A descriptive study of suspected perinatal asphyxia at Mitchells Plain District Hospital. A case series

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dc.contributor.advisorSpittal, Graeme W
dc.contributor.advisorHinkel, T
dc.contributor.advisorRas, Tasleem
dc.contributor.authorStofberg, Johannes Petrus Jordaan
dc.date.accessioned2022-03-17T11:23:52Z
dc.date.available2022-03-17T11:23:52Z
dc.date.issued2021
dc.date.updated2022-03-16T09:33:41Z
dc.description.abstractBackground: South Africa aims to end all preventable deaths of children under the age of five as part of their commitment to the Sustainable Development Goals. More than half of these mortalities occur in the neonatal period with perinatal asphyxia as one of the leading causes. This study investigated and identified the characteristics of perinatal asphyxia and its contributing factors at a district hospital in Cape Town. Methods: A retrospective descriptive case series was performed and included all suspected cases of perinatal asphyxia referred from Mitchells Plain District Hospital (MPH)) to a specialised centre in the years 2016-2018. A data collection tool was used to extract information. Data was processed with SPSS to produce descriptive statistics and to investigate associations between variables using the Chi-square tests. Results: The study included 29 cases of suspected perinatal asphyxia. Ten (34.5%) had abnormal amplitude Electroencephalograms (aEEG's) indicative of Hypoxic Ischaemic Encephalopathy (HIE) and four (13.8%) demised before day seven of life. Non-operative deliveries (p=0.005), lack of a doctor at the time of delivery (p=0.004) and neonatal chest compressions (p=0.044) were associated with abnormal aEEG's. Babies with Thompson score of equal to or more than 12 (p=0.006), neonatal seizures (p=0.036) and delayed arrival at referral hospital (p=0.005) were associated with abnormal aEEG findings. Mortality was associated with Thompson score ≥12 (p=0.007) and the need for neonatal intubation at delivery (p=0.016). Conclusions: Significant reversable factors were identified in the peri-and postpartum periods. More capacitated staff would have the greatest impact on outcomes. The profile of HIE is exceedingly complex and challenges the resources and services of district level of care. Therefore, these factors should be targeted for future development and investment to improve outcomes from district hospitals.
dc.identifier.apacitationStofberg, J. P. J. (2021). <i>A descriptive study of suspected perinatal asphyxia at Mitchells Plain District Hospital. A case series</i>. (). ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. Retrieved from http://hdl.handle.net/11427/36172en_ZA
dc.identifier.chicagocitationStofberg, Johannes Petrus Jordaan. <i>"A descriptive study of suspected perinatal asphyxia at Mitchells Plain District Hospital. A case series."</i> ., ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2021. http://hdl.handle.net/11427/36172en_ZA
dc.identifier.citationStofberg, J.P.J. 2021. A descriptive study of suspected perinatal asphyxia at Mitchells Plain District Hospital. A case series. . ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. http://hdl.handle.net/11427/36172en_ZA
dc.identifier.ris TY - Master Thesis AU - Stofberg, Johannes Petrus Jordaan AB - Background: South Africa aims to end all preventable deaths of children under the age of five as part of their commitment to the Sustainable Development Goals. More than half of these mortalities occur in the neonatal period with perinatal asphyxia as one of the leading causes. This study investigated and identified the characteristics of perinatal asphyxia and its contributing factors at a district hospital in Cape Town. Methods: A retrospective descriptive case series was performed and included all suspected cases of perinatal asphyxia referred from Mitchells Plain District Hospital (MPH)) to a specialised centre in the years 2016-2018. A data collection tool was used to extract information. Data was processed with SPSS to produce descriptive statistics and to investigate associations between variables using the Chi-square tests. Results: The study included 29 cases of suspected perinatal asphyxia. Ten (34.5%) had abnormal amplitude Electroencephalograms (aEEG's) indicative of Hypoxic Ischaemic Encephalopathy (HIE) and four (13.8%) demised before day seven of life. Non-operative deliveries (p=0.005), lack of a doctor at the time of delivery (p=0.004) and neonatal chest compressions (p=0.044) were associated with abnormal aEEG's. Babies with Thompson score of equal to or more than 12 (p=0.006), neonatal seizures (p=0.036) and delayed arrival at referral hospital (p=0.005) were associated with abnormal aEEG findings. Mortality was associated with Thompson score ≥12 (p=0.007) and the need for neonatal intubation at delivery (p=0.016). Conclusions: Significant reversable factors were identified in the peri-and postpartum periods. More capacitated staff would have the greatest impact on outcomes. The profile of HIE is exceedingly complex and challenges the resources and services of district level of care. Therefore, these factors should be targeted for future development and investment to improve outcomes from district hospitals. DA - 2021_ DB - OpenUCT DP - University of Cape Town KW - Hypoxic Ischaemic Encephalopathy KW - Perinatal Asphyxia KW - Perinatal Care KW - District Healthcare KW - Quality of Care LK - https://open.uct.ac.za PY - 2021 T1 - A descriptive study of suspected perinatal asphyxia at Mitchells Plain District Hospital. A case series TI - A descriptive study of suspected perinatal asphyxia at Mitchells Plain District Hospital. A case series UR - http://hdl.handle.net/11427/36172 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/36172
dc.identifier.vancouvercitationStofberg JPJ. A descriptive study of suspected perinatal asphyxia at Mitchells Plain District Hospital. A case series. []. ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2021 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/36172en_ZA
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Public Health and Family Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.subjectHypoxic Ischaemic Encephalopathy
dc.subjectPerinatal Asphyxia
dc.subjectPerinatal Care
dc.subjectDistrict Healthcare
dc.subjectQuality of Care
dc.titleA descriptive study of suspected perinatal asphyxia at Mitchells Plain District Hospital. A case series
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMMed
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