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Pneumothoraces in a neonatal tertiary care unit: case series.
MedLine Citation:
PMID:  23386951     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Neonatal pneumothoraces are associated with high mortality. Prompt recognition to minimize its complications is paramount for ultimate outcome of these babies.
METHODS: A retrospective case series study was carried out at Aga khan University Hospital, from January 2010 to December 2010 to determine the etiology and outcome of neonates with pneumothorax in a neonatal tertiary care unit.
RESULTS: Ten neonates diagnosed radiologically with pneumothoraces were included. M: F ratio was 1:2.3. Birth weight ranged from 1750-3600 grams with a mean of 2100 grams. The occurrence of pneumothoraces was 50% on the left side, 20% on right, and 30% were bilateral. Primary etiology included pneumonia and sepsis (30%), hyaline membrane disease (20%), meconium aspiration syndrome (20%) and congenital diaphragmatic hernia (10%). Spontaneous pneumothoraces were present in 20% of cases. In our study, the incidence of neonatal pneumothoraces was 2.5/1000 births compared to 10-15/1000 in Denmark, 10-20/1000 in Turkey and 6.3/1000 from Vermont Oxford Group. Despite the small number of cases, one incidental finding was the occurrence of pneumothorax, which declined in elective cesarean section after 37 weeks gestation i.e., 1.3 of 1000 births. Mortality was 60% determined mainly by the primary etiology and other co-morbid conditions.
CONCLUSION: The study showed a higher number of mortality cases (60%). Although, it was difficult to draw a conclusion from the limited number of cases, there may be a benefit on neonatal respiratory outcome to be obtained by better selection of mothers and by waiting until 37 weeks before performing elective cesarean section. Adequate clinician training in soft ventilation strategies will reduce the occurrence of pneumothoraces.
Authors:
Rehan Ali; Shakeel Ahmed; Maqbool Qadir; Prem Maheshwari; Rehan Khan
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Oman medical journal     Volume:  28     ISSN:  1999-768X     ISO Abbreviation:  Oman Med J     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-02-06     Completed Date:  2013-02-07     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  101526350     Medline TA:  Oman Med J     Country:  Oman    
Other Details:
Languages:  eng     Pagination:  67-9     Citation Subset:  -    
Affiliation:
Department of Pediatrics and Child Health, Aga Khan University Hospital, Karachi.
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