PERINATAL MORTALITY MEETINGPERINATAL MORTALITY MEETINGApril 2008April 2008

DEPARTMENT OF PAEDIATRICS RGHDEPARTMENT OF PAEDIATRICS RGH

Total AdmissionsTotal Admissions 224 224

Total ExpiriesTotal Expiries 47 47

RGH ExpiriesRGH Expiries 5 5

CASE NO 1CASE NO 1 B/O Amrozia, NB , MC , 1.8 kg wtB/O Amrozia, NB , MC , 1.8 kg wt ELSCS ,ELSCS , RGH ,G3P2 RGH ,G3P2+0+0 , , GA 34 wksGA 34 wks Admitted onAdmitted on 15/04/08 at 10 :15 pm 15/04/08 at 10 :15 pm Call was attendet by Paeds departmentCall was attendet by Paeds department Baby delivered with apgar score of 4/10 & 7/10 Baby delivered with apgar score of 4/10 & 7/10

ResuscitatedResuscitated with full protocol at birthwith full protocol at birth O/E:O/E:V.sick, cyanosed , hypothermic, with poor V.sick, cyanosed , hypothermic, with poor

p.pulses , depressed NNR.p.pulses , depressed NNR. DiagnosisDiagnosis: Prematurity, NNS, Septicemia, : Prematurity, NNS, Septicemia,

disseminated intravascular coagulation (DIC) disseminated intravascular coagulation (DIC) Managed withManaged with Broad spectrum antibiotics, Broad spectrum antibiotics,

Infusion dopamine, FFP transfused & remained Infusion dopamine, FFP transfused & remained on ventilatory support for 2:30 hours.on ventilatory support for 2:30 hours.

Expired onExpired on 16/04/08 at 06 :15pm 16/04/08 at 06 :15pm Total duration of hospital stayTotal duration of hospital stay was 15 was 15hrshrs

CASE NO 2CASE NO 2 B/O Hameeda, NB , MC , 1.5 kg wtB/O Hameeda, NB , MC , 1.5 kg wt ElLSCSElLSCS , RGH , G , RGH , G 33P2+◦, P2+◦, GAGA 30 wks 30 wks Admitted onAdmitted on 05/04/08 at 04:00 am 05/04/08 at 04:00 am Call was attendet by Paeds departmentCall was attendet by Paeds department No antenatal risk factors.No antenatal risk factors. APGAR score 6/10 and 8/10APGAR score 6/10 and 8/10 O/EO/E: : pale, moaning, cyanosed, hypothermic, pale, moaning, cyanosed, hypothermic,

with poor peripheral pulses & depressed NNRwith poor peripheral pulses & depressed NNR Diagnosis:Diagnosis: Prematurity, VLBW, Sepsis & DIC Prematurity, VLBW, Sepsis & DIC Managed withManaged with Incubator care, broad Incubator care, broad

spectrum antibiotics, Infusion dopamine , FFP spectrum antibiotics, Infusion dopamine , FFP transfusion in planned but nor arranged, transfusion in planned but nor arranged, remaind on ventilator for half hr.remaind on ventilator for half hr.

Expired onExpired on 06/04/08 at 02:00am 06/04/08 at 02:00am Total duration of hospital stay wasTotal duration of hospital stay was 22 22hrshrs

CASE NO 3CASE NO 3 B/O Farhat, NB , MC , 0.9 kg wtB/O Farhat, NB , MC , 0.9 kg wt ELSCSELSCS , RGH, Gyane COT , , RGH, Gyane COT , GA 28 wksGA 28 wks Admitted onAdmitted on 08/04/08 at 01:450pm 08/04/08 at 01:450pm Maternal risk factor PIH & HCV +veMaternal risk factor PIH & HCV +ve Call attended by Paeds DeptCall attended by Paeds Dept Baby delivered with apgar score 2Baby delivered with apgar score 2/10 & 4/10/10 & 4/10 Resuscitated in gynae COTResuscitated in gynae COT O/E:O/E: Cyanosed , hypothermic no spontaeous Cyanosed , hypothermic no spontaeous

respiration ,with poor peripheral pulses & respiration ,with poor peripheral pulses & depressed NNRdepressed NNR

Diagnosis:Diagnosis: Extreme Prematurity , Severe Birth Extreme Prematurity , Severe Birth AsphyxiaAsphyxia

Managed withManaged with immediate ventilatory immediate ventilatory support,Incubator care, broad spectrum support,Incubator care, broad spectrum antibiotics, Infusion dopamine , Infusion antibiotics, Infusion dopamine , Infusion Aminophylline , Aminophylline ,

Expired onExpired on 08/04/08 at 05 :45pm 08/04/08 at 05 :45pm Total duration of hospital stayTotal duration of hospital stay was 3 was 3 hrs hrs

CASE NO 4CASE NO 4 B/O Raqeeban , NB , FC , 2.5kg wtB/O Raqeeban , NB , FC , 2.5kg wt ELSCS ELSCS , RGH ,G, RGH ,G55 P4 P4+0+0 GA full termGA full term Admitted onAdmitted on 18/04/08 at 01:55pm 18/04/08 at 01:55pm Maternal Maternal H/O PV bleeding for 16 hrs H/O PV bleeding for 16 hrs Call attended by Paeds DeptCall attended by Paeds Dept Baby delivered with apgar score Baby delivered with apgar score 2/10 & 4/102/10 & 4/10 O/EO/E:: moaning, cyanosed , with absent peripheral moaning, cyanosed , with absent peripheral

pulses , gasping respiration & depressed NNRpulses , gasping respiration & depressed NNR Diagnosis:Diagnosis: Severe Birth Asphyxia (Sarnett 111) Severe Birth Asphyxia (Sarnett 111) Managed withManaged with Incubator care, broad spectrum Incubator care, broad spectrum

antibiotics, Infusion dopamine , Infusion, ventilatory antibiotics, Infusion dopamine , Infusion, ventilatory supports for 4 hrs & 35 min supports for 4 hrs & 35 min

Expired onExpired on 18/04/08 at 6:30pm 18/04/08 at 6:30pm Total duration of hospital stayTotal duration of hospital stay was was 4 hrs & 35 min4 hrs & 35 min

CASE NO 5CASE NO 5 B/O Rehana Zafar, NB , MC , 3 kg wtB/O Rehana Zafar, NB , MC , 3 kg wt ELSCS , RGH , ELSCS , RGH , GA full termGA full term Admitted onAdmitted on 28/04/08 at 10:45 am. 28/04/08 at 10:45 am. Call attended by Paeds DeptCall attended by Paeds Dept Baby delivered with apgar score Baby delivered with apgar score 6/10 & 9/106/10 & 9/10 O/E:O/E: V.sick ,cyanosed , hypothermic, with poor V.sick ,cyanosed , hypothermic, with poor

p.pulses , depressed NNR & Severe tachpnea p.pulses , depressed NNR & Severe tachpnea Diagnosis:Diagnosis: Septicemia ,Congenital Pneumonia with Septicemia ,Congenital Pneumonia with

CCF, disseminated intra vascular coagulation (DIC), CCF, disseminated intra vascular coagulation (DIC), rule out inborn error of metabolism rule out inborn error of metabolism

Managed withManaged with Broad spectrum antibiotics, Infusion Broad spectrum antibiotics, Infusion dopamine , antifailure drugs, FFP transfused & dopamine , antifailure drugs, FFP transfused & remained on ventilatory support for 25 minremained on ventilatory support for 25 min

Expired onExpired on 30/04/08 at 10 :45 am 30/04/08 at 10 :45 am Total duration of hospital stayTotal duration of hospital stay was was 46 hrs46 hrs