Cyanosis epidemiology and demographics: Difference between revisions
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Critical CHD accounts for approximately 25 percent of all CHD [12]. In infants with critical CHD, the risk of morbidity and mortality increases when there is a delay in diagnosis and timely referral to a tertiary center with expertise in treating these patients [9]. | Critical CHD accounts for approximately 25 percent of all CHD [12]. In infants with critical CHD, the risk of morbidity and mortality increases when there is a delay in diagnosis and timely referral to a tertiary center with expertise in treating these patients [9]. | ||
The incidence of RD in infants admitted to neonatal units doubled over the last 30 years in a geographically defined neonatal population. This rise can predominantly be ascribed to infants with birth weight >2500 g and may reflect the corresponding increase in the rate of caesarean section. | |||
The present prospective study was conducted to find out the incidence, etiology and outcome of respiratory distress (RD) in newborns. All newborns (n = 4505), delivered at this hospital over a period of 13 months, were observed for respiratory problems. Relevant antenatal, intranatal and neonatal information was noted. Cases were investigated for the cause of respiratory distress and followed up for the outcome. The overall incidence of RD was 6.7%. Preterm babies had the highest incidence (30.0%) followed by post-term (20.9%) and term babies (4.2%). Transient tachypnea of newborn (TTN) was found to be the commonest (42.7%) cause of RD followed by infection (17.0%), meconium aspiration syndrome (10.7%), hyaline membrane disease (9.3%) and birth asphyxia (3.3%). TTN was found to be common among both term and preterm babies. While Hyaline membrane disease (HMD) was seen mostly among preterms, and Meconium aspiration syndrome (MAS) among term and post-term babies. Overall case fatality ration for RD was found to be 19%, being highest for HMD (57.1%), followed by MAS (21.8%) and infection (15.6%). Our results indicate that RD is a common neonatal problem. TTN accounts for a large proportion of these cases. MAS and infection also contribute significantly and are largely preventable. Without adequate ventilatory support HMD and MAS carry high mortality. | |||
==References== | ==References== | ||
Revision as of 19:55, 11 March 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Epidemiology and Demographics
The reported prevalence of CHD at birth ranges from 6 to 13 per 1000 live births [13-19]. Variation is primarily due to the use of different methods to detect CHD (ie, fetal echocardiography versus postnatal referral to a cardiac center) [17,20].
The most common congenital heart defect is a bicuspid aortic valve (BAV), with a prevalence estimated between 0.5 and 2 percent, but as an isolated lesion it is rarely diagnosed in infancy [21-23]. The next most common defects are ventricular septal defects (VSDs) and secundum atrial septal defects (ASDs, prevalence of 4 and 2 per 1000 live births, respectively) [11,15,24,25]. Tetralogy of Fallot (TOF) (figure 2) is the most common cyanotic CHD (0.5 per 1000 births) [15,26].
CHD is the leading cause of perinatal and infant death from a congenital birth defect, although outcomes have significantly improved with the advancement of corrective or palliative interventions [1,16,27-29].
Critical CHD accounts for approximately 25 percent of all CHD [12]. In infants with critical CHD, the risk of morbidity and mortality increases when there is a delay in diagnosis and timely referral to a tertiary center with expertise in treating these patients [9].
The incidence of RD in infants admitted to neonatal units doubled over the last 30 years in a geographically defined neonatal population. This rise can predominantly be ascribed to infants with birth weight >2500 g and may reflect the corresponding increase in the rate of caesarean section.
The present prospective study was conducted to find out the incidence, etiology and outcome of respiratory distress (RD) in newborns. All newborns (n = 4505), delivered at this hospital over a period of 13 months, were observed for respiratory problems. Relevant antenatal, intranatal and neonatal information was noted. Cases were investigated for the cause of respiratory distress and followed up for the outcome. The overall incidence of RD was 6.7%. Preterm babies had the highest incidence (30.0%) followed by post-term (20.9%) and term babies (4.2%). Transient tachypnea of newborn (TTN) was found to be the commonest (42.7%) cause of RD followed by infection (17.0%), meconium aspiration syndrome (10.7%), hyaline membrane disease (9.3%) and birth asphyxia (3.3%). TTN was found to be common among both term and preterm babies. While Hyaline membrane disease (HMD) was seen mostly among preterms, and Meconium aspiration syndrome (MAS) among term and post-term babies. Overall case fatality ration for RD was found to be 19%, being highest for HMD (57.1%), followed by MAS (21.8%) and infection (15.6%). Our results indicate that RD is a common neonatal problem. TTN accounts for a large proportion of these cases. MAS and infection also contribute significantly and are largely preventable. Without adequate ventilatory support HMD and MAS carry high mortality.