PERINATAL MORTALITY MEETING April 2008 DEPARTMENT OF PAEDIATRICS RGH

Total Admissions 224 Total Admissions 224 Total Expiries 47 Total Expiries 47 RGH Expiries 5 RGH Expiries 5

CASE NO 1 B/O Amrozia, NB, MC, 1.8 kg wt B/O Amrozia, NB, MC, 1.8 kg wt ELSCS, RGH,G3P2 +0, GA 34 wks ELSCS, RGH,G3P2 +0, GA 34 wks Admitted on 15/04/08 at 10 :15 pm Admitted on 15/04/08 at 10 :15 pm Call was attendet by Paeds department Call 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 Resuscitated with full protocol at birth Resuscitated with full protocol at birth O/E:V.sick, cyanosed, hypothermic, with poor p.pulses, depressed NNR. O/E:V.sick, cyanosed, hypothermic, with poor p.pulses, depressed NNR. Diagnosis: Prematurity, NNS, Septicemia, disseminated intravascular coagulation (DIC) Diagnosis: Prematurity, NNS, Septicemia, disseminated intravascular coagulation (DIC) Managed with Broad spectrum antibiotics, Infusion dopamine, FFP transfused & remained on ventilatory support for 2:30 hours. Managed with Broad spectrum antibiotics, Infusion dopamine, FFP transfused & remained on ventilatory support for 2:30 hours. Expired on 16/04/08 at 06 :15pm Expired on 16/04/08 at 06 :15pm Total duration of hospital stay was 15hrs Total duration of hospital stay was 15hrs

CASE NO 2 B/O Hameeda, NB, MC, 1.5 kg wt B/O Hameeda, NB, MC, 1.5 kg wt ElLSCS, RGH, G 3 P2+◦, GA 30 wks ElLSCS, RGH, G 3 P2+◦, GA 30 wks Admitted on 05/04/08 at 04:00 am Admitted on 05/04/08 at 04:00 am Call was attendet by Paeds department Call was attendet by Paeds department No antenatal risk factors. No antenatal risk factors. APGAR score 6/10 and 8/10 APGAR score 6/10 and 8/10 O/E: pale, moaning, cyanosed, hypothermic, with poor peripheral pulses & depressed NNR O/E: pale, moaning, cyanosed, hypothermic, with poor peripheral pulses & depressed NNR Diagnosis: Prematurity, VLBW, Sepsis & DIC Diagnosis: Prematurity, VLBW, Sepsis & DIC Managed with Incubator care, broad spectrum antibiotics, Infusion dopamine, FFP transfusion in planned but nor arranged, remaind on ventilator for half hr. Managed with Incubator care, broad spectrum antibiotics, Infusion dopamine, FFP transfusion in planned but nor arranged, remaind on ventilator for half hr. Expired on 06/04/08 at 02:00am Expired on 06/04/08 at 02:00am Total duration of hospital stay was 22hrs Total duration of hospital stay was 22hrs

CASE NO 3 B/O Farhat, NB, MC, 0.9 kg wt B/O Farhat, NB, MC, 0.9 kg wt ELSCS, RGH, Gyane COT, GA 28 wks ELSCS, RGH, Gyane COT, GA 28 wks Admitted on 08/04/08 at 01:450pm Admitted on 08/04/08 at 01:450pm Maternal risk factor PIH & HCV +ve Maternal risk factor PIH & HCV +ve Call attended by Paeds Dept Call attended by Paeds Dept Baby delivered with apgar score 2/10 & 4/10 Baby delivered with apgar score 2/10 & 4/10 Resuscitated in gynae COT Resuscitated in gynae COT O/E: Cyanosed, hypothermic no spontaeous respiration,with poor peripheral pulses & depressed NNR O/E: Cyanosed, hypothermic no spontaeous respiration,with poor peripheral pulses & depressed NNR Diagnosis: Extreme Prematurity, Severe Birth Asphyxia Diagnosis: Extreme Prematurity, Severe Birth Asphyxia Managed with immediate ventilatory support,Incubator care, broad spectrum antibiotics, Infusion dopamine, Infusion Aminophylline, Managed with immediate ventilatory support,Incubator care, broad spectrum antibiotics, Infusion dopamine, Infusion Aminophylline, Expired on 08/04/08 at 05 :45pm Expired on 08/04/08 at 05 :45pm Total duration of hospital stay was 3 hrs Total duration of hospital stay was 3 hrs

CASE NO 4 B/O Raqeeban, NB, FC, 2.5kg wt B/O Raqeeban, NB, FC, 2.5kg wt ELSCS, RGH,G 5 P4 +0 GA full term ELSCS, RGH,G 5 P4 +0 GA full term Admitted on 18/04/08 at 01:55pm Admitted on 18/04/08 at 01:55pm Maternal H/O PV bleeding for 16 hrs Maternal H/O PV bleeding for 16 hrs Call attended by Paeds Dept Call attended by Paeds Dept Baby delivered with apgar score 2/10 & 4/10 Baby delivered with apgar score 2/10 & 4/10 O/E: moaning, cyanosed, with absent peripheral pulses, gasping respiration & depressed NNR O/E: moaning, cyanosed, with absent peripheral pulses, gasping respiration & depressed NNR Diagnosis: Severe Birth Asphyxia (Sarnett 111) Diagnosis: Severe Birth Asphyxia (Sarnett 111) Managed with Incubator care, broad spectrum antibiotics, Infusion dopamine, Infusion, ventilatory supports for 4 hrs & 35 min Managed with Incubator care, broad spectrum antibiotics, Infusion dopamine, Infusion, ventilatory supports for 4 hrs & 35 min Expired on 18/04/08 at 6:30pm Expired on 18/04/08 at 6:30pm Total duration of hospital stay was 4 hrs & 35 min Total duration of hospital stay was 4 hrs & 35 min

CASE NO 5 B/O Rehana Zafar, NB, MC, 3 kg wt B/O Rehana Zafar, NB, MC, 3 kg wt ELSCS, RGH, GA full term ELSCS, RGH, GA full term Admitted on 28/04/08 at 10:45 am. Admitted on 28/04/08 at 10:45 am. Call attended by Paeds Dept Call attended by Paeds Dept Baby delivered with apgar score 6/10 & 9/10 Baby delivered with apgar score 6/10 & 9/10 O/E: V.sick,cyanosed, hypothermic, with poor p.pulses, depressed NNR & Severe tachpnea O/E: V.sick,cyanosed, hypothermic, with poor p.pulses, depressed NNR & Severe tachpnea Diagnosis: Septicemia,Congenital Pneumonia with CCF, disseminated intra vascular coagulation (DIC), rule out inborn error of metabolism Diagnosis: Septicemia,Congenital Pneumonia with CCF, disseminated intra vascular coagulation (DIC), rule out inborn error of metabolism Managed with Broad spectrum antibiotics, Infusion dopamine, antifailure drugs, FFP transfused & remained on ventilatory support for 25 min Managed with Broad spectrum antibiotics, Infusion dopamine, antifailure drugs, FFP transfused & remained on ventilatory support for 25 min Expired on 30/04/08 at 10 :45 am Expired on 30/04/08 at 10 :45 am Total duration of hospital stay was 46 hrs Total duration of hospital stay was 46 hrs