The Medical Journal of Basrah University

Abstract

Objectives: a descriptive study was carried out on term neonates with respiratory distress in the early neonatal period who was admitted to the neonatal care units in Basrah Maternity and Children Hospital to assess the causes, outcome, and neonatal, maternal, labor, and delivery characteristics. Patients and Methods: a total of (167) full term neonates, (103) males and (64) females, their ages range from less than one hour to 7 days who were admitted for respiratory distress (from the first of March to the end of August 2010) were recruited in the study from a total of (2858) cases admitted to the 1st and 2nd neonatal care units during the study period, (1348) of them had respiratory distress. Detailed maternal, perinatal, labor and delivery histories were taken and full clinical examination was performed. Results: the most common presenting signs were chest retractions and tachypnea. Eighty four (50.3%) of cases were delivered by caesarean section. It was found that (78.4%) of cases had a gestational age less than 39 weeks and (80%.8) were less than 24 hours of age. Both are statistically significant with p value <0.00l. One hundred forty six) (87.4%) had a normal body weight (2500 to 4000 gm). Ninety one (54.5%( of cases need hospitalization for 3 days or more. It was found that 39(23.4%) of the mothers were risky regarding their ages (<18 years and >35 years) and (27.5%) of the cases had no antenatal care, 95% of mothers were not employed and had less than 10 years of schooling. It was found that 75 (44.9%) cases were due to Transient tachypnea of the newborn and 50.7% of them were delivered by elective caesarean section followed by birth asphyxia in 22(13.2%) cases; (16) (72.75%) of them were delivered vaginally. Meconium Aspiration syndrome was found in (9.6%) of cases, early sepsis in (8.4%), and pneumonia in (7.8%). Congenital heart diseases was responsible for (7.8%) of cases, while anemia was found in (4.2%) of total cases, pneumothorax in (3%) and Respiratory Distress Syndrome in only (1.2%). The deaths were 15(9%) from 167 cases, the commonest causes were found to be due to birth asphyxia and early sepsis, 13 deaths (12.6%) occurred among males and more deaths among those who were less than 39 weeks gestation (9.16%). The total deaths due to Respiratory Distress in the study period were (35) from a total (174) and (150) from a total of (680) deaths in the 1st and 2nd neonatal care units respectively which constitute one fifth of the total deaths. Conclusions: A wise and correct decision of timing of caesarean section is needed with prevention and management of asphyxia and sepsis in addition to adequate measures and facilities of treatment for hospitalized neonates.