Predictive factors for birth trauma in southwestern Nigeria

Birth trauma is a significant cause of neonatal morbidity and mortality. This prospective study determined the predictive factors for birth trauma as seen in a Nigerian university teaching hospital. This was a prospective descriptive evaluation of birth trauma at Wesley Guilds Hospital, Ilesa over three years. Semi-structured questionnaire was used to collect data on the age, gender, pattern of presentation, place and mode of delivery, level of birth attendants, and treatment offered. Outcome measures were factors predisposing to birth trauma. A total of 137 neonatal hospital admissions with birth related complaints were recorded between 10th December, 2002 and 9th December 2005, out of which 119(86.8%) patients had 121 birth injuries (Males: Females= 1.4: 1). The mean age was 6 ± 4.1 (range: 1-31) day. Non skeletal injuries included cephalohaematoma 30(24.8%), genital bruises/abrasion 4(3.3%), subconjuctiva haemorrhage 2(1.7%), subdural haemorrhage 1 (0.8%), nasal necrosis 1(0.8%), Erb`s`palsy 31(25.6%) and Klumpke`s palsy 2(1.7%). Skeletal injuries were mainly bone fractures 50(41.3%)with 2(1.7%)mortality. Ante natal care/delivery, level of birth attendants, mode of delivery, fetal distress, and emergency caesarian section were among the factors that determined birth trauma. The prevalence of birth trauma is high in southwestern Nigeria. The predictive factors are easily identifiable in the perinatal period; early recognition could reduce significantly birth trauma

Iatrogenic burns injury complication neonatal resuscitation

A case of iatrogenic thermal injury in a newborn infant during resuscitation for perinatal asphyxia at a secondary health facility is described. The injury; with surface area coverage of about 4; involved the lower limbs. This report highlights the poor newborn resuscitation skills of traditional medical practice

Improved survival rate in neonatal tetanus among babies of immunised mothers

Fifty-two neonates admitted for tetanus into our neonatal unit at Wesley Guild Hospital; Ilesa over a thirty-month period were analysed in relation to maternal immunisation with tetanus toxoid during pregnancy. Seventeen (32.7) of the babies were delivered to mothers who had tetanus toxoid immunisation during pregnancy. The male to female ratio; mean age and weight of babies in the two groups were similar. Six mothers took discharge of their babies against medical advice. Twenty (43.5) of the remaining 46 babies died. The fatality rates in the 16 infants of mothers who had tetanus toxoid and 30 infants of mothers who did not have tetanus toxoid during pregnancy were 12.5and 60respectively (P0.01). This report thus shows that neonatal tetanus can occur in babies of mothers immunised with tetanus toxoid during pregnancy but that maternal immunity probably improved the prognosis of neonatal tetanus in such infants