PROFILE OF CONGENITAL SURGICAL ANOMALIES IN NEONATES ADMITTED TO TERTIARY CARE NEONATAL INTENSIVE CARE UNIT OF SAURASHTRA REGION

Abstract

Background: Congenital surgical anomaly is a major indication for admission of a neonate to an intensive care unit. Profile of surgical conditions is variable by system affecting the neonate and outcomes of the individual conditions depending upon treatment and post surgical facilities. This study was undertaken to highlight the surgical conditions, their burden and their prognosis encountered in our newborn care unit.

Methodology: This study is a cross sectional study. All information was collected from the case records of all neonates admitted in newborn care unit of our centre between 1^st April, 2011 and 31^st October, 2014 with congenital surgical conditions and the following information extracted: surgical condition, age, sex, maturity, birth weight, its treatment and outcome, and other associated features were studied.

Result: A total of 9213 neonates were admitted in the study period, of which 328 neonates (3.6%) had surgical conditions. Surgery was performed in 225 neonates. Commonest congenital surgical condition was of gastrointestinal tract (GIT). Commonest GIT anomalies were tracheo-oesophageal fistula (28.6%), intestinal obstruction (23.7%), anorectal malformation (17.9%), and omphalocoele (7%). The overall mortality in neonates with congenital surgical condition in this study was 51.2%. Significantly, more deaths occurred in preterm than in term neonates (P = 0.00003) and low birth weight babies more than normal weight (p=0.0002).

Conclusion: High mortality is found in neonates suffering from surgical conditions. Commonest anomaly includes conditions of Gastrointestinal tract. Prematurity and low birth weight is a significant factor associated with high mortality.