Neonatal intensive care at the Leila Wynter intensive care unit over the past 5 3/4 years - abstract

ABSTRACT

Since February, 1974, 207 neonates have been admitted to the Bustamante Hospital for Children accounting for a third of the total admissions. 40 percent of these neonates were referred from country hospitals throughout the island. Two-thirds of the admissions had medical conditions, respiratory distress being the prime reason for referral. Idiopathic respiratory distress syndrome, neonatal tetanus, and whooping cough accounted for most of the medical admissions, whilst congenital anomalies of the gastro-intestinal tract accounted for most of surgical admissions. Eleven cases of necrotising enterocolitis have been seen. Neonatal deaths accounted for 45 percent of the total deaths. 63 percent of the neonates who died had medical conditions and 37 percent had surgical conditions. 58.9 percent of the neonatal deaths occurred within the first 24 hours. Aspiration pneumonia as the primary cause of death has been shown in neonates dying within 24 hours, and the average birth weight of these infants was 2 kgms. Trachio-oesophageal fistulae accounted for most of the surgical deaths, and the majority of these cases were seen between October and January. A success rate of 54 percent reflects some improvement in neonatal care in this hospital since 1974, factors hindering this improvement are mainly centred around lack of nursing staff, equipment maintenance and supplies. Of the 112 surviving neonates, only one has been referred for assessment of his mental status (AU)