Spectrum of Neonatal Surgical Emergencies at a Government Tertiary Care Centre in Madhya Pradesh: An Observational Study

Abstract

Introduction: This impoverished region of India, where the majority of the population suffers from poverty and malnourishment, lacks data regarding the epidemiological pattern for surgical congenital abnormalities to date. Hence, there is a dire need to gather epidemiological data on newborn surgical emergencies, which has been lacking. Aim: To study the epidemiological data of neonatal patients requiring emergency surgery and to evaluate the variables affecting morbidity and mortality in emergency newborn surgery cases. Materials and Methods: This retrospective observational study was carried out at Gajra Raja Medical College, Gwalior, Madhya Pradesh, India from October 2018 to August 2022. Case records of emergency surgical interventions in neonates presenting to the Emergency Department under the age of 30 days of life were reviewed. The outcomes, postoperative morbidity, and mortality were noted. The data was presented descriptively using frequency and percentages. Results: In the present study, the male-to-female ratio was 1:1.2, the mean age was 4.9 days±4.1 days, and the mean birth weight was 2025±635 grams. Anorectal Malformations (ARM), 178 (37.71%) and Oesophageal Atresia (EA), 133 (27.8%) were the most prevalent congenital abnormalities in the current investigation, followed by other congenital gastrointestinal anomalies. Nonetheless, the remarkably elevated prevalence of pouch colon among patients with ARM deserves particular attention. In compared to a well- prepared Neonatal Intensive Care Unit (NICU), an inadequately equipped Sick Newborn Care Unit (SNCU) with a small nursing staff represents inadequate infrastructure for the management of a surgical neonatal emergency. Conclusion: The majority of patients died from postoperative septicaemias, accounting for 35.5% of the mortality rate among these neonates who underwent emergency surgery. A large percentage of infant mortality in underdeveloped nations like India might be avoided with proper perioperative care, especially for surgical infants.