Spectrum of Neonatal Surgical Problems in the Newborn: Incidence, Clinical Course, Immediate Outcome, Follow up Study in a Tertiary Care NICU

Main Article Content

K. G. Sachin
K. R. Sachin
H. Ramesh
Guru Prasad
Harsha Bullapur

Abstract

Background: A congenital anomaly may be defined in terms of physical structure as a malformation, an abnormality of physical structure or form usually found at birth or during the first few weeks of life. Congenital anomalies affect approximately 1 in 33 infants and result in approximately 3.2 million birth defect-related disabilities every year. Congenital anomalies or birth defects are relatively common, affecting 3% to 5% of live births in the United States (US) and 2.1% in Europe. Congenital anomalies account for 8% to 15% of perinatal deaths and 13% to 16% of neonatal deaths in India.

Objectives: To provide an insight on the burden and types of surgical problems encountered in our NICU of Bapuji Child Health Institute & Research Center, JJM Medical College, Davangere, Karnataka, India and to study the incidence, clinical profile and outcome of surgical condition. Methodology: A total of 3820 babies were examined over a period of 2 years. The relevant information was documented on a semi-structured proforma and analysed.

Results: Overall incidence of congenital malformations at birth was 24.8 per 1000 births. The GIT system (51.58%) was most commonly involved followed by respiratory system (26.32%). The incidence of congenital malformation was more in male babies than female babies. Increased frequency was seen in babies born to mothers between 26–30 years & primigravida. The factors which significantly increased the rate of congenital malformations were consanguinity in parents & bad obstetric history. Out of 95 cases, 72% got discharged normally, 18% died in NICU and 10% got discharged against medical advise.

Conclusion: With emphasis on “small family” norms and population control it is necessary to identify malformations so that interventional programmes can be planned. Systematic clinical examination of newborns for early detection of anomalies that may warrant medical or surgical intervention. Accurate antenatal anomaly scan need to be done to identify major malformations and terminate the pregnancy.

Keywords:
Congenital anomaly, birth defects, NICU, neonatal deaths.

Article Details

How to Cite
Sachin, K. G., Sachin, K. R., Ramesh, H., Prasad, G., & Bullapur, H. (2019). Spectrum of Neonatal Surgical Problems in the Newborn: Incidence, Clinical Course, Immediate Outcome, Follow up Study in a Tertiary Care NICU. Asian Journal of Pediatric Research, 2(4), 1-9. https://doi.org/10.9734/ajpr/2019/v2i430116
Section
Original Research Article

References

Singh A. Pattern of congenital anomalies in newborn: A hospital based prospective Study. JK Science. 2009;11 (1):34-36.

Islam MN. Pattern of congenital anomalies in a tertiary level hospital in Bangladesh. Journal of surgery Pakistan (International). 2013;18(1):32-36.

Park K. Congenital malformations. In: K. Park’s Textbook of preventive and Social medicine, 22nd edition. 2013;533-34.

Chaturvedi P, Banerjee KS. Spectrum of congenital malformations in newborns from Rural Maharastra. Indian J Pediatr. 1989; 56:501-7.

Petrini J, Damus K, Russell R, Poschman K, Davidoff MJ, Mattison D. Contribution of birth defects to infant mortality in the united states. Teratology. 2002;66 (Suppl.1):3-6.

Gupta S, Gupta P, Soni JS. Study on incidence of various systemic congenital malformations and their association with maternal factors. National Journal of Medical Research. 2012;2(1):19-21.

Wynshaw A. Dysmorphology. In Behrman RE, Kliegman RM, Jenson HB, Stanton BF(eds) Nelson textbook of pediatrics 18th edn., Philadelphia: WB Saunders. 2008; 786-88.

Congenital malformations, deformations and chromosomal abnormalities. 2003; (Q00-Q99): Chapter: XVII.
Available:http://www3.who.int/icd/currentversion/fr-icd.html

Bhat BV, Babu L Congenital malformations at birth – A prospective study from South India. Indian J Pediatr. 1998;65(6):873-81.

Verma M, Chatwal J, Singh D. Congenital malformations - A retrospective study of 10,000 cases. Indian J Pediatr. 1991;58 (2):245-52.

Ronya R, Gupta D, Ghosh SK, Narang R, Jain KB. Spectrum of congenital surgical malformations in newborns. J Indian Med Assoc. 2002;100(9):565-6.

Agarwal SS, Singh U, Singh PS, Singh SS, Das V, Sharma A, et al. Prevalence & Spectrum of congenital malformations in a prospective study at a teaching hospital. Indian J Med Res. 1991;94:413- 9.

Grover N Congenital malformations in Shimla. Indian J Pediatr. 2000;67(4):249-51.

Kalra A, Kalra K, Sharma V, Singh M, Dayal MS. Congenital Malform- ations. Indian Pediatr. 1984;21:945- 950.

MacDonald AD. Maternal health in early pregnancy and congenital defects. Final report on prospective enquiry, Br J Prev Soc Med. 1961;15:154-166.

Kesavan P, Nataraja U, Murugesan K, Ramakrishnan MS. Congenital malformations and consanguinity. In medical genetics’ in India. Edi. I. C. Verma.
;I:65.

Sugunabai NS, Mascerene M, Syamalan K, Nair PM. An etiological study of congenital malformations in the newborn. Indian Pediatr. 1982;19: 1003.

Mini Sood, Neera Agarwal. Neural tube defects in East Delhi hospital. Indian J Ped. 1991;88:363-765.

Swain S, Agarwal A, Bhatia BD. Congenital malformations at birth. Indian Pediatr. 1994;31(10):1187-91.

Chaturvedi P, Banerjee KS. An epidemiological study of congenital malformations in newborn. Indian J Pediatr. 1993;60(5):645-53.

Kulshreshtha K, Nath LM, Upadyaya P. Congenital malformations in live born Infants in rural community. Indian Pediatr. 1983;20:45-49.

Vikram Datta, Pushpa Chaturvedi. Congenital malformations in rural Maharashtra. Indian Pediatr. 2000;37:998-1001.