Pulmonary hypertension in congenital heart disease of children

Background: Pulmonary arterial hypertension is the dreaded complication of congenital heart disease with left-right shunt. The aim of this study was to describe the epidemio-clinical aspects of PAH associated with congenital heart disease.Methods: This was a retrospective descriptive multicentre study over a 2-year period (1 January 2020 to 31 December 2021) conducted in three University Hospitals in Antananarivo. Hospitalized children with congenital left-right shunt heart disease were included.Results: A total of 74 cases were recruited. The sex ratio was 0.7. The mean age of the children was 10.9 (SD=18.2) months. The mean age of onset of heart disease was 8 (SD=13.6) months. Heart disease was dominated by ventricular septal defect (51.3%), patent ductus arteriosus (39.2%), and atrioventricular canal (8.1%). PAH was encountered in 49 cases (66.2%). The majority of children with PAH were under 12 months of age (71.4%) and malnourished (70.2%). According to the type of heart disease, PAH was encountered in all complete CAVs, in 76.3% of CIVs and in 55.2% of PCAs. Eseinmenger's syndrome was present in 4% of cases, and the death rate was 20.3%.Conclusions: Improved management of children with congenital heart disease is needed, both in terms of diagnosis and surgical treatment, to prevent the onset of PAH.

Feeding premature babies in the neonatology department of the Androva Mahajanga Hospital

Background: The initiation and progression of enteral nutrition in premature infants remains a challenge. The aim of this study was to evaluate enteral nutritional management in premature infants in the neonatology department at the mother and child complex Androva Mahajanga.Methods: This was a retrospective descriptive study over a 7-month period, from January to July 2018. All neonates under 37SA who received enteral feeding were included.Results: During the study period, 74 newborns were able to receive enteral feeding. The mean age of onset of enteral feeding was 10.6 hours. In 89.2% of cases, enteral feeding was started within the first 24 hours of life. On average, the initial quantity administered was 28.4ml/kg/d. Human milk was used most frequently (54.8%). The presence of residue was the most frequently encountered incident (31.5%). Ulcero-necrotizing enterocolitis occurred in 7 newborns (9.5%). Forty-five newborns had a good outcome, with an average weight gain of 9.28 g/kg/d.Conclusions: The implementation of a nutritional management protocol for newborns, especially premature babies, in the neonatology department would be beneficial for a better outcome and growth of the baby.

Donation of women's milk to the neonatology department at the Androva hospital in Mahajanga

Background: The functioning of a milk bank begins with the donation of milk from women donors. The objective of our study was to describe the demographic profile of mothers who donate milk and their practice of donating milk in the neonatology department at the hospital Center Androva Mahajanga.Methods: This is a prospective, descriptive study over a 7-month period, from August 2019 to February 2020. Were included all healthy breastfeeding women who agreed to donate excess breast milk.Results: The participation rate of breastfeeding women in milk donation was 6.6%. Vaginal delivery was the most common (85.9%). The majority had no knowledge about milk donation (83.8%). Manual breast pumping was the most used (43.8%). The average total amount of milk collected by a mother from the beginning to the end of the donation was 613 ml. The average duration of donation by a mother was 6.4 days.Conclusions: The participation and knowledge of mothers on the donation of women's milk was low, although it can improve the survival of newborns.