district.Methods: A hospital-based case control study was done taking mothers who had undergone caesarean section as cases and mothers who had undergone normal delivery as controls during two-month period. The sample size was calculated using the formulae: (Zα + Zβ)2x2xPQ/d2, and the calculated sample size was 88. The various determinants used were socio-demographic, obstetrics and cultural determinants.Results: In this study, it was found that the most common indications for C-section were previous C-section, PPROM and foetal distress. There was a statistically significant association between obstetrics determinants like complications during pregnancy, number of USG taken, period of gestation with mode of delivery. The present study also shows that mothers with educational status up to graduate/PG have lesser incidence of caesarean section. There was a statistically significant association between delivery date close to holidays/festival days and C-section.Conclusions: It is necessary to have health awareness sessions to pregnant mothers about the complication of pregnancy, benefits of normal delivery and complications of C-sections in-order to reduce the patients’ preference for C-section.


Author(s):  
Elango Krishnana ◽  
Venmugil Ponnusamy ◽  
Sathiya Priya Sekar

Background: Perinatal asphyxia is a common neonatal problem and there is significant contribution to neonatal morbidity and mortality. It is regarded as an important and common cause of preventable cerebral injury. The prediction of perinatal asphyxial outcome is important but formidable. There is only a limited role for the Apgar score for predicting the immediate outcome, such as HIE and the long-term neurological sequelae observational error can happen in APGAR. But biochemical parameters can be truly relied upon. This study was to evaluate the utility of urinary uric acid to creatinine ratio (UA/CR ratio) as non-invasive, easy, cheap and at the same time early biochemical means of asphyxia diagnosis.Methods: In this prospective case control study conducted in KAPV Government medical college between Feb 2017 to Sept 2017, 100 asphyxiated and 100 non-asphyxiated newborns were included. Detailed history and assessment were for all the enrolled newborns. Spot urine samples were sent for uric acid and creatinine estimation. Results were recorded, and statistical analysis was done.Results: The mean Uric acid/Creatinine ratio in the cases and controls groups were 2.58±1.09 and 0.86±0.17 respectively. The ratio also correlated well with the stage of HIE.Conclusions: The ratio of UA/Cr enables early and rapid recognition of asphyxial injury and also the assessment of its severity and the potential for short term morbidity or death.


1970 ◽  
pp. 32-39
Author(s):  
Lutfun Nahar Begum ◽  
Kishwar Azad ◽  
Shahida Akhter ◽  
Nazmun Nahar ◽  
Abu Hasan Md Abdullah

Objective: To determine the causes of perinatal death using Wigglesworth classification and to assess the feasibility of using Wigglesworth classification in a tertiary care hospital setting. Methods: All live and stillborn babies delivered at BIRDEM over a 5 yr period(from January 2000 to December 2004) were recorded. Perinatal deaths of that period were analysed according to Wigglesworth classification Results: According to Wigglesworth classification, majority of deaths were in the group "macerated stillbirths" (63.5%). Perinatal asphyxia was responsible for 13.6% of deaths, lethal congenital malformation was found in 11.2% and immaturity and "others" each accounted for 6.1%. Conclusion: Macerated stillbirth and asphyxia were the two leading causes of death at BIRDEM and Wigglesworth classification has been found to be feasible in BIRDEM for categorising perinatal deaths retrospectively. Key words: Perinatal death; Wigglesworth classification DOI: 10.3329/bjch.v31i1.6072 Bangladesh Journal of Child Health 2007; Vol.31(1-3): 32-39


2018 ◽  
Vol 5 (6) ◽  
pp. 326-335
Author(s):  
Dr. Uma Maheswara Rao Kuppili ◽  
◽  
Dr. Simhachalam Malluvalasa ◽  
Dr. Mudunuri Satya Revathi ◽  
◽  
...  

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