PF.49 Term Admissions to the Neonatal Unit; Are They Avoidable?
Introduction Approximately 10% of all babies born require admission to the neonatal unit and term infant represent a significant percentage of NICU admission and are major contributors to workload.
Aim To identify potentially avoidable admissions of term babies to neonatal unit and common avoidable factors.
Background Neonatal intensive care and special care nurseries provide a level of care that is both high in cost and low in volume. Term infant represent a significant percentage of NICU admission and are major contributors to workload.
Methods Retrospective audit from 01/01/2011 to 31/12/2011, patient list obtained from SCBU data base.
Results Total number of deliveries was 3882. Total admissions to SCBU were 316. Term baby admissions (>37 wks) were 117 (37%). 55% of babies stayed 3 to 5 days in SCBU. 19% babies required respiratory support. Readmission needed in 4 cases. External transfer was done in 8% (9) cases for reasons like cooling, surgical opinion and severe jaundice. No perinatal mortality was noted in these series.
Maternal profile 70% of the mothers were without any obstetric or medical risk factors. 50% mothers came in spontaneous labour. 50% of these mothers were delivered by vaginal delivery.
In RDS group –50% (vaginal delivery) and 20% (Elective LSCS).
In hypoglycaemic group-39% were diabetic mothers and 33% had good intrapartum blood sugar control.
Conclusions 70% of mothers were low risk and 50% of them were admitted in spontaneous labour. There were no major avoidable factors in the mothers to reduce term neonatal admissions.
Recommendations To set up a transitional care unit where babies needing intermediate care can be managed and this will reduce the cost of admissions to SCBU.
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Niger J Clini Practice 2009 Dec; 12(4):389–94. Morbidity and mortality patterns of admissions into the Special Care Baby Unit of University of Abuja Teaching Hospital, Gwagwalada, Nigeria.
Full term; an artificial concept, Neil Marlow, Arch Dis Child Fetal Neonatal Ed 2012; 97:F158-F159 doi: 10.1136/fetalneonatal-2011–301507.
Cochrane Database Syst Rev. 2009 Oct 7;( 4):CD006614. Corticosteroids for preventing neonatal respiratory morbidity after elective caesarean section at term. Sotiriadis A, Makrydimas G.