Muhammad Saleem, Mubarak Ali, Jamal Anwer, Masood Iqbal Babar, Mazhar Rafi, Rashid Mahamood, Ashiq Hussain, Qasim Mahamood.
Clinical audit of neonatal admissions in a tertiary care hospital.
J Sheikh Zayed Med Coll Jan ;02(04):231-5.

Background: Neonatal mortality and morbidity is always a great concern for clinicians and public health experts. Objectives: To determine the disease pattern and outcome in neonatal unit of Sheikh Zayed Hospital, Rahim Yar Khan. Patients & Methods: This prospective study was conducted in the neonatal unit of Sheikh Zayed Medical College /Hospital, Rahim Yar Khan from 1st January to 31st December 2010. The data of all the neonates admitted during the study period was analyzed regarding diagnosis, outcome (discharge, discharge on request, left against medical advice, death) and death cases were evaluated in detail regarding sex of patient, place of delivery and mode of delivery. Results: A total of 17150 patients were admitted in pediatric unit of which 4214 (24.6%) were neonates. Birth asphyxia was the commonest cause of admission in 1610 (38.2%) patients, followed by prematurity & low birth weight 1052 (24.9%), sepsis 631 (14.9%), congenital malformations 435 (10.3%), neonatal jaundice 225 (5.3%), meconium aspiration syndrome 181 (4.3%) & miscellaneous 80 (1.91%). Total Paediatric deaths were 1651 with neonatal deaths 1030 (24.4%) while post-neonatal deaths were 621 (4.8%). Main bulk of mortality was observed in first 7 days of life in 794 (77%). The commonest cause of mortality was prematurity with its complications in 470 (45.6%) deaths, followed by birth asphyxia 302 (29.3%) and sepsis 191 (18.5%). Of the total expired patients 405 (39.3%) were delivered in Sheikh Zayed Hospital, 385 (37.4%) at home, while 240 (23.3%) in private clinics & hospitals. Conclusion: Birth asphyxia, prematurity, low birth weight, sepsis, & congenital malformation are the main causes of neonatal admissions, while common causes of mortality are prematurity followed by birth asphyxia & sepsis. Solid & sustainable policies need to formulated & implemented to avoid the various preventable causes of neonatal morbidity & mortality.

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