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GG Hospital has a state-of-the-art, 8-bedded, level
III Neonatal Intensive Care Unit. This year from
January to May, there were 216 deliveries. Nine
babies were born before 30 weeks of gestation and
71 babies were born between 30 and 34 weeks of
gestation.
All preterm infants had received antenatal
betamethasone therapy. Only 8 babies required
ventilatory support for Respiratoty Distress
Syndrome (RDS). We begin ventilatory support or
continuous positive airway pressure (CPAP) early
in infants with RDS. This coupled with prophylactic
surfactant replacement therapy definitely improves
outcomes. A second (repeat) dose of surfactant is
given if the infant needs more than 40% oxygen at
12 hours of age. Prophylactic surfactant therapy in
synergy with antenatal steroids promotes early lung
recruitment and avoidance of hyperventilation by
reducing need for ventilatory support. This reduces
incidence of chronic lung disease. We had no deaths
from RDS.
Extremely low birth weight infants in GG Hospital
are fed expressed breastmilk by continuous
nasogastric infusion. In addition to stringent
asepsis and use of probiotics, this method of feeding
promotes feed tolerance even in the tiniest of
babies. We had no cases of necrotizing enterocolitis
this year. When babies are on full feeds, we
routinely use human milk fortifiers in all infants
with birth weight less than1 kg.
Routine tertiary level anomaly scan and triple
screen are done on the mothers. We had only 5
infants with major congenital anomalies. One
infant presented with bilious emesis, and was
operated successfully for malrotation.
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The other
anomalies were posterior urethral valve and
tracheo-esophageal fistula, which presented with
oligohydramnios and polyhydramnios respectively.
Two infants had cyanosis without respiratory
distress. Of these, one baby had hypoplastic right
heart syhdrome detected antenatally. This resulted
in early initiation of prostaglandin therapy and safe
transfer to a cardiac centre for surgery. The other
infant had hypoplastic left heart syndrome, a
condition more difficult to diagnose antenatally, as
right ventricle is the dominant ventricle in utero.
Overall, this year we have been very busy and
worked very hard, but the satisfaction in seeing so
many high-risk babies go home healthy with happy
parents has been a great reward.
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