patients who were confirmed with COVID-19 postoperatively (20.4%) compared with preoperatively (9.1%). Care and staffing needs differ, so preoperative COVID-19 testing and diagnoses can be helpful to ensure needs are met before complications arise. Strategies can be implemented to address more emergent surgeries where prior testing is not feasible. When making discussions, the mother, neonate, and HCWs should be considered to minimize risk and improve safety for all involved. Future research and studies should look at the clinical benefits and risks of the testing pathway, PPE use and its impact on HCW outcomes, and risks and benefits of maternal-neonate interaction after the mother tests positive for COVID-19.

Background Each year, approximately 15 million babies are born too early. Mortality associated with preterm birth is the highest contributor to under five mortality globally. At Komfo Anokye Teaching Hospital (KATH), preterm birth remains the leading cause of admission to the Mother and Baby Unit (MBU) and is the highest contributor to neonatal mortality. Objectives To determine the precipitating factors for preterm birth at KATH and to evaluate factors that influence the outcome of preterm babies admitted to the MBU. Methods A descriptive cross-sectional study was conducted on 80 babies delivered before 33 weeks gestation who were admitted to the MBU between January and March, 2021.Babies were selected prospectively by simple random sampling and their birth weight, gender, initial temperature, precipitating factors for delivery, admission and discharge/death dates were recorded on a case-record form and analysed using excel version 2016. Results Among the 80 cases studied, 56% were males, 54% were born vaginally and 42% were referred. Their gestational ages ranged from 25 to 32weeks (average 29 weeks). Their mean birth weight was 1.12kg (range 0.6kg to 1.9kg). Eighty-four percent of recruits had temperatures below 36.50C.Premature rupture of membranes (63%) was the leading precipitating factor and hypertensive disorders was associated with the highest mortality (55%). Conclusions The precipitating factors for preterm birth can be predominantly attributed to maternal infections therefore a comprehensive antenatal care with active screening and management of maternal infections can lead to a decline in preterm birth and its complications. Majority of babies were hypothermic on admission. The deleterious effect of hypothermia on the preterm infant has been widely studied. Robust interventions must be put in place especially during transfer of preterm infants to maintain their temperatures within the normal range. These can lead to improved outcomes which will contribute favourably to achieving the third sustainable development goal.

Background Neonatal sepsis is one of the commonest reasons for admission to the neonatal unit. Its non-specific clinical features makes its definition a conundrum for experts. This paves way for several conditions to hide behind the umbrella of neonatal sepsis. One of such conditions is salt-wasting crisis in babies with Congenital Adrenal Hyperplasia. The objective of this abstract is to highlight the importance of a good clinical history, thorough physical examination and investigations to avoid incorrect diagnosis and management of babies with adrenal crisis. Clinical presentation A month-old infant presented with poor feeding, vomiting, fever and seizures. Physical examination revealed high temperature of 38.2 degree Celsius, signs of dehydration, episodes of seizures and lethargy. A diagnosis of neonatal sepsis with differential of neonatal meningitis was made. Empiric antibiotics and supportive therapy with intravenous infusions and anticonvulsants were started. After 24 hours, there was deterioration in baby’s presentation with spiking temperature and progressive lethargy requiring escalation of care.  This prompted further history and examination. Baby had a notably hyperpigmented skin and ambiguous genitalia. The external genitalia was a phallus-like/large clitoris-like structure measuring 1.8cm in length. Urethral meatus was at the base of the phallus – like structure. The sac-like folds in the perineum were fused with no vaginal opening or palpable testes. Biochemical investigations showed hyponatremia (Na-121umol/l), hyperkalaemia(K-6.4umol/l) and 17-hydroxyprogesterone of 1057.5nmol/l (< 18.9nmol/l). The diagnosis was revised to Congenital Adrenal Hyperplasia with salt wasting crisis. The baby underwent aggressive electrolyte correction and was started on high dose steroids. There was remarkable improvement in baby’s condition and was discharged after five days. Conclusion Several conditions can mimic neonatal sepsis therefore the importance of a detailed history and thorough physical examination cannot be over-emphasized.