CLINICAL PRESENTATION AND OUTCOME OF NICU ADMISSIONS IN GOVERNMENT GENERAL HOSPITAL, ANANTHAPURAMU

Dr.Bellamkonda Sravani; Dr.C.V.Prathyusha

Volume : VII, Issue : XII, December - 2018

CLINICAL PRESENTATION AND OUTCOME OF NICU ADMISSIONS IN GOVERNMENT GENERAL HOSPITAL, ANANTHAPURAMU

Dr. Bellamkonda Sravani, Dr. C. V. Prathyusha

Abstract :

Knowing the pattern of neonatal diseases is a useful indicator of the availability, utilization, and effectiveness of maternal and child health care services and varies from place to place and time to time even in the same locality. Information on admission and mortality patterns of hospitalized neonates reflects the major causes of illnesses and standard of care provided to neonates in a particular locality. Such information identify gaps and provide a basis on which interventions to improve neonatal outcomes are designed which ultimately help in reduction of neonatal morbidity and mortality.

Objective: To study the clinical presentation of NICU admissions and their outcome in GGH, Ananthapuramu.

Materials & Methods: A retrospective study of all NICU admissions in the period of six months from January2018 to June 2018. All admissions are analysed in terms of sex, gestational age, birth weight, in or outborn, clinical diagnoses and their outcomes.

Results: During the study period, 945 neonates are admitted in NICU of which 513 (54.28%) are male and 432(45.71%) are female. Majority of the cases are term 644(68.15%) and rest are preterm 301 cases (31.85%). Of the total cases studied, 444(46.98%) are intramural and 501(53.01%) are extramural. 490 cases (51.9%) are admitted on D1OL, 328 cases (34.7%) are admitted on D2-5OL and the rest are admitted after D5OL. The most common indication for admission is prematurity with 31.85% and commonest disease is respiratory distress seen in 265 neonates (28.04%) followed by perinatal asphyxia in 244 neonates (25.8%), neonatal sepsis in 135 neonates (14.28%), NNJ in 128 neonates (13.54%), MAS in 32 cases (3.38%), congenital malformations in 19 (2%), hypoglycemia in 11 neonates (1.16%). Mortality is seen in 165neonates (22.3%), majority in term neonates 93(56.36%) and almost equally distributed among both sexes. Majority 585neonates (62%) are small for gestational age. The most common primary cause for death is perinatal asphyxia (49.69%), followed by respiratory distress (38.18%), neonatal sepsis (27.27%), meconium aspiration syndrome (9.09%), NEC, congenital malformations.

Conclusions:

Improving the survival chances of newborns, and reduction of neonatal morbidity is a health sector priority and remains an urgent challenge. Neonatal period is a very vulnerable period with a high risk of morbidity and mortality; most of which are preventable with good obstetric and subsequent neonatal care. Early anticipation and prompt management is very essential to reduce neonatal mortality. In order to reduce neonatal mortality rates, special emphasis must be placed on ready and affordable access to essential obstetric care, well-equipped and adequately staffed maternal health-care services, skilled attendance at delivery, emergency obstetric care, effective referral and transport to higher levels of care when necessary and post-natal care particularly for those living in areas without access to services