Mortality in the special care baby unit of the main children's hospital in Tripoli, Libyan Arab Jamahiriya

We investigated the prevalence of neonatal deaths in the special care baby unit [SCBU] at the main children's hospital in Tripoli and the factors associated with these deaths. We reviewed the medical records of all neonates who died in our SCBU from 1 January 2003 to 31 December 2005. A total of 1176 neonates were admitted to our SCBU [59.6% males and 40.4% females]. Of these, 260 [22.1%] died: 165 males and 95 females. The reasons for admission to SCBU of the neonates who died were: prematurity [43.9%], birth asphyxia [16.7%], congenital malformations [15.9%], neonatal infections [14.6%], other reasons [4.6%] and data unavailable [4.3%]. The factors associated with death were: respiratory distress [40.4%], congenital malformation [19.6%], neonatal infections [18.5%] and perinatal asphyxia [15.8%], with 5.8% attributed to other causes. The majority of deaths [63.1%] occurred during the early neonatal period. Mortality in our SCBU is high and action is needed to reduce it with emphasis on prematurity

Perinatal mortality and morbidity at Alkhadra hospital Tripoli Libya

Reevaluation of neonatal services after the initial perinatal mortality assessment, which was carried out at neonatal unit in Algalla maternity hospital, which have been moved in 1992 to Alkhadra general hospital, the transfer included medical and nursing staff and the equipment. It is a retrospective study over a period of one year [1/1/1995-31/12/1995] where the medical files or admitted newborn in the neonatal unit and the registration book at the labour room and operating theater were reviewed. The review included the history, clinical examination, Investigation, treatment and outcome. We reviewed the nursing staff and the medical equipment. The total delivery was 15407 births include 153 stillbirth and 15254 were live birth 7.8% of total live births were admitted. 246 babies died in the 1[st] week of life and the calculated perinatal mortality rate was 25. 8/1000 total births, Stillbirth contributed to 38.35% of total perinatal death and the death in the 1st week was 61.65%. One third [18.3%] of the 1[st] week death died in the 1[st] 24 hours. The main causes of admission were respiratory distress 49.3%, prematurely 31.2%, jaundice 29.3%, infant of diabetic mother 23.4%, birth asphyxia 13.4%, sepsis 12-1% and congenital malformation 8.2%. The main associated causes of early neonatal death in general were respiratory distress 79%, birth asphyxia 41%, sepsis 32%, and congenital anomalies 10%. The main association with preterm death were respiratory insufficiency 85.14%, birth weight below 1.5 kg 52.2%, sepsis 23.2%, hypoglycemia infant of diabetic mother 8.1%, congenital malformation 6% and asphyxia 5%, Inadequate number of experienced nursing staff [one third of international recommendation] and lack of proper maintenance of medical equipment were among the factor, which affected the neonatal care. On comparison with the study at Algalla maternity hospital five years previous to our study, we found no improvement in the perinatal mortality rate or morbidity pattern in neonates, which calls for: 1-Tighter control of preventable diseases like infection, prematurity, some congenital malformation, IDM, birth asphyxia and hemolytic diseases.2-Early surgical interference in treatable congenital deformities by improves our facilities both quantitatively and qualitatively. 3-Further her training for adequate number of nursing staff. 4-Center for periodic maintenance of medical equipment