Clinical Profile of Neonates with Hypernatremic Dehydration in an Outborn Neonatal Intensive Care Unit

This hospital-record review describes the clinical profile ofhypernatremic dehydration in neonates. 49 neonates (3.4% of thetotal admitted newborns) developed hypernatremic dehydrationbetween January 2014 and August 2015. The major presentingcomplaints were fever (34.6%), poor feeding (42.8%), loosestools (40.8%) and lethargy (26.5%). The mean (SD) time neededfor correction of hypernatremia was 38.6 (15.1) hours. Exclusivelybreastfed neonates had lesser complication rates ofhypernatremic dehydration.

Study of Meconium Aspiration Syndrome in Neonates.

Meconium is the first faeces of a newborn. The incidence of meconium stained liquor is 10-25% of deliveries; out of which 10% develop meconium aspiration syndrome. It is regarded as a sign of foetal compromise. Aim: To study the babies born with meconium stained amniotic fluid (MSAF) developing Meconium aspiration syndrome (MAS) and factors associated with it. The study also aimed to find out the complications and outcome of MAS. Method: A total 90 babies born with MSAF and admitted to the NICU were studied. Detail maternal history was taken. All babies underwent routine septic screen and a chest x-ray. MAS was designated in a baby as per the defined criteria. Results: Out of the total 90 babies born with MSAF, 41 were female and 49 were male. Majority (95.6%) cases with MSAF occurred either in full term or post term babies. MAS was found in 68 of the total 90 babies, of which 48(70.5%) were vigorous and 20 (19.5%) were non vigorous. Abnormal X-ray was found in 39(43.3%) babies. 23.5% babies required ventilator care. Overall mortality rate was 15.5%. Conclusion: MSAF affects mostly full term and post term babies. History of antenatal foetal heart rate abnormalities and MSAF together are good predictors of non vigorous babies. The duration for which baby remains in contact with MSAF also affect the ultimate outcome. The management of babies born of MSAF should be a combined approach of obstetrician and paediatrician, right from proper monitoring of maternal risk factors to meticulous newborn resuscitation.