Effect of Prophylactic Phenobarbital on Seizures; Encephalopathy and Mortality in Neonates with Perinatal Asphyxia

Background. Seizures after an asphyxial insult may result in brain damage in neonates. Prophylactic phenobarbital may reduce seizures.Objective. To determine the effect of prophylactic phenobarbital on seizures; death and neurological outcome at hospital discharge.Methods. Neonates with base deficit 16 mmol/l and Apgar score at 5 minutes 7 or requiring resuscitation for 5 minutes at the time of birth were randomised to prophylactic phenobarbital 40 mg/kg (n=50) or placebo (controls) (n=44) within the first 6 hours of life. They were monitored for clinical seizures; hypoxic ischaemic encephalopathy (HIE) and mortality.Results. Seizures developed in 30.0 of the phenobarbital group as opposed to 47.7 of the control group (relative risk 0.63; 95 confidence interval -0.37 - 1.06; p=0.083). The proportions of patients who had died and/or had HIE II or III at time of discharge from hospital were similar in the two groups (42.0 v. 45.5). There were no differences in mortality between the two groups (14.0 v. 15.9). Conclusion. In infants with asphyxia; prophylactic phenobarbital does not reduce the incidence of seizures; HIE and mortality

Morbidity and Mortality Pattern of Neonates Admitted into Nursery Unit in Wad Medani Hospital; Sudan

Background: Neonatal outcome is an important indicator of obstetrics and health care. Few or no published data are available concerning neonatal morbidity and mortality in Sudan. Objectives: To study morbidity and mortality pattern amongst inborn neonates admitted into nursery unit in Wad Medani Hospital; Sudan during the period Jan-June; 2009. Results: A total of 1211 (29.5) out of 4098 in-born neonates were admitted during study period. The major indications for neonatal admission were; infections 300 (24.8); low birth weight (LBW) 307(25.4) and asphyxia 130(10.7). There were 133(11) neonatal deaths; preterm delivery; LBW and birth asphyxia were the major causes of death among these neonates. Conclusion: neonatal infection; preterm birth and LBW were the common causes of neonatal morbidity and mortality. There is an urgent need for more research throughout the country concerning these common causes of morbidity and mortality