National Hospital Abuja, Nigeria
Abuja , FCT | Nigeria
Main Specialties: Pediatric Cardiology, Pediatric Critical Care Medicine, Pediatric Emergency Medicine, Pediatric Gastroenterology, Pediatric Hematology-Oncology, Pediatric Infectious Diseases, Pediatric Nephrology, Pediatric Pulmonology, Pediatrics
Primary Affiliation: National Hospital Abuja, Nigeria - Abuja , FCT , Nigeria
BJMMR. 2016; 16(8): 1-11
British Journal of Medicine and Medical Research
Background: Severe neonatal hyperbilirubinaemia remains an important cause of neonatal admissions in Nigeria, often giving rise to irreversible neurotoxicity. Access to effective phototherapy is restricted to a few centers while salvage therapy with exchange blood transfusion may occur too late to reverse acute bilirubin encephalopathy (ABE).Aim: We set out to identify modifiable socio-demographic risk factors for severe neonatal jaundice in babies of ≥34 week gestation at the National Hospital Abuja.Methodology: Late preterm and term babies admitted into Special Care Baby Unit (SCBU) with jaundice from April 2014 to May 2015 were consecutively recruited into the study with parental consent. Socio-demographic information, history of common risk factors for neonatal jaundice and results of laboratory investigations were obtained for statistical analysis. Jaundice was classified as severe (≥ 20 mg/dl) or non-severe (10-19 mgdl). Bivariate and multiple logistic regressions were carried out to determine the significance of associations between risk factors and severity of jaundice.Results: A total of 123 babies were seen with an Inborn/Out born ratio of 1:2.3. Eighty two percent were term. Severe Jaundice accounted for 43(35%). The mean TSB for babies with severe jaundice was 29.1(9.6) mg/dl while that of controls was 16.9(5.9) mg/dl, (p=0.000). There was no significant difference in the distribution of primary risk factors (ABO/Rh incompatibility, sepsis, G6PD deficiency and concealed haemorrhage) among severe and non-severe groups. Among investigated secondary risk factors, late presentation (P=0.043), being out born (OR=0.164 95% CF=0.054-0.504), vaginal delivery (p=0.012), prematurity (OR=2.233 95% CF=1.051-4.740) and maternal education (p=0.017) were significantly associated with severe jaundice. Over 98% of the mothers had antenatal care while 91% delivered in hospitals/clinics. Thirty two (26%) had signs of acute bilirubin encephalopathy and exchange blood transfusion was done in 50 (40.7%) babies.Recommendation: There is a need to refocus preventive strategies on modifiable risk factors, increasing awareness about the consequences of neonatal jaundice and the essence of early identification as well as prompt hospital presentation.
Audu L. I, Mukhtar-yola M, Otunete A.T, Mairami A.B, Nwatah V.E, Mahmud M.R, et al. Unexplained massive subdural haematoma in a newborn delivered by elective caesarean section: a case report. Niger J Paediatr 03/2015; 43(3):234-236. DOI: 10.4314/njp.v42i3.13
Niger J Paediatr
International Journal of Pediatrics, vol. 2015, Article ID 175867, 5 pages
International Journal of Pediatrics
Anaemia is a common morbidity in the NICU and often requires transfusion of packed red blood cells. Haematocrit equilibration following red cell transfusion occurs over time ultimately resulting in a stable packed cell volume (PCV). Knowledge of this equilibration process is pertinent in the accurate timing of posttransfusion (PT) PCV. We conducted a prospective study to determine an appropriate timing for PT PCV estimation on 47 stable anaemic babies at the Neonatal Unit of National Hospital, Abuja. Values of PCV were determined before transfusion and at 1, 6, 12, 24, and 48 hours posttransfusion. Forty of the recruited neonates and young infants were analyzed. Their gestational age range was 26 to 40 weeks. 1-hour PT PCV (48.5% ± 5.5%) was similar to the 6-hour PT PCV (47.8% ± 5.6%) , but both were significantly different from the 12-hour (46.8% ± 5.9%), 24-hour (45.9 ± 5.8%), and 48-hour (45.4% ± 6.2%) PT PCVs. The 12-hour PT PCV was similar to the 24-hour and 48-hour PT PCVs ( and 0.063, resp.). We concluded that, in stable nonhaemorrhaging and nonhaemolysing young infants, the estimated timing of haematocrit equilibration and, consequently, posttransfusion PCV is 12 hours after red blood cell transfusion.