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Year : 2019  |  Volume : 21  |  Issue : 2  |  Page : 130-133

Managing extramural neonates: Experience from a zonal hospital

1 Department of Paediatrics, INHS Kalyani, Visakhapatnam, Andhra Pradesh, India
2 Department of Paediatrics, INHS Asvini, Mumbai, Maharashtra, India

Correspondence Address:
Surg Capt (Dr) Ranjeet Wishram Thergaonkar
Department of Paediatrics, INHS Asvini, Colaba, Mumbai - 400 005, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmms.jmms_6_19

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Introduction: There are many challenges in the care of extramural neonates (born outside the hospital), especially in resource-limited secondary care (zonal) hospitals of the Armed Forces. The objective of the present study was to describe the workload and complications faced in the care of extramural neonates in a zonal hospital of the Armed Forces. Subjects and Methods: The study design was descriptive. The setting was a 306-bedded zonal hospital. Records of all neonates transferred from other hospitals between January 1, 2017 and December 31, 2017 were studied. Median and interquartile range of continuous data, as well as the number and percentages of ordinal data, were calculated. Results: Seventeen neonates (10 males) were received from a median distance of 70 km. The workload comprised 539 patient-days and 12.4% of the nursery workload. The extramural neonates included 2 (11.8%) extremely low birth weight (<1000 g), 6 (35.3%) very low birth weight (1000–1499 g), and 4 (23.5%) low birth weight (1500–2499 g) babies. Thirteen (77.4%) neonates were lateral referrals from private nurseries. The complications included hypothermia in 4 (23.5%), hypoglycemia in 3 (17.6%), and sepsis in 8 (47.1%) neonates. One (5.9%) baby died after admission. Conclusions: Extramural neonates constitute approximately 12% of the nursery workload. High number of low birth weight babies, lateral referrals from other neonatal intensive care units, relatively lower but significant rates of hypothermia and hypoglycemia, high rate of sepsis and low mortality highlight the management of extramural neonates in a zonal hospital.

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