Background: Meconium aspiration syndrome is a severe life-threatening illness in the neonate and is a major cause of perinatal morbidity and mortality. MSAF is reported around 10 to 20% of live births in which MAS seen around 5-10%. Various maternal and neonatal factors have been found associated with MAS which lead to several complications in the neonates and succumb to the disease.
Methods: The present study is a observational study was done on 59 babies admitted in NICU of Government medical college, Chidambaram for a period of 1 year and 2 months who fulfilled the clinical criteria for diagnosing MAS. Babies born with MSAF were resuscitated as per NRP guidelines and observed for their immediate outcome.
Results: Out of 460 MSAF babies, 59 developed MAS with incidence of (12.8%). MAS was common with thick meconium (55.9%) compared to thin with male preponderance (54.2%) and Primi gravida (74.6%). MAS occurred more in babies having fetal distress and antenatal risk factors like PIH, PROM, and anaemia. MAS was common in babies born through normal vaginal delivery and in term gestation of 37-40weeks with mean birth weight of 2860±394. 1minute APGAR score less than 7 in (57.6%) MAS babies and most common complications were PPHN, seizures and pneumothorax. Mortality in MAS was around (13.5%) with most common cause was hypoxic ischemic encephalopathy.
Conclusion: Babies with MAS requires proper diagnosis and careful decisions are made about the timely intervention which reduces morbidity and mortality.
Fetal lymphangioma is one of the rarest congenital malformation occuring in the newborn. We are reporting a giant fetal lymphangioma which may be the largest one so far reported in medical literature and its association with non immune hydrops fetalis. A late preterm 35+3 weeks gestation female neonate with birth weight of 3.8 kg was delivered via emergency caesarean section, for prevention of birth injuries in view of large for gestation. Baby had weak cry at birth. On examination a giant cystic mass extending from right hemithorax to right anterolateral abdominal wall measuring 25×12.5×9 cm was present. Systemic examination revealed respiratory distress and ascites. Neonate was admitted in NICU and started on supportive measures, despite which went into cardio respiratory arrest at second hour of life and revived with Cardiopulmonary resuscitation. Baby had second cardiopulmonary arrest at 9 hours of life and couldn’t be revived. Antenatal ultrasound showed massive ascites, bilateral pleural effusion with cardiomegaly and multiseptated cystic swelling over right chest wall. Based on clinical and antenatal findings we made a diagnosis of Giant fetal lymphangioma with non-immune hydrops fetalis. Giant fetal lymphangioma is an antenatal diagnosis. Its association with non-immune hydrops fetalis is a bad prognostic indicator with high mortality.
Background: Mechanical ventilation refers to artificial methods used for supporting ventilation and oxygenation. With the advent of mechanical ventilation, the intensive care for pediatric patients have witnessed high success rates, better management of complications and improved outcomes with reduced mortality and morbidity rates. This study was done to assess the preceding risk factors, indication, clinical profile and outcome of mechanically ventilated children from rural population admitted in a tertiary care hospital. Methods: Prospective observational study of critically ill cchildren between 2 months and 12 years of age who required mechanical ventilation in Pediatric Intensive Care Unit of a tertiary care hospital. The data collected includes epidemiological profile, risk factors, clinical, laboratory and mechanical ventilation profile. Results: A total of 70 children required mechanical ventilation .The mean ± SD age of the participants was 2.05 ±2.4 years. Bronchopneumonia was the most common diagnosis (n=20, 28.6%) and the most common indication for mechanical ventilation among the study participants was severe respiratory distress (n=23, 32.9%).The most common complication observed among the study participants was Ventilator associated pneumonia (n=21, 30%). Overall, majority of the participants survived (n=44, 62.9%) while 26 (37.1%) participants expired in this study.
Conclusion:Majority of the children were less than 1 year of age from poor socio economic status. Respiratory causes like bronchopneumonia and bronchiolitis were the common conditions requiring mechanical ventilation. More analytical studies are needed in future, to estimate the long term sequelae and outcome in mechanically ventilated children.
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