Philippine E-Journals

A 3-year Retrospective Study of Failed Essential Intrapartum and Newborn Care in a Tertiary Government Hospital

Maria Carmen M. Neri | Christopher J. Grageda | Ma. Lucila M. Perez

 

Abstract:

Background: The Department of Health implemented the Essential Intrapartum Newborn Care (EINC), an evidence-based program, to decrease admission rate in the Neonatal ICU and under-five mortality rate. This study looks into patients who failed to complete the 90-minute time bound of the protocol as part of evaluation of the program. Objective: To determine the etiology of UGIB based on endoscopic findings among patients in a tertiary hospital in Manila. To determine the profile of the newborns with failed EINC in a tertiary government hospital from 2014-2016 as to clinic-demographic profile, reasons of failure and maternal risk factors. Study Design: Descriptive Retrospective Study Subjects: All newborns delivered from January 1, 2014 to December 31, 2016 in Ospital ng Makati who are eligible for EINC and failed to complete the protocol. Methodology: Charts of all newborns delivered during the study period were reviewed. Clinico-demographic data of these patients who failed the time-bound period of EINC were gathered. Reason/s for termination of the protocol, diagnosis upon admission and length of stay in the Neonatal ICU were also collected from the charts. Results: A total of 8,090 livebirths were recorded of whom 5,700 babies (71%) were eligible for EINC. There were 128 babies who were not able to complete the 90-minute time bound of EINC accounting for 2.2% EINC failure rate. Signs of respiratory distress/failure accounted for most common reason (48.4%) for failure. Majority of patients had unremarkable maternal history or did not present with any maternal risk factors. Ninety-nine patients (77.3%) were transferred to the Neonatal ICU and were eventually sent home. Conclusion: Despite the strict compliance to eligibility criteria of the “Unang Yakap” campaign by the DOH, there are still 2.2% who were admitted to the Neonatal ICU although most were subsequently sent home. This single-center reported EINC failure rate can serve as a baseline for comparison with other centers.