Males were affected more than females M:F ratio was 1.36:1 many of them were delivered by LSCS. The most common causes of respiratorydistress were TTN, RDS, MAS, and perinatal asphyxia. In most of the cases X-ray findings correlated with the clinical picture. The survival rate was 79% among RD cases admitted to NICU. The common cause of death was HMD. Mortality is significantly higher than developed and even much higher than other developing countries and rest of India because of low socioeconomic status. Early detection and appropriate management is essential to ensure better outcome in all infants presenting with respiratorydistress. The outcome of neonatal respiratorydistress was found as: a survival rate of 78.5%, mortality rate of 21.5%. Funding: No funding sources
In our study various risk factors like low birth weight, prematurity, need for resuscitation, high downe score, evidence of sepsis, provision of ventilatory support, ph FiO2>40%, Ph<7.2 were related to mortality with statistically significant relationship. In a study conducted by Rajavarapu Chandrasekhar et al risk factors which found to be statistically significant (p<0.05) were age of mothers, socio economic status, parity, liquor, mode of delivery, gestation of baby, 1min APGAR score, birth weight and sex of the newborn. 14
Results: Transient tachypnoea of newborn (60%) was the commonest cause of newbornrespiratorydistress. Development of severe distress was more when onset is at 6 hours after birth (77%), duration persists more than 24 hours (65.5%) Oxygen requirement in number of days increases depending on diagnosis TTNB 100% for <1 day, MAS 95.4% for 2 days and RDS 100% for 3 days. Ventilation was done in 3 cases and there was no mortality. Conclusions: Transient tachypnea of the newborn is the most common cause of respiratorydistress in newborn. Almost 50% of newborn with respiratorydistress develop severe respiratorydistress which require intensive monitoring. Risk factors like high maternal age, primigravida mothers, more than 4 per vaginal examinations, meconium stained liquor, cesarean delivered newborns, Small for gestation age, and 1 min Apgar score less than 7, birth weight less than 2.5Kg and male sex of newborn were associated with severe respiratorydistress in newborns. Keywords: Respiratorydistress, New-born, Risk factors, Chest x rays, Oxygen requirement
both sexes, with any gestational age and birth weight, were included. Syndromic neonates and surgical conditions leading to respiratorydistress were excluded. Sample size estimation was done by n Master version 2.0 (BRTC) Vellore, using method one group proportion- confidence interval estimating single proportion- absolute precision of 4% method. As per the previous study “A clinical study of respiratorydistress in newborn and its outcome”, prevalence of respiratorydistress among neonates is 13.7%. Taking confidence interval of 95%, minimum sample size is 284. Adding10% dropout, final minimum sample size was approximately 312.Out of 5760 neonates admitted in SNCU/NICU in the said study period, 417 cases were enrolled in the study after meeting inclusion and exclusion criteria through convenience sampling.
All newborn babies admitted to Tertiary Care Hospital NICU during a period of 12 months from April 2016 to March 2017 who developed respiratorydistress were studied. These admissions comprised of neonates delivered in our hospital as well as those neonates who were referred to our NICU from other hospitals and delivery centres and neonates who were delivered at home. Study is done on 281 neonates admitted in Neonatal Intensive Care Unit as a Prospective Cohort and Descriptive Study and Simple Random sampling is used to include neonates in the study. Neonates whose parents did not give the consent, neonates who left the study against medical advice and neonates with birth weight <500g/ gestational age <26 weeks were excluded from the study. All the neonates included in study were subjected to the following detailed perinatal history with special emphasis on history of Maternal illness like fever/ rashes/ h/o BT / anaemia/ hypertension. Whether steroid was given in case of anticipated preterm delivery (Two dose course of betamethasone or four dose course of dexamethasone). Age of mother, Status of mother according to Gravidity, Parity, Abortion, Live Births. Noting of any obstetric complication like ante partum hemorrhage (APH), premature rupture of membranes (PROM), Pregnancy induced hypertension(PIH), pre- eclampsia, eclampsia. presence of fetal distress, presence of meconium (MSL), place of delivery, mode of delivery, whether pregnancy was singleton or twin or triple geststion, whether antenatal checkup done or not. (ANC: Adequate antenatal checkup considered when the pregnant woman was registered at any time, had atleast three antenatal checkup, had taken two doses of inj TT Vaccine, had taken atleast 100 iron folic acid tablets). Thorough clinical examination of newborns including the following are noted: complaints of poor feeding, lethargy/irritability, yellowish discoloration of eyes and skin, excessive crying, fever, rash, vomiting, loose stools, fast / noisy breathing, abdominal distension, loss of weight, dryness of skin. Gestational age was assessed using New Ballard Scoring System. 5 Anthropometry of
Background: Respiratorydistress in neonates is one of the important clinical manifestations of a variety of disorders of the respiratory system and non-respiratory disorders. It has been estimated that 40-50% of all the perinatal deaths occur following respiratorydistress. The objective of this study was to estimate the proportion of respiratorydistress in the new-born period. And know the etiological factors of respiratorydistress in first day of life and to study the first day of life morbidity and mortality of respiratorydistress in NICU.
Respiratory failure secondary to surfactant deficiency is a major cause of morbidity and mortality in low birth weight premature infants. Surfactant therapy substantially reduces mortality and respiratory morbidity for this population. Exogenous surfactant therapy has become well established in newborn infants with respiratorydistress. Many aspects of its use have been well evaluated in high-quality trials and systematic reviews. Secondary surfactant deficiency also contributes to acute respiratory morbidity in late-preterm and term neonates with meconium aspiration syndrome, pneumonia/ sepsis, and perhaps pulmonary hemorrhage; surfactant replacement may be beneficial for these infants. This article summarizes the evidence and gives recommendations for the use of surfactant therapy for respiratorydistress syndrome (RDS) in newborn.
This prospective observational study was conducted to include 250 babies admitted with respiratorydistress in a 15 bedded level III unit in Chengalpattu Hospital, Tamil Nadu, India where 900 deliveries occur per month. This study was conducted between January 2018 to June 2018. All procedures performed in this study were in accordance with ethical standards of Chengalpattu hospital, Tamil Nadu, India. Newborns with respiratorydistress at birth started bCPAP within 6 hours of admission were included.
Respiratorydistress is a common manifestation in neonates requiring admission. Its significance ranges from a self limiting process due to a delayed adaptation to the post natal environment to potentially lethal conditions. The underlying etiology for distress may be due to respiratory problem or non respiratory pathologies like neurologic, cardiovascular, metabolic, hematologic, or neuromuscular disorders, as well as reflection of sepsis, drug withdrawal, and other conditions such as severe anemia. A good history to identify the possible risk factors, clinical assessment of the newborn with supporting evidence from investigations helps in tailoring the management according to the etiology. While general supportive measures, including provision of supplemental oxygen, thermal support and provision of adequate fluid and calories are common to all newborns with respiratorydistress. Specific intervention depends on accurate diagnosis. In the majority of infants, the respiratory illness will be self limited with full recovery, but management and outcome depend heavily on the underlying cause.
Background: Respiratorydistress syndrome is the most important cause of morbidity and mortality in preterm neonates. Intermittent positive pressure ventilation with surfactant therapy was standard treatment of RDS. IIPV is invasive, costly and requires expertise. It is not a viable option for many of the resource limited SNCU set ups of our country. Trials have showed that CPAP is noninvasive, easy to use, safe and effective. This study was done to find out effectiveness of CPAP in RDS, and also to find CPAP failure factors.
RespiratoryDistress Syndrome (RDS) is a clinical pres- entation of many diseases in the neonatal period and is one of the most frequent causes of admission to the neo- natal intensive care unit (NICU), both in term and pre- term infants. The etiology of RDS in term newborn infants includes pulmonary and extra pulmonary diseases, with a pronounced prevalence of the first ones. Among the extra pulmonary causes, even if rare, it has to be men- tioned a mediastinal mass, which can lead to external compression on the airways and thus lead to RDS.