scholarly journals An Analysis of Five years Neonatal Mortality in NICU of a Tertiary Care Hospital of Rawalpindi 2014-2019

2020 ◽  
Vol 24 (4) ◽  
pp. 328-333
Author(s):  
Rai Muhammad Asghar ◽  
Muddasir Sharif ◽  
Khalid Saheel ◽  
Rai Rijjal Ashraf ◽  
Abid Hussain

Objective: This study was done to find out the main causes and magnitude of neonatal mortality in the neonatal intensive care unit (NICU) of Benazir Bhutto Hospital, Rawalpindi over a period of five years.Material and Methods: A hospital-based cross-sectional study was done from June 2014 to July 2019. The registration book of admitted neonates was reviewed by using a checklist to collect data. Data was analyzed in SPSS 24 for descriptive and bi-variate analysis applying the chi-square test and presented in text, frequencies, tables, and percentages.Results: The study assessed a total of 24,459 neonates admitted to the NICU at Benazir Bhutto Hospital over a span of five years (June 2014 to July 2019). The mean birth weight was 2432 grams ± 740 g (range: Between 800 and 6000 g). Male neonates accounted for 59.8% with male to female ratio of 1.5:1. 67.5% male neonates and 32.5% female neonates expired. Overall 19,832 neonates (81.1%) were discharged, while 4636 (18.9%) died, making a Neonatal Mortality Rate of 18.9% (189 per 1000 admissions). 86.21% of these deaths were early neonatal that occurred in the first week of life. The causes of death were pre-maturity/ low birth weight (LBW), suspected sepsis, birth asphyxia, neonatal jaundice, and meconium aspiration syndrome, accounting for 32%, 31%, 30%, 4%, and 3% respectively.Conclusion: In our NICU the neonatal mortality is high with prematurity/low birth weight (LBW), birth asphyxia (BA), neonatal jaundice (NNJ), and meconium aspiration syndrome (MAS) accounting for most of the deaths. These deaths are largely preventable with better antenatal, perinatal, and neonatal care.

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.


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.


2019 ◽  
Vol 6 (4) ◽  
pp. 1485
Author(s):  
Gunasekhar Raju S. ◽  
Somasekhara Rao S.

Background: Four million newborn babies die in the neonatal period, India 1.2 million neonatal deaths every year. India contributes for a quarter of global neonatal deaths and thus faces the biggest newborn health challenge of any country in the world. The aims of the study were done with the objective to conclude the morbidity and mortality pattern of neonates admitted to a neonatal intensive care unit (NICU).Methods: Hospital based prospective study was conducted at NICU Government Medical Collage, Srikakulam, Andhra Pradesh, India. Neonates from admission to discharge flowed, LAMA or death collecting the data by using a predesigned standardized preform.Results: Neonates were admitted in the NICU during period April 2014 to March 2019. The data analysis for the morbidity showed that the neonatal jaundice (NNJ) were 765(10.57%) , septicemia were 1110 (15.34%), prematurity were 593 (8.19%), birth asphyxia were 963 (13.30%), respiratory distress syndrome (RDS) were 184 (2.54%),hypoxic ischemic encephalopathy (HIE) were 984 (8.46%), meconium aspiration syndrome (MAS)were 612 (8.46%),transient tachypnea of neonate (TTN) were 634 (8.76%), low birth weight (LBW) were 418 (5.77%), intra uterine growth retardation (IUGR) were 179 (2.47%), congenital anomalies were 131 (1.81%), meningitis were 83 (1.15%), seizure disorder were 49 (0.68%) and others. The disease wise mortality among the neonates admitted to NICU was studied and were found that prematurity 212 (35.75%), septicemia were 74 (6.67%), birth asphyxia were 91 (21.70%), meconium aspiration syndrome were 70 (11.44%) and respiratory distress syndrome were 66 (35.87%), low birth weight were 102 (24.40%) congenital anomalies were 31 (23.66%) the top major contributors to the neonatal mortality.Conclusions: The commonest causes of admission were neonatal jaundice (NNJ), sepsis, prematurity, meconium aspiration syndrome, birth asphyxia, low birth weight, congenital anomalies. The most common cause of case fatality was prematurity, meconium aspiration syndrome, birth asphyxia, low birth weight, congenital anomalies in NICU in a tertiary care teaching hospital, government medical college, Srikakulam, Andhra Pradesh, India.


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.


Author(s):  
Badri Kumar Gupta ◽  
Amit Kumar Shrivastava ◽  
Laxmi Shrestha

Background: Hypertensive disorders in pregnancy remain a major cause of maternal and neonatal morbidity and mortality worldwide. This study prospectively examined the immediate neonatal outcome of women with maternal hypertensive disorder of pregnancy (HPD).Methods: This is a prospective study conducted at NICU in Universal College of Medical Sciences Hospital over a period from 2nd February 2018 to 1st February 2019. Fifty-two mothers and their newborn were selected. Mothers with gestational hypertension, preeclampsia, and preeclampsia superimposed on chronic hypertension and chronic hypertension were included.Results: Mean maternal age was 26.4 years. Mean gestational age was 34±4 weeks. 38 were male and 24 were female with male: female ratio 1.72:1. Thirty seven (71.2%) mothers needed lower uterine caesarian section, fourteen (26.9%) mothers delivered NVD and one (1.9%) forceps delivery. Low birth weight (<2.5kg) babies were 25 (48.1%%), very low birth weight (<1.5kg) were 9 (17.3%) and normal weight were 18 (34.3%). Intrauterine growth retardation (IUGR) were 18(30%). Perinatal asphyxia 10 (19.2%) were most common cause of admission, other cause of admission were sepsis and prematurity.Conclusions: Eclampsia is still a common and serious complication of pregnancy. Proper antenatal care, detection of preeclampsia with early management and timely referral of high risk patient, administered of MgSO4 in correct doses and properly timed caesarean section in selected cases would reduce the incidence of eclampsia associated maternal and perinatal morbidity and mortality in our facility.


2019 ◽  
Vol 26 (11) ◽  
pp. 1815-1819
Author(s):  
Mirza Liaqat Ali ◽  
Naila Jabbar ◽  
Abdul Hannan ◽  
Azher

Respiratory distress in neonate defines as when rate of respiration is greater than sixty in one minute, nasal flaring, grunting and intercostal / sub coastal recession is present. Various causes are reported of respiratory distress in new born. Objectives: To determine frequency of respiratory distress in new born and to Find frequency of various etiologies of respiratory distress in full term newborn admitted up to the age of 24 hours of birth in Study Design: Cross sectional studies. Setting: Neonatal unit of Jinnah Hospital Lahore. Period: From February 10, 2016 till August 10, 2016. Material and Method: SPSS v-20 was used for analysis of data like name, age, sex, gestational age, maternal record of pregnancy and fetus for etiologies of respiratory distress. Results: There were 100(66.7%) male and 50(33.3%) females in this study. The mean gestational age of these newborn was 39.51±1.51 weeks. Respiratory distress was seen in 16(10.7%) of the cases. Transient tachypnea seen in 4(25%) of the cases, Meconium aspiration syndrome was diagnosed in 2(12.5%), Pneumothorax in 3(18.8%), Congenital pneumonia in 2 (12.5%), Sepsis in 6(37.5%) and Birth asphyxia 2 (12.5%) of early neonatal age were the common observed causes. Conclusion: Respiratory distress was 1/10 of the cases. The commonest etiologies were Sepsis preceding to Respiratory distress syndrome, MAS (Meconium Aspiration Syndrome), TTN (Transient Tacyhpnea of Newborn), Pneumothorax, Congenital pneumonia, Birth asphyxia.


2021 ◽  
Vol 10 (36) ◽  
pp. 3099-3102
Author(s):  
Mihir Kumar Sarkar ◽  
Arindam Halder

BACKGROUND Jaundice in pregnancy contributes to a significant proportion of maternal and perinatal morbidity and mortality in our country. Overall incidence in India is 1 - 4 per 1000 deliveries. There are increased risks of preterm labour, low birth weight babies, meconium-stained liquor, intrauterine fetal death and postpartum haemorrhage. The purpose of this study was to assess the fetomaternal outcome in pregnancy with jaundice in a tertiary level hospital. METHODS This was a two-year retrospective observational study conducted by reviewing the records of jaundice in pregnancy from April 2018 to March 2020. RESULTS Viral hepatitis comes out as the most common cause accounting for 70.37 % of the cases, whereas intrahepatic cholestasis with an incidence of 20. 37 % comes out as the second aetiology. Post-partum haemorrhage is depicted as the major maternal complication whereas prematurity and birth asphyxia come out as the major perinatal complications. CONCLUSIONS The present study projects viral hepatitis (Hepatitis A and E) as the major cause of jaundice in pregnancy. Although low maternal mortality has been recorded in the present study, a high perinatal mortality due to low birth weight and birth asphyxia remains to be a matter of major concern. KEY WORDS Jaundice in Pregnancy, Viral Hepatitis, Postpartum Haemorrhage, Prematurity, Birth Asphyxia


2020 ◽  
Vol 7 (2) ◽  
pp. 47-49
Author(s):  
Dr. Kajalkumari Jain ◽  
Dr. Ramesh B. Kothari ◽  
Dr. Sunil Natha Mhaske ◽  
Dr. Ganesh B. Misal ◽  
Dr. Ujjwala Shirsath

Neonates born through meconium stained amniotic fluid,2-3% of them develop Meconium Aspiration Syndrome. Out of them,5-10% of them develop complications. Meconium Aspiration is typically seen in post-mature, small for date infants or a term infant with intrauterine hypoxia and in babies born with birth weight more than 2500gm.The objective is to study the complications of Meconium Aspiration Syndrome and their outcome in relation to gestational age and birth weight. Methodology: It is an prospective observational study was carried out in NICU of tertiary care centre and included 32 cases of Meconium aspiration syndrome. Study was done in a period of 14 months in and around Ahmednagar district. Result: The complications are Hypoxic Ischemic Encephalopathy (HIE), Seizures, Septicaemia, Pneumonia, Persistent Pulmonary Hypertension(PPHN), Airleak. Outcome of meconium aspiration syndrome in relation to gestational age is maximum death of 56.25% occurred in term babies which were 18.Outcome of meconium aspiration syndrome in relation to birth weight is maximum death of 53.12% occurred in neonates weighing between 2.5 to 3.5 kg which were 17. Conclusion: Meconium aspiration syndrome is seen in the new born period and contributes significantly to the neonatal morbidity and mortality. Severe Hypoxic ischemic encephalopathy being most common complication and birth asphyxia being most common cause of death.


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