PERINATAL MORTALITY August 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 = 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, O 2 inhalation, I/V antibiotics, I/V fluids, infusion dopamine, resuscitation/CPR D.O.E = 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 = 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 = 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 = 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, O 2 inhalation, I/V antibiotics, I/V fluids, infusion dopamine, resuscitation/CPR D.O.E = 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 G 2 P 1 mother Mode of admission = ER D.O.A = 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

Management O2 inhalation, I/V antibiotics, I/V fluids, dopamine & aminophylline infusion, resuscitation/CPR D.O.E 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 = 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, O 2 inhalation, I/V antibiotics, I/V fluids, infusion dopamine resuscitation/CPR D.O.E = Duration of stay in NICU = 13 hrs

Case 07 B / o Shamshad, NB, B/B, wt 2.5 kg FTP, LSCS at BBH to G 4 P 2 A 1 mother Mode of admission = ER D.O.A = 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 = Duration of stay in NICU 16hrs

Thank You