Short Term Outcome of Neonates Born With Abnormal Umbilical Cord Arterial Blood Gases

Background: Umbilical arterial blood gas (UABG) analysis is more objective than other methods for predicting neonatal outcome. Acidemic neonates may be at risk for unfavorable outcome after birth, but all neonates with abnormal arterial blood gas (ABG) analysis do not always have poor outcome. Objectives: This study was carried out to determine the short term outcome of the neonates born with an abnormal ABG. Patients and Methods: In a cohort prospective study 120 high risk mother-neonate pairs were enrolled and UABG was taken immediately after birth. All neonates with an umbilical cord pH less than 7.2 were considered as case group and more than 7.2 as controls. Outcomes like need to resuscitation, admission to newborn services and/or NICU), seizure occurrence, hypoxic ischemic encephalopathy (HIE), delayed initiation of oral feeding and length of hospital stay were recorded and compared between the two groups. P value less than 0.05 was considered as being significant. Results: Comparison of short term outcomes between normal and abnormal ABG groups were as the fallowing: need for advanced resuscitation 4 vs. 0 (P = 0.001), NICU admission 16 vs. 4 (P = 0.001), convulsion 2 vs. 0 (P = 0.496), HIE 17 vs. 4 (P = 0.002), delay to start oral feeding 16 vs. 4 (P = 0.001), mean hospital stay 4 vs. 3 days (P = 0.001). None of the neonates died in study groups. Conclusions: An umbilical cord PH less than 7.2 immediately after birth can be used as a prognostic factor for unfavorable short term outcome in newborns.

Hospital Care for Newborn Babies: Quality Assessment, A Systematic Review

Context: Neonatal mortality rate is declining globally. The aim of the present study is to identify relevant indicators for assessing newborn care in hospitals by a systematic review. Evidence Acquisition: A search on electronic data base and manual searches of personal files for studies on quality indicators of newborn care were carried out. Searching 9 bibliographic databases, we found 85 articles of which 22 exactly related ones were selected and studied. Hand search yielded 1 record were also searched and 2 records were included. Results: A list of 87 structure, process and outcome indicators was formulated from the articles. Also 26 excess measures were identified in gray literature. After removing duplicates, and categorizing in 3 domains, 18 measures were input, 41 process and 34 outcome measures. Conclusions: These 93 indicators provide a framework for assessing how well the hospitals are providing neonatal care. These measures should be discussed in each context expert panels to address nationally applicable indices of neonatal care and may be adapted for local health settings.