Aspects cliniques et évolutifs de la pré-éclampsie sévère traitée à la maternité Befelatanana, Madagascar / Clinical aspects and outcome of severe pre-eclampsia treated at the Befelatanana maternity hospital, Madagascar

Pre-eclampsia is a major public health problem and is one of the main causes of maternal-fetal morbidity. The main objective of this study is to describe the clinical and evolutionary aspects of severe pre-eclampsia. Methods: This was a retrospective, monocentric, descriptive, observational and cross-sectional study of 6 months, from January 01, 2019 to June 30, 2019, conducted at the level of the resuscitation service of the university hospital of gynecology obstetrics Befelatanana (CHU GOB). Results: Three hundred and fourteen (5.10%) cases out of 6153 admissions of severe pre-eclampsia were collected in the study; the average age was 27.29 ±7.47 years. Eclampsia (30.25%, n= 95), retroplacental hematoma (13.38%, n= 42) and acute renal failure (7.96%, n= 25) were the most frequent maternal complications. Maternal prognosis was favorable in 92.36% of cases (n= 290). Maternal death represented 3.18% (n= 10). Prematurity (44.82%, n= 95), fetal hypotrophy (37.26%, n= 79) and fetal asphyxia (14.15%, n= 30) were the most common fetal complications. Fetal death was 26.47% (n= 81). Conclusion: It is necessary to reinforce the information and education of parturients on the first signs for an early detection, diagnosis and management

Intraocular pressure values using icare® rebound tonometer and correlation with postconceptional age in premature infants

Purpose: This study aimed to determine a normative range of intraocular pressure (IOP) values measured with Icare rebound tonometer in premature infants and evaluate IOP variation over time and its correlation with the progression of postconceptional age (PCA). By doing so, we also evaluated advantages of this IOP-measuring method in this population when compared to more traditional methods. Methods: We conducted a single-center prospective study that included premature infants (gestational age ≤32 weeks) who were admitted to the neonatal intensive care unit (NICU) in Hospital Professor Doutor Fernando Fonseca. The study took place between January and December 2021. IOP was measured using Icare tonometer on the occasion of the first retinopathy of prematurity (ROP) screening requested by the NICU and again after a two-week interval if PCA was still ≤37 weeks. IOP measurements were stopped at 37 weeks or if the infant was discharged. The evaluated outcomes were mean IOP values and their correlation with PCA. Results: Thirty-four eyes of 17 preterm infants with a mean gestational age of 29.4 ± 2.3 weeks and a mean birth weight of 1222.9 ± 361.9 gr were evaluated. The mean IOP registered was 16.1 ± 6.4 mmHg, with a median value of 15.3 mmHg. The top 90 mmHg. The average IOP reduction was 4.8 ± 6.7 mmHg (P = 0.0019) within the two-week interval of PCA.

Probable horizontal transmission of SARS-CoV-2 in an asymptomatic neonate: A case report

Introduction: Preterm delivery is of considerable concern to clinicians and researchers being a leading cause of infant morbidity and mortality in the industrialized countries and also contributes to substantial complications among survivors. Sub-Saharan Africa, including Nigeria accounts for significant proportion of preterm births, with over million deaths due to complication of prematurity. Objectives: The study aimed to determine the prevalence and associated morbidities of preterm deliveries at the University of Maiduguri Teaching Hospital, Maiduguri, North-Eastern Nigeria. Patients and methods: This is a retrospective review of neonates delivered before 37 completed weeks of gestation and admitted into the Special Care Baby Unit (SCBU) of the University of Maiduguri Teaching Hospital, from 1st January 2008 to 31st December 2015. Results: There were 3435 admissions into the Special Care baby Unit (SCBU) during the 8 year period. Out of these 1129 were preterm babies giving a prevalence of 32.9%. Of the 1129 preterm babies managed in SCBU, 714 case records were retrieved and analyzed giving a retrieval rate of 63%. There were 372 (52.1%) males and 342 (47.9%) females; with the male to female ratio of 1:1.08. There were 17(2.3%) extreme low birth weight (1000-1499 g), 406 (56.9%) low birth weight (1500- 2499 g) babies. The range of admission weights was 700-2500g with mean of 1600±900g. Conclusion: The burden, complications and mortality from preterm newborns remain significant public health challenges to care givers in Nigeria

Ictère néonatal. Etude des facteurs associés au Centre Hospitalier Départemental de l'Ouéme-Plateau (CHD-OP)

Introduction : l'ictère néonatal est très fréquent dans le monde et est dominé par les ictères à bilirubine libre. Son évolution est le plus souvent favorable mais il peut être grave et engendrer des complications comme une encéphalopathie hyperbilirubinique, une anémie, voire le décès en absence ou en cas de retard à la prise en charge. L'objectif de ce travail était d'étudier les facteurs associés à l'ictère néonatal dans l'unité de néonatologie du CHUD-OP.Méthodes : il s'agissait d'une étude transversale descriptive et analytique qui avait été conduite du 01 juillet 2015 au 30 juin 2016 et avait porté sur tous les nouveau-nés ayant présenté un ictère et admis dans l'unité de néonatologie du service de pédiatrie du CHUD-OP. La saisie et l'analyse des données avaient été faites à l'aide de Epi info 2000 version 3.5.3 et Microsoft Excel 2016. Le test de Pearson avait été utilisé pour les proportions et le test de Student pour la comparaison des moyennes. La différence était statistiquement significative lorsque p est inférieur à 0,05. Résultats : la fréquence hospitalière de l'ictère néonatal était de 11,0% (170, N=1542). Les principales causes retrouvées étaient : l'infection néonatale bactérienne (29,4% ; n=50), l'incompatibilité fœto-maternelle dans les systèmes ABO et rhésus (15,9% ; n=27). La majorité de ces nouveau-nés était guérie et 22,4% (n=38) avaient présenté : une anémie sévère 21,6% (n=25), une encéphalopathie hyperbilirubinémique 18,2% (n=31) et 26 étaient décédés (15,3%). Les nouveau-nés accouchés en dehors de l'hôpital, la prématurité et l'incompatibilité fœto-maternelle dans les systèmes ABO et rhésus étaient des facteurs associés aux complications de l'ictère néonatal. Conclusion : l'organisation de la référence et l'amélioration de la qualité des soins au couple mère-enfant permettra la réduction des facteurs associées à l'évolution défavorable de l'ictère

Evaluation of patent ductus arteriosus by using two dimensional echocardiography in infant and neonate

Background: Patent ductus arteriosus (PDA) is a part of the typical morbidity profile of the preterm infant, with a high incidence of 80­90% in extremely low birth weight infants born before 26 weeks of gestation. Whereas spontaneous closure of the ductus arteriosus (DA) is likely in term infants, it is less so in preterm ones. The aim of this study is to Evaluate Patent Ductus Arteriosus by using two dimensional echocardiography in infant and neonate. Method: The present study is a case-control study including 46 cases aged between neonate below 37 weeks of gestation to infant ˂6 months. This study was conducted in Neonatal ICU, Cardiology Unit and Pediatric Echocardiography Unit in Pediatric Department, Zagazig University. The period of the study was from January 2017 t0 December 2017. Results ECHO findings of both PDA cases and their controls were close to each other and there was no statistical significant difference between them except in size of left atrium which was significantly higher among PDA cases ranged from 0.91 cm to 1.7 cm with mean of 1.25±0.24, also ratio of LVED/ AO was higher among PDA cases than their controls and the difference was statistically highly significant. 9 cases (39%) of the studied PDA cases presented with high significant PDA, while 14 cases (61%) had low significant PDA.Concolusion: 1. Clinical assessment is somewhat helpful at detecting PDA early in the course of sick infants. Echocardiography is a safe method of detecting PDA and classifying it as HSPDA and LSPDA

A retrospective study on the prevalence, severity and outcomes of intraventricular haemorrhage in infants with a low birth weight in a quarternary hospital in a low- to middle-income country

Background. Intraventricular haemorrhage (IVH) is a serious complication in infants with a low birth weight (LBW). Objective. To study the prevalence, severity and outcomes of IVH in LBW infants admitted to a neonatal intensive care unit (NICU). Methods. This was a retrospective cohort study of LBW infants admitted to the NICU at a quarternary hospital between January and December 2012. Neonates with recorded cranial ultrasound scans were included and followed up to between 18 and 24 months of age for neurological outcomes. Results. An overall IVH prevalence of 44.3% (95% confidence interval 40 - 50) was observed in the study population (N=210). The prevalence of IVH in infants with a very low birth weight (VLBW) was 67.0%. Multivariable logistic regression showed risk factors for IVH to be VLBW, extreme prematurity, exposure to HIV, outborn delivery and receipt of a blood transfusion. Moderate to severe IVH was more common in VLBW and extremely premature infants. Severe IVH was associated with high mortality. At follow-up, 18.8% of the subjects showed signs of neurodevelopmental delay, while 6.3% were diagnosed with epilepsy. The overall all-cause mortality rate was 15.7% at discharge. Mothers' antenatal clinic attendance and caesarean delivery were protective factors. Conclusion. Improved perinatal care for women in preterm labour, especially in rural areas in South Africa, could lead to better outcomes in infants. A screening schedule could contribute to timeous detection of brain injury in at-risk babies to facilitate appropriate medical management and detection of lesions associated with adverse long-term neurodevelopmental outcomes

Incidence of hypoglycaemia in late preterm and term infants born to women with diabetes mellitus

Background. Diabetes mellitus (DM) is a common metabolic disorder affecting pregnant women and is associated with adverse outcomes in their offspring, including hypoglycaemia. The incidence and factors associated with development of hypoglycaemia in infants of diabetic mothers (IDM) from developing countries such as South Africa are not well known. Objectives. To determine the incidence of hypoglycaemia and factors associated with its development in IDM. Methods. Medical records of mothers diagnosed with DM, and their infants who were term and/or late preterm and admitted to the neonatal unit at Chris Hani Baragwanath Academic Hospital, were retrieved and reviewed. Maternal characteristics, type and management of diabetes, infant characteristics and glucose measurements were captured for analysis. Results. Over the 2-year period, 234 infants were born to diabetic mothers (median age 33 years) and 207 met the diagnostic criteria and were admitted for monitoring of blood glucose using the hemoglucotest. Among the mothers with DM, 56% had gestational diabetes; ~19% of IDM were large for gestational age (LGA) and 10% were macrosomic. Hypoglycaemia occurred in 39% of IDM, and 85% of the infants were diagnosed within the first 6 hours of life. There were no statistically significant differences in maternal characteristics, including type of maternal diabetes and its management between hypoglycaemic and normoglycaemic infants. Hypoglycaemic infants were more likely to be LGA (28.2% v. 12.8%; p=0.009). Conclusion: Hypoglycaemia is a common finding in IDM. It presents early (within the first 6 hours of life) and rarely beyond 24 hours after birth. The only characteristic found to be associated with development of hypoglycaemia in IDM was a neonate being LGA

Facteurs associés à la survie du nouveau-né prématuré à l'Hôpital de la Mère et de l'Enfant de N'Djaména au Tchad

Introduction : la prématurité est responsable d'une lourde morbi-mortalité qui freine la réduction de la mortalité néonatale et infanto-juvénile dans les pays à faible niveau de développement sanitaire comme le Tchad. L'objectif de la présente étude était de rechercher les facteurs associés à la survie du nouveau-né prématuré à N'Djaména au Tchad, un pays à faible revenu. Patients et méthodes : il s'agissait d'une étude descriptive et analytique qui a été conduite de mai à octobre 2015 dans le service de néonatologie de l'Hôpital de la Mère et de l'Enfant de N'Djaména.Elle avait concerné tous les 172 nouveau-nés prématurés hospitalisés au cours de la période d'étude. Les données collectées comportaient l'anamnèse gestationnelle, la morbidité en cours d'hospitalisation, le taux de survie et les facteurs associés. Le test de Chi2 avait servi à l'analyse statistique avec un seuil de signification de 5%. Résultats : La fréquence de la prématurité était de 21,4%. L'âge gestationnel était inférieur à 33 semaines d'aménorrhée chez 75% des nouveau-nés prématurés. La morbidité était dominée par la détresse respiratoire (57,6%), l'anémie (28,5%) et les infections (25%). La survie était de 57,6% avec un seuil de viabilité de 26 semaines d'aménorrhée. Les facteurs de bon pronostic étaient l'âge gestationnel proche du terme (p=0,000), la cotation d'APGAR normale (p=0,002), l'accouchement par césarienne (p=0,000), la naissance à l'hôpital de référence (p=0,004), l'admission précoce (p=0,039) et l'absence de détresse respiratoire (p=0,000). Conclusion : La survie du prématuré, encore faible à l'Hôpital de la Mère et de l'Enfant de N'Djaména peut être améliorée par des actions de périnatologie basées sur les facteurs de bon pronostic identifiés

Growth patterns of preterm infants: a prospective study in an indigenous African population

Background: Optimal growth of preterm infants reflects their overall health status; however, indigenous growth charts are rarely available to monitor them adequately in infancy. Objectives: The aim of this study was to describe growth patterns of preterm infants and to generate percentile charts as well as relevant predictive equations for expected weight­for­age in their various birth weight categories.Materials and Methods: This was a prospective, analytic study. Anthropometric measurements of eligible consecutive preterm babies were monitored biweekly/monthly in infancy. Temporal changes in body weights and occipitofrontal circumferences (OFCs)were presented graphically. The Pearson's correlation coefficient was done toderivepredictiveequations. LMS chartmaker light version 2.54 (Medical Research Council, UK) generated percentile charts. P <0.05 was considered statistically significant.Results:A total of 154 preterm infants were recruited during the study period, with a male­to­female ratio of 1:1.5. Their mean gestational age (GA) was 31.3 ± 2.4 weeks, and mean birth weight was 1510.8 ± 347.5 g. Average daily weight gains were 9.4, 17.4, and 20.0 for extremely low birth weight (ELBW), very LBW (VLBW), and LBW, respectively, in the 1st month (F = 1.733, P = 0.183). The peak weight gain period occurred at the 4th month for ELBW (28.3 g/day), 5th month for VLBW (38.3 g/day), and 7th month for LBW (38.3 g/day).There was a strong positive correlation of their body weight with their postnatal age (y = 505.6x + 1511.5; R2 = 0.92) as well as OFC with age (y = 1.33x + 29.94; R2 = 0.94). Growth charts for weights and OFCs were generated showing 5th, 50th, and 95th percentiles. Conclusion: The preterm infants gained weight with increasing postnatal age following an initial weight loss in the early neonatal period. Their relative growth velocities were similar in all birth weight categories

Lived experiences of parents of premature babies in the intensive care unit in a private hospital in Johannesburg, South Africa

Background: Many of the 15 million premature babies born worldwide every year survive because of advanced medical interventions. Their parents have intense experiences when their babies are in the intensive care unit (ICU), and these have an impact on their thoughts, feelings and relationships, including their relationships with their premature babies. Objectives: The aim of the study was to explore and describe the lived experiences of parents of premature babies in an ICU. Method: Research design was qualitative, exploratory, descriptive and contextual. A purposive sample of parents with premature babies in an ICU in a private hospital in Johannesburg Gauteng in South Africa was used. Eight parents, four mothers and four fathers, married and either Afrikaans or English-speaking, were included in the study. Data were collected by conducting in-depth phenomenological interviews with them and making use of field notes. Trustworthiness was ensured by implementing the strategies of credibility, transferability, dependability and confirmability. Ethical principles such as autonomy, beneficence, nonmaleficence and justice were adhered to throughout the research process. Results: Thematic analyses were utilised to analyse the data. Two themes in the experiences of parents with premature babies in ICU became apparent. Parents experienced thoughts, emotions and hope while their premature babies were in the ICU as well as challenges in their relationships and these challenges influenced their experiences.Recommendations: Mindfulness of intensive care nurses should be facilitated so that intensive care nurses can promote the mental health of parents with premature babies in the ICU.Conclusion: Parents with premature babies in the ICU have thoughts and emotional experiences which include hope and they affect parents' relationships

A review of antenatal corticosteroid use in premature neonates in a middle-income country

Background. Antenatal corticosteroid (ANS) use in premature neonates has become a standard of practice. However, there is low ANS coverage in low- to middle-income countries (LMICs). Recent studies have questioned the efficacy of ANSs in such countries.Objective. To review the use of ANSs in preterm neonates at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH), South Africa.Methods. This was a retrospective observational study of all neonates with a birth weight of 500 - 1 800 g born at CMJAH between 1 January 2013 and 30 June 2016. Neonatal and maternal characteristics of neonates exposed to ANSs were compared with those of neonates who were not exposed.Results. The ANS coverage of the final sample was 930/2 109 (44.1%). The mean (standard deviation (SD)) birth weight was 1 292.4 (323.2) g and the mean gestational age 30.2 (2.9) weeks. Attending antenatal care and maternal hypertension were associated with increased use of ANSs, whereas vaginal delivery was associated with decreased use. In neonates weighing <1 500 g, the use of ANSs was associated with decreased mortality, decreased intraventricular haemorrhage and decreased patent ductus arteriosus. There was no association between ANSs and respiratory distress syndrome, necrotising enterocolitis, sepsis or need for respiratory support in all premature neonates, and no association with improved outcomes in those weighing ≥1 500 g.Conclusion. The benefits of ANSs in terms of neonatal morbidity in this study were not as marked as those published in high-income countries. A randomised controlled trial may be indicated in LMICs

Pronostic des références obstétricales à l'Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé (HGOPY)

Introduction: l'impact des références sur la survenue des complications obstétricales n'est pas encore connu. Notre but était d'identifier les complications associées aux références obstétricales à Yaoundé.Méthodes: il s'agissait d'une étude transversale descriptive et analytique du 1er Février au 31 Juillet 2015 à l'Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé, ayant comparé les femmes référées aux non référées et leurs nouveau-nés respectifs. L'échantillonnage était consécutif et exhaustif pour l'analyse des caractéristiques sociodémographiques, obstétricales et néonatales précoces. Les tests de Chi carré et exact de Fisher ont aidé à comparer les variables qualitatives. L'analyse par régression logistique a permis d'éliminer les facteurs confondants. P était significatif si p < 0,05.Résultats: après analyse multi variée, les complications obstétricales statistiquement significatives chez les patientes référées étaient: la rupture prématurée des membranes (OR ajusté = 9,37, IC95%: 2,52-66,98, p = 0,002); la prématurité (OR ajusté = 4,14 (1,88-9,16; P < 0,001) et le décès après asphyxie néonatale sévère (OR ajusté = 6,48 (1,17-35,80); P = 0,032).Conclusion: la rupture prématurée des membranes, la prématurité et le décès après asphyxie néonatale sévère sont les complications associées aux références obstétricales à Yaoundé

Screening for Retinopathy of Prematurity in a Provincial Hospital in Port Elizabeth; South Africa

Background. Retinopathy of prematurity (ROP) is an emerging public health problem in many middle-income countries where improved neonatal survival rates coupled with inadequate health resources have created a new epidemic. There are limited available data on the magnitude of the problem; and screening in South African (SA) hospitals has not been uniformly practised.OBJECTIVE:To describe the results of various interventions implemented over a 6-year period while developing a new ROP screening service in a provincial hospital in Port Elizabeth; SA.METHOD: A retrospective case folder review of ROP screening at Dora Nginza Hospital; Port Elizabeth; SA; over the 6-year period 2009 - 2014 was conducted.RESULTS:A total of 919 new cases were seen. Fifteen patients received treatment for type 1 ROP (T1ROP); 223 had type 2 (T2) or earlier ROP; 1 had stage 4 ROP and 6 had stage 5 ROP. The combination of healthcare worker education; improved equipment and human resources and the introduction of dual responsibility for case referrals resulted in an increase in the number of new infants screened from 33 in year 1 to 292 in year 6. The number of infants who were screened late decreased from 33/33 (100%) in year 1; prior to the interventions; to 23/292 in the final year (7.9%). Improved oxygen delivery and adequate oxygen saturation monitoring contributed to a decrease in the incidence of T1ROP from 1.5% to 1% over 1 year and in the incidence of T2 or earlier ROP from 30.3% to 24%.CONCLUSIONS:Better management of ROP can be achieved through adequate provision of healthcare professionals and material resources coupled with education and a well-supported referral system. A close working relationship between paediatricians and ophthalmologists results in a more efficient screening programme

Readmission precoce des prematures au service de neonatalogie du CHU de Cocody (Abidjan)

Introduction. La sortie precoce des prematures lors de leur premier sejour en neonatalogie les expose au risque de rehospitalisation. L'objectif de notre travail etait d'identifier les causes et les facteurs de risques associes a cette readmission. Population et methode. Il s'agissait d'une etude transversale a visee descriptive et analytique qui s'est deroulee sur 12 mois. ont ete inclus tous les prematures ayant deja sejourne au moins 24 h au service de neonatalogie du CHU de Cocody et qui y reviennent avant d'avoir atteint 40 semaines d'age corrige. Resultats : Durant la periode d'etude; 348 prematures ont ete admis. La prematurite legere (age gestationnel=34-37 semaines) etait la plus frequente (34;7). Le poids moyen de naissance etait de 1700g et le sexe ratio etait de 1;01. La morbidite etait dominee par l'infection neonatale (47;1); les troubles metaboliques (40;1) et la detresse respiratoire (22;7). Le traitement prescrit etait incomplet ou interrompu dans 57;8 des cas pour des raisons financiere (98). L'evolution etait favorable chez 242 prematures. L'age gestationnel corrige moyen de sortie etait de 35;5 semaines d'amenorrhee; le poids moyen de sortie etait de 1795 g et la duree moyenne d'hospitalisation etait de 11;82 jours. La majorite des parents ont ete sensibilises avant la sortie (91;1). Quarante et un prematures (15;8) ont ete rehospitalises pour anemie (51;2); infection post- natale (14;6) et ictere (9;7). Le taux de mortalite etait de 17;1. Les facteurs de risque de admission etaient le poids moyen de sortie (p=0;04) et l'irregularite ou l'interruption des traitements (p=0;03) lors de la premiere admission

Readmission precoce des prematures au service de neonatalogie du CHU de Cocody (Abidjan)

Introduction. La sortie precoce des prematures lors de leur premier sejour en neonatalogie les expose au risque de rehospitalisation. L'objectif de notre travail etait d'identifier les causes et les facteurs de risques associes a cette readmission. Population et methode. Il s'agissait d'une etude transversale a visee descriptive et analytique qui s'est deroulee sur 12 mois. Ont ete inclus tous les prematures ayant deja sejourne au moins 24 h au service de neonatalogie du CHU de Cocody et qui y reviennent avant d'avoir atteint 40 semaines d'age corrige. Resultats : Durant la periode d'etude; 348 prematures ont ete admis. La prematurite legere (age gestationnel=34-37 semaines) etait la plus frequente (34;7%). Le poids moyen de naissance etait de 1700g et le sexe ratio etait de 1;01. La morbidite etait dominee par l'infection neonatale (47;1%); les troubles metaboliques (40;1%) et la detresse respiratoire (22;7%). Le traitement prescrit etait incomplet ou interrompu dans 57;8% des cas pour des raisons financiere (98%). L'evolution etait favorable chez 242 prematures. L'age gestationnel corrige moyen de sortie etait de 35;5 semaines d'amenorrhee; le poids moyen de sortie etait de 1795 g et la duree moyenne d'hospitalisation etait de 11;82 jours. La majorite des parents ont ete sensibilises avant la sortie (91;1%). Quarante et un prematures (15;8%) ont ete rehospitalises pour anemie (51;2%); infection postnatale (14;6%) et ictere (9;7%). Le taux de mortalite etait de 17;1%. Les facteurs de risque de admission etaient le poids moyen de sortie (p=0;04) et l'irregularite ou l'interruption des traitements (p=0;03) lors de la premiere admission. Conclusion. En attendant la creation de structures de relai pour prematures; l'organisation de soins a domicile permettrait d'ameliorer la survie de ces nouveau-nes

"""Raw"" Formula for Calculating Maintenance Fluid Volumes in Low Birth-Weight and Premature Babies"

BACKGROUND.Fluid management of low birth weight and preterm babies can be challenging; as the determination of maintenance fluid volumes have to be calculated to suit the demands of this delicate neonates in order to avoid fluid over-load or dehydration. It is on this background that this study to derive an easy to use formula for calculating maintenance fluid volumes in this category of babies was embarked upon; utilizing existing Tables.METHOD.One of the most developed Tables on this subject matter; the 'Paediatric Surgical Unit Guidelines; Sheffield Children's Hospital' was selected; re-ordered; subjected to analysis; factorization and simplification; in order to derive the formula. To validate its accuracy the Table was re-constructed using the derived Formula. The derived Table was then compared with the original table. The paired sample T- test; using variation in days and in weights; did not show any statistically significant (p0.05) difference between the two Tables RESULTS.From the Table the formula; 20{(R+A)-W}; ml kg~ 1 day~ 1 was derived. This translates to 20(R+A-W) ml kg~ 1 day 1or 0.8(R+A-W) ml kg ~ 1Hr~ K Where: R - Rehydration factor (ranging mostly from 3 to 5); A

Facteurs de risque de deces du premature dans un service de reference a Abidjan

Introduction. La prematurite represente 29% des principales causes directes de mortalite neonatale. L'objectif de notre travail etait d'identifier les facteurs de risques associes au deces des prematures. Methode. Il s'agissait d'une etude prospective a visee descriptive et analytique qui s'est deroulee sur 6 mois. Ont ete inclus tous les prematures ages de 0 a 28 jours. Resultats. Durant la periode d'etude; 213 prematures ont ete admis avec un taux de mortalite de 18;3%.L'etat clinique a l'admission etait marque par une mauvaise impression generale(44;6 %); une detresse respiratoire (44;1%); une hypothermie (9;9%) et une paleur (8;5%).Les etats morbides les plus frequents associes a la prematurite etaient les troubles metaboliques (60;8%); l'infection neonatale (45;1%); les affections hematologiques (18;8%) et la detresse respiratoire (9;5%). Les facteurs de risque associes a la mortalite etaient le poids de naissance inferieur a1500 grammes (p=0;000); la mauvaise impression generale a l'admission (p=0;000); et l'infection maternofotale (p=0;000). Conclusion. Les facteurs de risque de mortalite identifies etaient deja pris en compte dans l'elaboration des programmes des soins obstetricaux et neonataux d'urgence. Une evaluation de la mise en ouvre des SONU s'avere necessaire

Utility of Kangaroo Mother Care in Preterm and Low Birthweight Infants

Preterm birth ( 37 completed weeks of gestation) is the largest direct cause of neonatal mortality; accounting for an estimated 27 of the 4-million neonatal deaths every year. Kangaroo mother care (KMC) is a type of care for preterm and premature infants whereby the infant is placed in an upright position against the parent's chest; with early skin-to-skin contact between the parent and infant. Mothers who practise KMC exhibit less maternal stress and fewer symptoms of depression; and have a better sense of the parenting role and more confidence in meeting their babies' needs than those who don't. Despite the apparent feasibility of KMC; currently; only a few preterm babies in low-income countries have access to this intervention. Knowledge of the effectiveness and safety of KMC in the community and home setting; and its effects on growth; is still incomplete. Only one study has examined KMC initiation at home. There is an immense need for the promotion of research to improve the delivery of existing cost-effective interventions in low-resource settings and to address key gaps in knowledge. KMC improves growth in low birthweight and preterm infants; and has a significant role to play in protecting them from hypothermia and sepsis; as well as promoting exclusive breastfeeding. KMC helps to reduce neonatal mortality; and inculcates confidence and a better sense of parenting in mothers with regard to their babies' needs