Background: India contributes to 25% of neonatal mortality around the world. In developing countries neonatal mortality is quite high despite of advances in perinatal and neonatal care. The establishment of Special Newborn Care Units (SNCU) has been quite essential in reducing the neonatal morbidity and mortality. This study was conducted to assess the outcome of SNCU at a newly commissioned tertiary care teaching hospital at Nellore District, Andhra Pradesh. Aim of this study the morbidity and mortality patterns in an SNCU at tertiary care teaching hospital.Methods: It was a Retrospective, Hospital based, Descriptive study which was done among neonates admitted to SNCU, Nellore District, Andhra Pradesh for a period of 1 year (January 2015-December 2015). All the neonates admitted to SNCU, Nellore District, Andhra Pradesh during the study period were included in the study. Data was recorded in a predesigned semi-structured proforma. the data was entered into excel-sheet and analyzed using SPSS software version 21.Results: A total of 1015 babies were included in the study. Almost half 592(58.32%) were born in this hospital(inborn) and 423(41.67%) babies were referred from peripheral hospitals and nursing homes (out born). about 3/4th 767(75.5%) of babies were admitted in the first 24 hours of life. Almost half (53.4%) of the study group were male and 46.6% were female. The chief causes of admission in SNCU were Respiratory Distress Syndrome (40.2%) followed by birth asphyxia (19.1%), sepsis (13.3%), Neonatal Jaundice (9.9%) and prematurity (6.6%). In our study 63.0% patients were discharged, 19.3% had left hospital against medical advice, 10.1% died and 7.6% were referred to other institutions for specialized treatment.Conclusion: Respiratory Distress Syndrome, neonatal sepsis, neonatal hyperbilirubinemia, and HIE as the major causes of morbidity. Low Birth Weight and prematurity were the commonest contributors of death, therefore, attempts to prolong the pregnancy each week might improve the neonatal outcome considerably.

Background: Nutrition rehabilitation centre (NRC) is a unit in a district health facility, where children with severe acute malnutrition are admitted and provided with nutritional and therapeutic care.Methods: Analysis of nutritional data of all the children admitted to NRC at Krishna district from January 2017 to July 2018. Statistical analysis was done using SPSS.Results: A total of 200 children were included in the study. The overall mean weight at admission was found to be 8.30 kg with a standard deviation of 2.35 kg and the mean weight at the time of discharge is 9.57 kg with a standard deviation of 2.61 kg. There is a statistically significant difference in weight and mid arm circumference at admission and discharge. Mean duration of hospital stay is around 18.67±5.4 days. Target weight is achieved in 71% of the study group.Conclusions: Present study reflects that NRCs have been playing a key role to cope up with the problem of severe acute malnutrition as demonstrated by a high rate of weight gain at discharge as well as during follow ups.

Background: Breastfeeding is the corner stone of child survival, nutrition and development and maternal health. The World Health Organization recommends that all neonates be breastfed within one hour of birth. Early initiation of breast feeding (EIBF) is a sentinel indicator for successful breastfeeding. The aim of this study is to assess the practice of early initiation of breastfeeding among babies delivered in our tertiary care teaching unit and to list out the reasons for delay in implementation.Methods: This study is done on 409 postnatal mothers who delivered in our hospital. All the mother-baby dyads enrolled were interviewed within 12 hours of delivery. Data was collected through clinical records and interview of mothers.Results: EIBF is seen only in 19.8% of babies. Median time of initiation of breast feed is 110 minutes. Primiparous mothers had a delay in initiation of feed (p<0.01). The mothers who received practical support from health care providers had successful EIBF(p< 0.01). The main reasons for delay in feeding were lack of early, uninterrupted skin to skin contact between baby and mother and the separation of mother - baby dyads immediately after delivery.Conclusions: EIBF rate in our centre is extremely low compared to the national standards of 44.6%. Several gaps in EIBF need to be addressed and a strict institutional protocol need to be followed. Periodic review of EIBF rates needs to be done by every institute to achieve a global target of > 90%.

BACKGROUNDMeconium is the first faeces of a newborn. Meconium-stained amniotic fluid (MSAF) occurs in about 7-22% of live births and is regarded as a sign of foetal compromise. Meconium aspiration syndrome (MAS) is a serious and potentially preventable condition with risk factors like post-dated pregnancy, small for gestational age, oligohydramnios, hypertensive disorder of pregnancy, gestational diabetes, and maternal drug abuse. Hence, the present study was conducted to find out the rate of MAS, analyse associated maternal and neonatal risk factors and final outcome in babies born through MSAF in a tertiary health care facility. Objectives-1. To find out the rate of Meconium aspiration syndrome (MAS) in babies born with Meconium-stained amniotic fluid (MSAF) in a tertiary health care facility, GGH, Guntur. 2. To analyse the associated maternal and neonatal risk factors associated with Meconium aspiration syndrome (MAS). 3. To evaluate the outcome of Meconium aspiration syndrome (MAS). MATERIALS AND METHODSA prospective, hospital based, observational study was carried out among 160 babies born with MSAF admitted to the NICU in a tertiary health care setting in the Department of Paediatrics, during a period of 5 months. Patient details were recorded in a predesigned semi-structured proforma. Informed written consent was taken from parents of babies. MAS was designated in a baby as per the defined criteria. Their risk factors and outcomes were analysed by using SPSS Software 18 version. Institutional ethics committee approval was obtained. RESULTSOut of the total 160 babies born with MSAF, 68 (42.5%) were female and 92 (57.5%) were male. MAS was seen in 21 (13.12%) babies. It was observed that there is significant association between MAS & MSAF and the following risk factors like Post maturity (1.25%), Small for Gestational Age (SGA) (11.25%), Oligohydramnios (4.38%) and low APGAR (5.62%). MAS babies who required ventilation (CPAP & IMV) were 9 (42.85%). The mortality observed in our study was 5 (23.80%), and the rest of the 16 MAS babies were discharged without any complications. CONCLUSIONMSAF and MAS affect mostly full term and post-term babies. MAS has significant effect on neonatal outcome when it is associated with risk factors like post-term gestation, SGA, Oligohydramnios, APGAR score < 7. These babies required ventilator support, hence they require continuous and close monitoring in a tertiary care setting. MSAF and MAS can be prevented by appropriate antenatal and natal care by the obstetrician and neonatologist. HOW TO CITE THIS ARTICLE: Avula TR, Bollipo S, Potharlanka S. Meconium-stained amniotic fluid and meconium aspiration syndrome-A study on risk factors and neonatal outcome. KEYWORDS