1. PERINATAL MORTALITY August 2009 By Dr Rashida Amir Paeds Department

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

3. 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

4. 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

5. Management Prop-up, O 2 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

6. 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

7. On examination sick-looking, absent NNR, gasping respiration, meningoencephalocele, polydactyly, short neck, low-set ears Diagnosis Birth Asphyxia III, Meningoencephalocele Syndromic Baby

8. Management resuscitation/CPR, I/V antibiotics, I/V fluids D.O.E = 12-08-09 Duration of stay in NICU =01 hr

9. 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

10. On examination V.sick-looking, moaning, bruises all over the body, depressed NNR Diagnosis Birth Asphyxia III, Meconium Aspiration Syndrome

11. Management Prop-up, O 2 inhalation, I/V antibiotics, I/V fluids, infusion dopamine, resuscitation/CPR D.O.E = 13-08-09 Duration of stay in NICU = 19 hrs

12. 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 = 19-08-09 Risk Factors * h/o PROM > 18hrs * h/o Previous preterm delivery * preterm labour

13. 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

14. Management O2 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

15. 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

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

17. Management Prop-up, O 2 inhalation, I/V antibiotics, I/V fluids, infusion dopamine resuscitation/CPR D.O.E = 22-08-09 Duration of stay in NICU = 13 hrs

18. 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 = 27-08-2009 Risk Factors * placenta praevia II & abruptio placenta * non-booked Call not sent. Baby sent from COT with nurse

19. On Examination Sick-looking baby, lethargic, hypothermic, depressed NNR Diagnosis Birth Asphyxia III, N.N.Sepsis

20. 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

21. Thank You