Download - Discharge May 2011

8/6/2019 Discharge May 2011

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NURSERY UNIT

DISCHARGE CLINIC OF MAY2011

Unit : DR. Mohamed YosifPrepaired by : ARWA ABD-ELBAGI


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MONTHLY STATISTIC SHEET

y TOTAL NUMBER OF DELIVERIES : 400

y TOTAL NUMBER OF NURSERY ADMISSIONS

137

yADMISSON PERCENTAGE : IS34.3%


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y TOTAL NUMBER OF NEONATAL DEATHS : 11

y NUMBER OF NEONATAL DEATHS IN THE FIRST

WEEK OF LIFE ARE : 10

y

NUMBER OF STILL BIRTH : 9y PERINATAL MORTALITY PERCENTAGE : 4.8 %

y NEONATAL MORTALITY PERCENTAGE : 2.8 %


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CONDITIONS AND

DISORDERSCONDITIONS &DISORDERS NUMBERS No/

admission%

1-TTN (TRANSIENT TACHYPNEA OFNEOBORN)

2 1.5

2-RESPIRATORY DISTRESSRespiratory distress syndrome

202

14.51.5

3-MAS(MECONIUM ASPIRATION )

MECONIUM STAINED LIQOUR

36

2.14.2

4-HYPOXIC ISCHEMIC ENCEPHALOPATHYGRADE 1,2, 3 (HIE)

4 2.9

5-DELAYED TRANSITION 22 16

6- Hemorrhagic Disease of the Newborn 3 2.1

7- Hemolytic Disease of the Newborn 1 0.7


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CONDITION & DISORDERS NUMBERS No /

Admission%

8- Neonatal Encephalitis 2 1.5

9- NE N E - 9 .5

10- Neonatal jaundice 4.2

11- N N & N EVEN U EMM GE

1 0.7

12- Neural ube Defect 1 0.7

13- hromosomal bnormalities 2 1.5


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CONDITIONS &DISORDERS NUMBERS No/ admission

%14- IUGR 6.5

15-CONGENITAL HEART DISEASES 3 2.1

16- GROSS CONGENITAL ANOMALIES 5 3.6

1 - Si l G D ts 1 0.

18-Pr T rms 1 13.8

1 - I a t o Diab ti Moth r (IDM) 2 1.5

20- Post Dat s

Post T rm2

6.51.5

21- I bor Error o M tabolism 1 0.


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Interesting Case:y D: Preterm with Extremely low Birth Weight & RD.

y WT: 700 g, GA: 29 weeks, Female

y

Baby is outcome of NVD, mother has J and screening forhepatitis B was ve.

y Baby cried immediately and started spontaneous breathingimmediately after a while, baby developed RD withgrunting, RR: 80/min with intercostals recession and

sluggish reflexes with poor suckling.y Baby admitted to nursery on 7/3/2011 for 70 days, during

this period baby put on stabilized preterm control regimen(thermal control, incubation, IV f luids with electrolytesCa-K, FFP, blood transfusion and milk formula{neosure}).


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y During admission baby developed recurrent attacks ofapnea and resuscitation (ambubaging) was done andtheophylline was given.

yAll important investigation were done (RFT, LFT, arenormal, CBC-HB was low).

y Baby discharged on 16/5/2011 on good condition and

with weight 1.6 kg, and good suckling on regularfollow-up .HB :13 g/dl


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CASE-1y D: congenital heart disease (Edward)

yWT: 2 kg, GA: Term, Female

y

Baby is outcome of El C/S, she delivered seriously ill,flat, apnic and e central cyanosis

y Baby started spontaneous breathing after initialresuscitation

y Baby has dysmorphic features: prominent occiput, lowset ears, flat nose and rocker bottom feet

y On the same day baby developed apnea, ambubagingand CPR were done with no response.


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CASE-2y D: Anencephaly.

yWT: 1.8 kg, GA: Term, Female.

y Baby is outcome EM C/S due to placenta abruption.y Baby was delivered seriously ill and die after six hours.


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CASE-3y D: inborn error metabolismy WT: 3.3 kg, GA: Term, Female.y Baby is outcome of EL C/S due to BOH (4 abortions and 4

early neonatal death) her mother is RH ve and baby is B+ve and DCT ve.

y On day two baby became suddenly distress, febrile and J&confused. she put on supportive management andphototherapy.

yBaby plan for chromatography, amino-acid assay andamino-acid free formula, unfortunately baby died beforewere done.

y On day 4Baby devoloped apnea e no heart beatresuscitation was done for 10 min e no response.


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CASE-4Wt: 600 g GA 25 , female

y Diagnosis : extremely low birth weight preterm +RD

y Baby is outcome of NVD , baby delivered seriously illput on supportive management .

y On day 5 ,baby looked ill and distressed. Shedeveloped recurrent attacks of apnea and

resuscitation was done. the last one associated ecardiac arrest no heart beats CPR was done for 10 min.

y Cause of death : central apnea due to dysmaturity


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CASE-5y D: PRETERM WITH EXTERMLY LOW BIRTH WT and

RD

yWt :900 g GA :29 WK FEMALE

y Baby is outcome of NVD ,not cried immediately. shecried and started spontaneous breathing afterresuscitation by ambubaging for one min and put on

supportive management.y On the same day baby developed apnea &ambubaging

was for 4 hours e no response .


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CASE-6y D:HIE G 3 WITH SEVER BIRTH ASPHXIA

y WT:2.9 KG GA :TERM FEMALE

y

Baby is outcome of VD ,not cried immediately,delivered flat, apnic & cyanosis e absent reflexes.

yAmbubaging &CPR were done for20 min .babyreceived supportive management .

y Onday3 she developed apnea &bradycardia ,CPR wasdone for 30min &baby put on CPAP .

y Cause of death respiratory &circulatory collapse dueto sever birth asphyxia.


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CASE-7 Wt : 2.1 kg .. male , post term 42 wksy DIAG : congenital heart disease.y Outcome of EL/CS due to post maturity and

oligohydramnios.y Was delivered after difficult manipulation and cried after

initial resuscitation had central cyanosis and sluggishreflexes .

y Baby had pansystolic murmur with max intensity at 3rd to

4th

Lt intercostal.y Baby received supportive management and plan for ECHO.y On the same day baby developed apnea ambubaging was

done for 30 min with no response.


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CASE-8y D: NEONATAL SEPSIS and ENCEPHALAITIS

yWt: 3 kg, GA: Term, Male.

y

Baby is outcome of ELC/S, delivered smoothly and cryimmediately.

y On day 3 baby was found on the ward febrile andconvulsing and he refused feeding.

y Baby received FFP, blood transfusion and inj AB.

y On day 9 baby developed suddenly apnea andbradycardia, ambubaging and CPR were done with noresponse.


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CASE-9y D: NEONATAL SEPSIS and ENCEPHALITIS

y Wt: 2.8 kg, GA: Term, Male

y

Baby is outcome of ELC/S, his mother hasantiphospholipid syndrome on anticoagulant.

y On day 3 baby developed fever and bleeding per mouth, helooked distress, toxic, irritable with sluggish reflexes.

y

Baby received supportive management (vita K, FFP andblood transfusion and inj AB).

y Baby developed apnea and bradycardia, CPR was done withno response.


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CASE-10y D: HIE G-3 and BIRTH ASPHYXIA.y Wt: 3.5 kg, GA: Term, Male.y Baby is outcome of VD, he delivered seriously ill, flat, apnic with

central cyanosis, resuscitation (warming, suction, stimulationand ambubaging) for 30 min.y Baby started spontaneous breathing RR 10/min, irregular with

absent reflexes.y Baby received supportive management and plan for brain CT.y On second day baby looked distress, unconscious with

tachycardia HR 200/min, RR 84/min with gallop rhythm &liver 6cm below ICM.{congestive heart failure}

y Baby put on CPAP &received lasix e close monitoringy Baby developed apnea &cardiac arrest inside CPAP,CPR was

done for 10 min.


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CASE-11y D: Multiple Congenital anomalies and Chromosomal

abnormality.y Wt:3 kg, GA: Term, Male.

y Baby is outcome of VD, delivered apnic, flat with centralcyanosis and bradycardia, ambubaging and CPR were donefor 7 min, then baby start spontaneous breathing and puton oxygen.

y Baby has dysmorphic features, wide fontanelle, Rt kidney

palpable and Lt congenital hydrocele.y On the same day baby developed &cardiac arrest,CPR was

done for 10 min.y Plan for ABD US.

Download - Discharge May 2011

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