Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Neonatal deaths in a tertiary care hospital in sri lanka(The Sri Lanka College of Paediatricians, 2008) Pannala, W.S.; Adikari, A.M.C.; Mettananda, D.S.G.; Rajindrajith, S.; Devanarayana, N.M.BACKGROUND: Neonatal mortality rate reliably assesses the level of perinatal care in a country. Lethal congenital malformations and extreme prematurity are the main causes of neonatal mortality in developed countries. Developing countries continue to lose neonates due to infections, malnutrition and birth asphyxia. OBJECTIVE: To describe the clinical characteristics, timing and causes of neonatal deaths Jn a tertiary care hospital in Sri Lanka, DESIGN, SETTING AND METHOD: A descriptive study was conducted at the Special Care Baby Unit of the University Paediatric Unit of North Colombo Teaching Hospital, Ragama. Data on all neonatal deaths which occurred from January 2006 to June 2007 were extracted from hospital records using a data collection form. RESULTS: Fifty-nine neonatal deaths were studied. All babies were born at hospitals and there were no home deliveries. Thirty (51%) were males and 42% were first born. Sixty six percent were deliveredpreterm including 13% delivered before 28 weeks. Mean birth weight was 1.81 (SD^O.87) kg. Twenty eight (47%) were delivered following an' uncomplicated antenatal period while 9 (15%) mothers had pre-labour rupture of membranes, 8 (14%) had pregnancy induced hypertension and 6 (10%) had antepartum haemorrhages. Fifty four percent were delivered vaginally and 41% by emergency caesarean section. Forty five (76%) needed resuscitation at birth. Eight (14%) newborns did not survive more than an hour and a further 16 (27%) died within the first 24 hours. Forty four (75%) died within one week. Twenty six (44%) died of complications of prematurity of which half had surfactant deficient lung disease. Other causes of death were sepsis (20%), congenital abnormalities (14%), meconium aspiration syndrome (12%) and birth asphyxia (10%). Pathological postmortems were done on 17 (29%). CONCLUSIONS: Seventy five percent of deaths occurred in the first week of life, 41% occurring within the first 24 hours. Forty four percent died of complications of prematurity. Birth asphyxia accounted for only 10% of deaths.Item Neonatal deaths in a tertiary care hospital in Sri Lanka: a clinical audit(Sri Lanka Medical Association, 2008) Pannala, W.S.; Adikari, A.M.C.; Mettananda, D.S.G.; Rajindrajith, S.; Devanarayana, N.M.OBJECTIVE: To describe the clinical characteristics, timing and causes of neonatal deaths in a tertiary can centre in Sri Lanka. DESIGN, SETTING AND METHODS: A clinical audit was conducted on all neonatal deaths occurred at specia care baby unit of the university pediatric unit of North Colombo Teaching Hospital from January 2006 tc June 2007. Data were extracted from hospital records using a data collection form. RESULTS: Fifty-nine neonatal deaths were audited. All baies were born in hospitals and there were no home deliveries. Thirty (51%) were males and 42% were first borns. Sixty-six percent were delivered preterm while 13% were delivered even before 28 weeks. Mean birth weight was 1.81(SD=0.87) kg. Twenty-eight (47%) were delivered following an uncomplicated antenatal period while 9(15%) mothers had pre-labour rupture of membranes, 8( 14%) had pregnancy induced hypertension and 6( 10%) had antepartum haemorrhages. 54% were delivered vaginally and 41% were delivered by emergency caesarian section. Forty-five (76%) needed resuscitation at birth. Eight (14%) newborns did not survive more than an hour and 16 more (27%) died within the first 24-hours; 44(75%) died within one week. Twenty-six (44%) died of complications of prematurity of which half had surfactant deficient lung disease. Other causes of death were sepsis (20%), congenital abnormalities (14%), meconium aspiration syndrome (12%) and birth asphyxia (10%). Pathological postmortems were done on 17(29%). CONCLUSIONS: Three-quarters of deaths were early neonatal deaths and over 40% occurred within the first 24 hours. Nearly half died of complications of prematurity and asphyxia accounted only for 10% of deaths.