ABSTRACT
Objective: To determine the impact of pre-eclampsia on neonatal outcome at a tertiary care hospital
Methods: This was a cross-sectional study conducted in the Neonatal Intensive Care Unit [NICU] and High Dependency Unit [HDU] of Liaquat National Hospital over a period of six months, i.e from June 2015 till December 2015. The inclusion criteria includes all neonates born to pregnant women with systolic blood pressure from 130 to 200 mmHg, Diastolic blood pressure of >110mmHg and proteinuria >1 on dip stick or >300mg/l in 24 hour urinary specimen irrespective of gestational age
The exclusion criteria was all babies born to mother with chronic hypertension, glucose intolerance, renal disease, multiple pregnancy, congenitally abnormal fetus or sepsis
Results: A total of 80 babies met the inclusion criteria and were included in our study of which only 39 babies were admitted in NICU. Majority of babies were discharged home. Approximately 48.71 % babies managed to stay for 72 hours. Moreover, the major chunk of babies were delivered moderate to late preterm in the study. A total of 23 out of 39 babies presented with IUGR [Intrauterine Growth Restriction] which constitute about 58.97% of total. Regarding the impact of eclampsia on neonatal hematological profile, 25 [64.10%] developed thrombocytopenia, 8 [20.51%] developed anaemia while 6 [15.38%] were found showing no fluctuation in their haematological profiles
Conclusion: Babies born to pre-eclamptic mothers were found to have higher rates of NICU admissions and longer period of stay compare to those who born to non-eclamptic mothers
Moreover, premature birth and Respiratory Distress Syndrome [RDS] also impose significant risk to newborn babies
Early identification and collaborative approach regarding pre-eclampsia could help us mitigate the poor outcome of neonates born to eclamptic mothers
ABSTRACT
Objective: To study the effect of implementing locally devised CPAP alone or in combination with INSURE protocol [Intubation, Surfactant, Extubation] in preterm neonates with respiratory distress syndrome in a tertiary care hospital
Methods: The study was conducted from August 2012 to August 2014 in Neonatal Intensive Care Unit [NICU] of Liaquat National Hospital, Karachi. Total 113 neonates were enrolled in the study. They were grouped in two categories on the basis of severity of respiratory distress syndrome [RDS]. Infants with clinical evidence of respiratory distress and radiological evidence of patchy reticulogranularpattern were given a trial of bubble CPAPalone. Neonates with severe RDS were given INSURE protocol along with bubble CPAP. The intervention was considered to be successful if respiratory distress improved and the baby could be successfully weaned off from CPAP
Results: In this study 113 neonates were enrolled. Fifty neonates were initially managed with bubble CPAP alone out of which 29 [58%] improved. Neonates with severe RDS were 63 and received bubble CPAP along with INSURE protocol out of which 45 [71.4%] improved
Conclusion: Locally devised Bubble CPAP along with selective surfactant therapy is a safe and effective intervention in the management of respiratory distress syndrome in preterm. It decreases the need for mechanical ventilation and its subsequent complication