PERINATAL MORTALITYAugust 2009

By

Dr Rashida Amir

Paeds Department

Total admissions = Total expiries = 52 expiries of BBH = 07

Case 1

B/o Fouzia , NB , B/B , wt 2.5kg Preterm , SVD at BBH Mode of admission = ER D.O.A = 10-08-09 Risk Factors

* booked pt

* breech presentation

* h/o PIH & gestational diabetes

* Polyhydramnios

• Call not sent.baby sent to ER with nurse.

APGAR mentioned = 5/10 & 8/10• On examination sick-looking , depressed NNR , peripheral

cyanosis, Bruise on left hip Diagnosis Birth Asphyxia , IVH , Septicaemia , DIC

Management Prop-up , O2 inhalation , I/V antibiotics , I/V

fluids , infusion dopamine , resuscitation/CPR D.O.E = 12-08-09 Duration of stay in NICU = 02 days 16 hrs

Case 03

B/o Shama , NB, B/G, wt 02kg Preterm , SVD at BBH Mode of admission = ER D.O.A = 12-08-09 Risk Factors Call not sent .baby sent to ER with nurse from LR

On examination sick-looking , absent NNR , gasping

respiration , meningoencephalocele , polydactyly , short neck , low-set ears

Diagnosis Birth Asphyxia III , Meningoencephalocele

Syndromic Baby

Management

resuscitation/CPR , I/V antibiotics ,

I/V fluids D.O.E = 12-08-09 Duration of stay in NICU =01 hr

Case 04

B/o Sonia , 02DOL , B/G , wt 2.5kg FTP , SVD at BBH to PG mother Mode of admission = ER D.O.A = 12-08-09 Risk Factors

Call not sent .baby sent to ER with nurse APGAR mentioned 2/10

On examination V.sick-looking , moaning , bruises all over the

body , depressed NNR Diagnosis Birth Asphyxia III , Meconium Aspiration

Syndrome

Management Prop-up , O2 inhalation , I/V antibiotics , I/V fluids,

infusion dopamine , resuscitation/CPR D.O.E = 13-08-09 Duration of stay in NICU = 19 hrs

Case 05

B/o Nosheen , NB , B/B , wt 2 kg Preterm GA 34+ wks , SVD at BBH to

G2P1mother Mode of admission = ER D.O.A = 19-08-09 Risk Factors

* h/o PROM > 18hrs

* h/o Previous preterm delivery

* preterm labour

Call not sent, baby sent from LR with nurse On examination Sick-looking , moaning, Hypothermic baby,

pallor , depressed NNR , weak cry , Diagnosis Preterm 34+ wks , LBW AGA , Birth asphyxia II,

N.N.Sepsis, N.N. Jaundice, Apnea of Prematurity

ManagementO2 inhalation , I/V antibiotics , I/V

fluids , dopamine & aminophylline infusion , resuscitation/CPR

D.O.E 23-08-2009 Duration of stay in NICU – 4 days

Case 06

B/o Yasmeen , NB , B/G , wt 03kg FTP , LSCS at BBH Mode of admission = ER D.O.A = 21-08-09 Risk Factors Call attended by Paeds department Baby delivered with APGAR 3/10 & 7/10

On examination V.sick-looking , resuscitated in COT , Absent NNR Diagnosis Birth Asphyxia III , Meconium Aspiration

Syndrome

Management Prop-up , O2 inhalation , I/V antibiotics , I/V

fluids , infusion dopamine resuscitation/CPR D.O.E = 22-08-09 Duration of stay in NICU = 13 hrs

Case 07

B / o Shamshad , NB , B/B , wt 2.5 kg FTP , LSCS at BBH to G4P2A1 mother Mode of admission = ER D.O.A = 27-08-2009 Risk Factors * placenta praevia II & abruptio placenta * non-booked Call not sent. Baby sent from COT with nurse

On Examination Sick-looking baby , lethargic , hypothermic,

depressed NNR Diagnosis Birth Asphyxia III , N.N.Sepsis

Management O2 inhalation , I/V antibiotics , I/V fluids ,

dopamine transfusion , resuscitation/CPR D.O.E = 28-08-2009 Duration of stay in NICU 16hrs

Thank You