Profil épidémiologique, diagnostique, thérapeutique et évolutif des nouveau-nés de faible poids de naissance transfusés au Centre Hospitalier Universitaire de Bouaké (Côte d'Ivoire)

Introduction : La transfusion sanguine est une pratique fréquente en néonatalogie. Aucune étude n'a porté sur cette thérapeutique salvatrice chez le Faible Poids de Naissance (FPN) au CHU de Bouaké. L'objectif de cette étude était de décrire le profil épidémiologique, diagnostique, thérapeutique et évolutif du FPN transfusés pour l'amélioration du pronostic et de la pratique professionnelle. Méthodes : Il s'agissait d'une étude rétrospective, descriptive et analytique réalisée de janvier 2016 à décembre 2017 dans l'unité de néonatalogie du CHU de Bouaké. Etaient inclus tout nouveau-né transfusé quel que soit l'âge gestationnel. Les variables étudiées étaient, l'âge, le sexe, les signes cliniques, les étiologies, la transfusion et l'évolution. Résultats : Sur 1186 nouveau-nés de faibles poids de naissances hospitalisés, 121 (65 garçons, 56 filles) ont été transfusés soit 10,2%. Le nouveau-né, référé dans 78,2%, était prématuré dans 85 cas et hypertrophie dans 36 cas. La prématurité (42,9%), la souffrance néonatale (14,7%) et la difficulté respiratoire (11,4%) étaient les principaux motifs d'admission. Le taux d'hémoglobine médian était de 12,1g/dL. L'infection néonatale (56%) et la prématurité (19%) étaient les principales étiologies. Le culot globulaire érythrocytaire était utilisé dans tous les cas. La transfusion était efficace dans 94,3%. La polytransfusion, 7 cas (5,7%), était motivée par la persistance des signes de décompensation anémique. L'évolution des nouveau-nés était marquée par la guérison 51,2%, le décès 43% et la sortie contre avis médical 5,8%. Conclusion : La transfusion est fréquente chez le FPN au CHU de Bouaké. L'amélioration du pronostic nécessite une bonne collaboration entre le gynécologue-obstétricien, le Centre de Transfusion Sanguine et le pédiatre

Birth Preparedness and Complication Readiness among Women in Mpwapwa District; Tanzania

Abstract:Avoidable mortality and morbidity remains a formidable challenge in many developing countries like Tanzania. Birth preparedness and complication readiness by mothers are critical in reducing morbidities and mortalities due to these complications. The aim of this study was to assess knowledge and practices with respect to birth preparedness and complication readiness among women in Mpwapwa district in Tanzania. A total of 600 women who became pregnant and or gave birth two years preceding the survey were interviewed. Among them 587 (97.8) attended antenatal clinic (ANC) at least once during their last pregnancy. Two thirds of those who attended ANC made four or more visits. The median gestation age at booking for antenatal care was 16 weeks. However; 73.9 the women booked after 16 weeks of gestation. Two thirds of the women were 20-34years old and had at least primary education level. Three hundred and forty six (57.7) had parity between two and four. Only 14.8 of the women knew three or more obstetric danger signs. The obstetric danger signs most commonly known included vaginal bleeding during pregnancy (19); foul smelling vaginal discharge (15) and baby stops moving (14.3). The majority (86.2) of the women had decisions made on place of delivery; a person to make final decision; a person to assist during delivery; someone to take care of the family and a person to escort her to health facility. Majority (68.1) of the women planned to be delivered by skilled attendant. One third of the women planned to deliver at home in the absence of a skilled birth attendant. In the bivariate analysis; age of the woman; education; marital status; number of ANC visits and knowing ?3 obstetric danger signs were associated with birth preparedness and complication readiness. In multivariate logistic regression analysis; women with primary education and above were twice more likely to be prepared and ready for birth and complications. Women who knew ?3 obstetric danger signs were 3 times more likely to be prepared for birth and complications. In conclusion; women with higher level of education and those who knew obstetric complications were more prepared for birth and complications. Further studies are recommended to find out why women do not prepare for birth or complications especially that need blood transfusion

Care of the Newborn: Community Perceptions and Health Seeking Behavior

Background: Every year; 120;000 newborns die in Ethiopia. In 2005 a national Safe Motherhood Community-Based Survey was carried out on behalf of the Family Health Department to explore community practices surrounding newborn health and care seeking behavior. Objective: To explore and understand health seeking behavior; and identify the positive practices surrounding care of the newborn. Methods: In-depth interviews and focus group discussions regarding newborn care practices were conducted with mothers; older women; men with young children; health providers; religious leaders and elders across Ethiopia's 11 regions. Important findings: Tradition recommends mothers and their newborns to stay at home for 40 days. The principle behind the practice; facilitates the period of rest and repair; establishes breastfeeding and is justified on the grounds that the mother and newborn are vulnerable to malevolent spirits. Perceptions of the causes of newborn mortality and morbidity are consistent with those relating to biomedical causes. Many complained of lack of accessible health care that in event of emergencies. Therefore they have to rely on traditional medicine as it is easily accessed; readily acceptable. Conclusions: When families seek care for their newborns; remedies from traditional healers are often preferred to skilled health workers because of cultural and religious beliefs; poor access to health facilities; (including distance and terrain) and financial barriers

A 4 Year Review of Neonatal Outcome at the University of Benin Teaching Hospital; Benin City

Background: Neonatal morbidity and mortality rates reflect a nation's socio-economic status; the efficiency and effectiveness of health care services. This important indicator is useful in planning for improved healthcare delivery. A four year review of neonatal outcome was therefore conducted in the special care baby Unit (SCBU) of University of Benin Teaching Hospital (UBTH). Methods and Subjects: The study was done between 2003 and 2006 and sought to review the morbidity; mortality; salvage rate of low birth weight babies and outcome of all inborn and outborn babies admitted into the SCBU of UBTH. The biodata; birth weight; sex; APGAR scores and reasons for admissions and outcome were abstracted from case notes/admission records. Result: A total of 3075 babies were admitted to the unit during the period under review. 2602 (84.6) were inborn while 473 (15.4) were out-born. There were more males 1676 (54.6). There were 855(27.8) preterm babies of which 803(26.1) were low birth weight babies. Neonatal sepsis; severe birth asphyxia; pre-maturity and neonatal tetanus were the most common morbidities suffered by the neonates. Mortality was recorded amongst 625 (20.3) babies. Mortality rate was significantly higher amongst the out-born than in born babies; P value 0.0001. Conclusion: The neonatal mortality rate in this study is high. The morbidity profile observed in the study is attributable to preventable causes. Of note is the contribution of NNT to morbidity and mortality. Strengthening of linkages in perinatal care; improving maternal emergency obstetric care and neonatal resuscitation skills are proposed measures to reduce neonatal mortality

Managing Neonatal Jaundice at the General Practice and Primary Health Care Level: An Overview

Neonatal Jaundice (NNJ) is one of the commonest causes of neonatal morbidity and mortality in the developing world. The physiological form of NNJ occurs in about two thirds of newborns. In addition to this however; are the various pathological forms which apart from being potentially fatal if not well managed; are often very difficult to differentiate from the benign physiological form; except with detailed laboratory investigations. Although the pathological forms of NNJ are ordinarily beyond the facilities usually available to General Practitioners (GPs) in developing countries; it is important that these GPs and the health workers at the primary health care level be well informed about NNJ since they are usually the first set of practitioners to receive babies with this illness. For better case management and reduction of mortality in NNJ; GPs should be able to sort babies with NNJ and manage them according to the severity of the illness. Mothers should be educated against harmful traditional practices which may provoke severe NNJ like the home use of naphthalene-containing balls. Home treatment of NNJ with the various local remedies should also be discouraged since these may not be helpful and may inadvertently cause them to seek medical advice late; with the attendant grave consequences

Medecine neonatale au Benin : etat actuel et perspectives d'avenir

Pour le Benin se pose actuellement le douleureux choix de developper une medecine neonatale a l'image des pays developpes ou d'instituer une politique de prevention pre et perinatale. La decision reside dans l'analyse de l'etat actuel et des perspectives de la medecine neonatale. L'analyse de l'etat actuel montre que: le Benin est un pays aux ressources humaines; materielles et financieres limitees; les structures de prise en charge du nouveau-ne malade sont deficientes avec un manque de personnel qualifie; de moyens diagnostiques et therapeutiques; la mortalite neonatale est elevee a 56 pour cent en 1989; et la morbidite est dominee par le faible poids de naissance (prematurite et hypotrophie); les infections et les traumatismes de naissance. Ces conditions de deficience amenent les soignants a mettre en oeuvre des gestes therapeutiques simples. Les perspectives resident dans l'institution d'une politique de prevention perinatale tout en ameliorant les structures actuelles de prise en charge du nouveau-ne malade

Review of neonatal admissions; Lilongwe 1991

Data for 1199 neonatal admissions to the special care nursery in Lilongwe during 1991 were analyzed in relation to birth weight; mode and place of delivery; diagnoses; outcome; and length of stay. This paper is an audit of these admissions