H. Alobaidy1, M. Kreasta1, M. Dekna1, E. R. Juma2
1) Paediatric Department, Faculty of Medicine, Elfateh University, Tripoli, Libya
2) Department of Paediatrics, Alkhadra Hospital, Tripoli, Libya
JMJ Vol.3 No.1 (March) 2004: 48-51
Aim: Re-evaluation of neonatal services after the initial perinatal mortality assessment, which was carried out at Neonatal Unit in Aljalla Maternity Hospital, which have been moved in 1992 to Alkhadra General Hospital, the transfer included medical and nursing staff and the equipment. Methods: It is a retrospective study over a period of one year (1/1/1995-31/12/1995) where the medical files of admitted newborn in the neonatal unit and the registration book at the labour room and operating theatre were reviewed. The review included the history, clinical examination, investigation, treatment and outcome. We reviewed the nursing staff and the medical equipment. Results: The total delivery was 15407 births include 153 stillbirths and 15254 were live births. 7.8% of total live births were admitted. 246 babies died in the 1st week of live and the calculated perinatal mortality rate was 25.8/1000 total births. Stillbirth contributed to 38.35% of total perinatal death and the death in the 1st week was 61.65%. One third (18.3%) of the 1st week deaths died in the 1st 24 hours. The main causes of admission were respiratory distress 49.3%, prematurely 31.2%, jaundice 29.3%, infant of diabetic mother 23.4%, birth asphyxia 13.4%, sepsis 12.1% and congenital malformation 8.2%. The main associated causes of early neonatal death in general were respiratory distress 79%, birth asphyxia 41%, sepsis 32%, and congenital anomalies 10%. The main association with preterm death were respiratory insufficiency 85.14%, birth weight below 1.5 kg 52.2%, sepsis 23.2%, and hypoglycaemia in infant of diabetic mother 8.1%, congenital malformation 6% and asphyxia 5%. Inadequate number of experienced nursing staff (one third of international recommendation) and lack of proper maintenance of medical equipment were among the factor, which affected the neonatal care. Conclusion: On comparison with the study at Aljalla maternity hospital five years previous to our study, we found no improvement in the perinatal mortality rate or morbidity pattern in neonates, which calls for: l-Tighter control of preventable diseases like infection, prematurity, some congenital malformation, IDM, birth asphyxia and haemolytic diseases.2-Early surgical interference in treatable congenital deformities by improves our facilities both quantitatively and qualitatively. 3- Further training for adequate number of nursing staff. 4- Centre for periodic maintenance of medical equipment.
Keywords: Perinatal mortality, perinatal morbidity