Introduction: Metabolic neonatal adaptation is a complex phenomenon and metabolic disorders can be frequent in immature newborns or in life-threatening situations. In Low and Middle income countries (LMIC) the difficu...Introduction: Metabolic neonatal adaptation is a complex phenomenon and metabolic disorders can be frequent in immature newborns or in life-threatening situations. In Low and Middle income countries (LMIC) the difficult access to some diagnostic tests makes the management of the metabolic emergencies challenging. The main objectives of this study were to assess the frequency and circumstances of occurrence and to describe the clinical picture associated with glucose, sodium and potassium disorders in neonates. Patients and Methods: Our study was a retrospective and descriptive study conducted in the neonatology unit of National Children Hospital Albert Royer in Dakar (Senegal) from January 1 to December 31, 2014. Results: The prevalence of the studied metabolic disorders was 46.7%. The most common metabolic disorder noted was Hyperglycemia followed by Hyponatremia. Thermoregulation disturbances were found particularly in newborns with serum sodium disorders (hyponatremia 33.5% and hypernatremia 59.7%). Neurological signs were noted in case of blood sugar abnormalities (hypoglycemia 26.1% and hyperglycemia 29.8%). Half of the newborns with hyperglycemia (82 cases/50%) had blood sugar levels greater than or equal to 2 g/l. Hypernatremia was severe (Serum sodium> 180 mmol/l) in 12 neonates (16.7%). The main diagnoses retained were sepsis (159 cases/45.4%), prematurity (96 cases/27.4%), intrauterine growth retardation (66 cases/18.9%), malformations (63 cases/18%), perinatal asphyxia (44 cases/12.6%) and malnutrition (36 cases/10.3%). For most metabolic disorders, the correction was late and was done beyond 48 hours. On average, the correction time varied between 3 hours and 6 days. The most frequent complications were cerebral edema (12 cases), brain death (8 cases) and increased intracranial pressure (3 cases). The most lethal disorders were Hyperkalemia followed by Hyperglycemia. Conclusion: Metabolic disorders especially glucose, sodium and potassium disorders are common in newborns. They are medical emergencies that can lead to vital instability and death. Their management is challenging in low-income countries due to the lack of adapted facilities and means to diagnose them. It is therefore important to improve the availability of technical methods and means of biological analysis in hospital laboratories and to monitor closely all newborns for early diagnosis of these disorders.展开更多
Most newborn deaths occur in two regions of the world, South Asia and sub-Saharan Africa. In Senegal, much progress has been made over the past two decades with a reduction in overall infant mortality by 38%. However,...Most newborn deaths occur in two regions of the world, South Asia and sub-Saharan Africa. In Senegal, much progress has been made over the past two decades with a reduction in overall infant mortality by 38%. However, the decline in neonatal mortality has been slower during the same period. The objective of this study is to assess neonatal mortality, to determine the different causes and to make recommendations for improving care in rural areas. This is a retrospective study with a descriptive and analytical aim carried out in the pediatrics department of the Diourbel regional hospital, 130 km from Dakar, the Senegalese capital, over a 12-month period from January 1 to January 31, December 2018. All newborns hospitalized in the pediatric ward during the study period were included. Overall mortality was 30.6%, newborns between 0 and 7 days accounted for 90.6% of deaths, INBORNs accounted for 62.3% of deaths. Newborns whose mother’s age was between 20 and 35 years of age accounted for 69.3% of deaths. Newborns of first-time mothers accounted for 40.2% of deaths and those of multiparous mothers 31%. Newborns who did not reach term accounted for 58.9% of deaths. Newborns admitted for respiratory distress represented the majority of deaths 45.5% (n = 93) followed by those with low birth weight 32.5 (n = 65) followed by those with neurological manifestations 30.5 (n = 62). Conclusion: Neonatal mortality is very high in the Diourbel region and the main cause is the lack of human resources and a very insufficient technical platform. The fight against this mortality involves improving the technical platform and recruiting sufficient and well-trained staff.展开更多
文摘Introduction: Metabolic neonatal adaptation is a complex phenomenon and metabolic disorders can be frequent in immature newborns or in life-threatening situations. In Low and Middle income countries (LMIC) the difficult access to some diagnostic tests makes the management of the metabolic emergencies challenging. The main objectives of this study were to assess the frequency and circumstances of occurrence and to describe the clinical picture associated with glucose, sodium and potassium disorders in neonates. Patients and Methods: Our study was a retrospective and descriptive study conducted in the neonatology unit of National Children Hospital Albert Royer in Dakar (Senegal) from January 1 to December 31, 2014. Results: The prevalence of the studied metabolic disorders was 46.7%. The most common metabolic disorder noted was Hyperglycemia followed by Hyponatremia. Thermoregulation disturbances were found particularly in newborns with serum sodium disorders (hyponatremia 33.5% and hypernatremia 59.7%). Neurological signs were noted in case of blood sugar abnormalities (hypoglycemia 26.1% and hyperglycemia 29.8%). Half of the newborns with hyperglycemia (82 cases/50%) had blood sugar levels greater than or equal to 2 g/l. Hypernatremia was severe (Serum sodium> 180 mmol/l) in 12 neonates (16.7%). The main diagnoses retained were sepsis (159 cases/45.4%), prematurity (96 cases/27.4%), intrauterine growth retardation (66 cases/18.9%), malformations (63 cases/18%), perinatal asphyxia (44 cases/12.6%) and malnutrition (36 cases/10.3%). For most metabolic disorders, the correction was late and was done beyond 48 hours. On average, the correction time varied between 3 hours and 6 days. The most frequent complications were cerebral edema (12 cases), brain death (8 cases) and increased intracranial pressure (3 cases). The most lethal disorders were Hyperkalemia followed by Hyperglycemia. Conclusion: Metabolic disorders especially glucose, sodium and potassium disorders are common in newborns. They are medical emergencies that can lead to vital instability and death. Their management is challenging in low-income countries due to the lack of adapted facilities and means to diagnose them. It is therefore important to improve the availability of technical methods and means of biological analysis in hospital laboratories and to monitor closely all newborns for early diagnosis of these disorders.
文摘Most newborn deaths occur in two regions of the world, South Asia and sub-Saharan Africa. In Senegal, much progress has been made over the past two decades with a reduction in overall infant mortality by 38%. However, the decline in neonatal mortality has been slower during the same period. The objective of this study is to assess neonatal mortality, to determine the different causes and to make recommendations for improving care in rural areas. This is a retrospective study with a descriptive and analytical aim carried out in the pediatrics department of the Diourbel regional hospital, 130 km from Dakar, the Senegalese capital, over a 12-month period from January 1 to January 31, December 2018. All newborns hospitalized in the pediatric ward during the study period were included. Overall mortality was 30.6%, newborns between 0 and 7 days accounted for 90.6% of deaths, INBORNs accounted for 62.3% of deaths. Newborns whose mother’s age was between 20 and 35 years of age accounted for 69.3% of deaths. Newborns of first-time mothers accounted for 40.2% of deaths and those of multiparous mothers 31%. Newborns who did not reach term accounted for 58.9% of deaths. Newborns admitted for respiratory distress represented the majority of deaths 45.5% (n = 93) followed by those with low birth weight 32.5 (n = 65) followed by those with neurological manifestations 30.5 (n = 62). Conclusion: Neonatal mortality is very high in the Diourbel region and the main cause is the lack of human resources and a very insufficient technical platform. The fight against this mortality involves improving the technical platform and recruiting sufficient and well-trained staff.
