Abstract
Present study was a Hospital based observational study of 100 newborns admitted in level II NICU. The study was done to assess the development of severe distress against onset, duration, oxygen requirement & outcome in terms of final diagnosis, mortality & treatment intervention. Among the 100 cases, 90% cases were of respiratory in origin. Commonest cause of respiratory distress was transient tachypnoea of newborn followed by Meconium aspiration syndrome & Respiratory distress syndrome of newborn. The onset of respiratory distress in newborn developing after 6 hours of birth & respiratory distress > 24 hours duration had severe respiratory distress. Newborn with risk factors like high maternal age, primigravida, >4 PV examinations, Meconium stained liquor and lower socioeconomic strata developed severe respiratory distress. Statistically significant correlation of severity of respiratory distress was not found with the mode of the delivery, Apgar score <7 at 1 min, gestational age of the baby, birth weight and sex of the newborn. Only neonates with RDS & MAS required ventilator care. Two of the patients of RDS required only surfactant therapy, while other two required surfactant with ventilator support. Amongst the 100 newborns with respiratory distress, mortality was in 5 newborn (5%) which includes 2 of Respiratory Distress Syndrome & 3 of Meconium Aspiration Syndrome.
Highlights
The first breath and cry have always been mystical, signaling the beginning of new life
In a study done by Alok Kumar [8] it was seen that the respiratory distress syndrome (RDS) was found to be the commonest (42.7%) cause of respiratory distress followed by transient tachyponea of newborn (TTNB) (17.0%), meconium aspiration syndrome (MAS) (10.7%), Sepsis (9.3%) and birth asphyxia (3.3%)
Similar observations were observed by Negendra K [10] who concluded that there is no significant difference in neonatal respiratory distress in male and female neonates
Summary
The first breath and cry have always been mystical, signaling the beginning of new life. Therapies for respiratory diseases were aimed at delivery of high concentration of O2. Recognition and appropriate therapy of neonatal respiratory disease has got impressive results. Continued efforts in prevention of premature birth, early recognition of fetal distress, maternal risk factors for neonatal sepsis and diagnosis of diseases in utero will lead to further improvements in the neonatal outcome. [2] Certain risk factors for developing respiratory distress includes prematurity, meconium-stained amniotic fluid (MSAF), caesarian section delivery, gestational diabetes, maternal chorioamnionitis, or prenatal ultrasonographic findings, such as oligohydramnios or structural lung abnormalities. The New born chest has limitation when compared to the adult chest. Pulmonary causes account for 80 - 85% cases of respiratory distress in a newborn. [8]
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