Pattern of Respiratory Problems in Neonates in a Level III Neonatal Care Unit with Special Reference to Pneumonia

Pattern of Respiratory Problems in Neonates in a Level III Neonatal Care Unit with Special Reference to Pneumonia

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Introduction: Respiratory distress constitutes one of the commonest cause of morbidity and mortality in the neonatal period.It is more commonly encountered within the first 48-72 hours of life.Aim: To find out the incidence, causes and outcome of respiratory distress in inborn newborn babies and also to determine the common organisms of pneumonia.

Settings and Design: A hospital based prospective study was carried out for a period of 7 months (October 2015 to April 2016) in the NICU (Neonatal Intensive Care Unit) of AMCH (Assam Medical College and Hospital).Materials and Methods: All inborn newborn babies admitted to NICU of AMCH who developed respiratory symptoms were included in the study.Maternal and baby details templar were filled up in a predesigned structured proforma.

Statistical Analysis: Data were entered in SPSS (Software package for statistical analysis), version 16 and the frequencies were analyzed.Results: Of all the inborn deliveries during our study period, 5.3% developed respiratory distress.

It constituted 22.4% of all NICU admission, 61.5% were males and 38.

5% were females.TTNB was the most common cause (42.8%) of respiratory distress followed by pneumonia (29.

6%), sepsis (8.9%), MAS (8.2%) and RDS (5.

9%).TTNB was more in term babies (54.6%), RDS among preterm babies (94.

4%) and MAS was found exclusively in the term babies.Of the 90 Pneumonia cases, sepsis screen was positive in 87.8% cases and blood culture was positive in 14.

4% cases.The most common organism was CONS (coagulase negative staphylococcus) which was found in four cases (4.4%), followed by acinetobacter in three cases (3.

33%) and klebsiella in two cases (2.2%).In UltraTemp Parts the pneumonia cases, predisposing factors like PROM was detected in 25.

6%, maternal fever in 16.6% and foul smelling liquor in 11.1%.

The overall case fatality rate is 23%.Mortality is highest (77.8%) in RDS.

Conclusion: Respiratory distress is a common cause of NICU admission, TTNB being the commonest cause, followed by pneumonia.The burden of neonatal pneumonia is high in our NICU.