CLINICOETIOLOGICAL PROFILE OF RESPIRATORY DISTRESS IN NEONATES
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2019, Vol 8, Issue 12
Abstract
BACKGROUND Respiratory distress is the most common cause of morbidity and mortality in newborn. In the last 3 decades, several improvements have been introduced to reduce the incidence, severity, and mortality of neonatal respiratory distress. The objectives of the study were- 1. to estimate the proportion of various aetiology of respiratory distress among neonates born in Cheluvamba hospital. 2. to investigate the maternal and perinatal risk factors for the development of respiratory distress. 3. to determine the immediate outcome of neonates with respiratory distress admitted in the NICU. MATERIALS AND METHODS This was a cross sectional descriptive study conducted among neonates admitted with respiratory distress to the NICU of Cheluvamba hospital attached to Mysore Medical College from January 2015 to June 2016. A total of 250 neonates were included. Maternal details were collected from the mothers’ case records. Intrapartum details were documented. Baby’s birth weight, sex and gestational age were noted. Respiratory distress was defined as presence of tachypnoea, chest retraction and grunting, any two of the three. RESULTS Among the various aetiologies, majority were meconium aspiration syndrome 78 cases (31.2%), followed by hyaline membrane disease 65 cases (26%). There was significant male predilection (M: F=1.3:1; p<0.023). Majority were between 2.5-3.5 Kgs. 46.8% (117 cases). Majority were term 57.6% (144 cases). There was no significant association of severity of respiratory distress and maternal age. Majority were primi mothers, 60.8% (p < 0.005). Maternal fever or urinary tract infection were in 17 cases, of which 58.82% had positive sepsis screen. There were 11 diabetic mothers who predisposed to either TTNB or HMD (p<0.006). Among 47 mothers with pre-eclampsia, HMD was 31.91% followed by MAS 25.53% (p<0.001). Among twins, majority had HMD 82.35% (p < 0.004). Of 101 cases with meconium stained liquor, 78 cases (77.23%) developed meconium aspiration syndrome. 18 cases had prolonged rupture of membranes of which 11 cases had culture positive sepsis. Majority were born of normal vaginal delivery 147 cases (58.8%). The neonates with respiratory distress had a survival rate of 75.2% in our NICU. Majority who had expired were due to hyaline membrane disease 53.3% (33 out of 62 cases). Surgical causes of respiratory distress had highest case fatality (100%) followed by hyaline membrane disease (50.8%). CONCLUSION Meconium aspiration syndrome is the most common cause of respiratory distress among neonates born in Cheluvamba hospital followed by hyaline membrane disease. Neonatal respiratory distress had a male predilection. Maternal risk factors which were significant were primi parity, gestational diabetes, pre-eclampsia, multiple gestation, not receiving antenatal steroids in preterm labour. Intrapartum risk factors like prolonged labour, meconium stained amniotic fluid mode of delivery and low Apgar scores at birth also affects the aetiology of respiratory distress in neonates. Mortality among the neonates with respiratory distress was 24.8%. The highest case fatality rate is for hyaline membrane disease 50.8%.
Authors and Affiliations
Reshmi Reshmi, Manjunatha Manjunatha, Sagar Bharamakkanavar
Keywords
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- EP ID EP555643
- DOI 10.14260/jemds/2019/198
- Views 60
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