No abstract

Background: Neonatal period carries higher risk of death inspite of advances in perinatal and neonatal services. The objective of the study was to assess the morbidity/mortality pattern of intramural and extramural neonates.Methods: Prospective observational study was undertaken on all intramural and extramural neonates who fulfill the inclusion criteria at a tertiary institute for one year. Morbidity and mortality patterns were analyzed.Results: A total 1770 intramural and 997 extramural neonates required admission during the study period. Mortality rate in intramural neonate was 22.26% while in extramural neonate was 28.79%. The male to female ratio was 1.27:1 in intramural while 1.3:1 in extramural neonates. Preterm neonates with extremely/very low birth weight were predominant in intramural group and term neonates in extramural group (p<0.001). Maternal illness during pregnancy were significantly more in mothers of extramural neonates compared to that of intramural neonates (p<0.001). Lethargy and hypothermia was significantly more in extramural group (p<0.001) while respiratory distress was significantly higher in intramural group (p=0.01). The leading causes of admission in intramural neonates was prematurity with respiratory distress syndrome (31.64%) while sepsis (37.01%) in extramural group of neonates. Preterm birth complication (51.52%) was the common cause of mortality in intramural neonates while sepsis (42.16%) in extramural neonates.Conclusions: Sepsis is the most common cause of morbidity/mortality in extramural neonates while prematurity and its complication in intramural neonates.

Cardiac rhabdomyoma is the most common primary cardiac tumor in neonatal age group. A full term male neonate, whose antenatal ultrasound revealed mass in foetal heart, became symptomatic on day two of life. Echocardiography revealed pericardial mass with global left ventricular hypokinesia. Diagnosis was confirmed by histopathological examination of autopsy specimen. Due to social stigma, encouragement of the parents for clinical autopsy was of prime importance for definitive diagnosis and preventive measures in future pregnancies.