USE OF EARLY LABOUR ROOM BUBBLE CPAP IN PRETERMS BORN AT 28-32 WEEKS OF GESTATION

Dr.K.Aruna Jyothi; Dr.S.A.Sardar Sulthana; Dr.G.V.Ramadevi

Volume : VIII, Issue : X, October - 2018

USE OF EARLY LABOUR ROOM BUBBLE CPAP IN PRETERMS BORN AT 28-32 WEEKS OF GESTATION

Dr. K. Aruna Jyothi, Dr. S. A. Sardar Sulthana, Dr. G. V. Ramadevi

Abstract :

Objective: To study the use of early labour room Bubble CPAP in preterm neonates born at 28–32 weeks of gestation and to analyse the outcome in relation to need for mechanical ventilation, duration of hospital stay and mortality at the Neonatal Intensive Care Unit (NICU), Tertiary Care Teaching Government Hospital Kurnool, Andhra Pradesh for a period of 1 Year.

Methods : Facility Based Interventional Studied (Randomised Control Study)

Participants : Study sample of 109 preterm babies of age 28–32 weeks of gestation

Cases : 54 cases, neonates with respiratory distress who were started on CPAP in the labour room within 15 minutes of life.

Controls : 55 babies, neonates with respiratory distress who were started on CPAP after 15 minutes to 6 hours of life.

In the present study, both the groups(cases and controls) were monitored till they were discharged and the need for mechanical ventilation was noted. Clinical diagnosis of RDS was made based on the time of onset of respiratory distress and clinical examination and respiratory scoring(Silverman Anderson Score) . Chest X–ray and routine investigations were done in all neonates. Duration of CPAP and difference in mortality between the two groups was analysed.

Outcome : In the present study, preterm neonates born at 28–32 weeks of gestation who were started on early labour room CPAP vs control group outcome is assessed in relation to need for mechanical ventilation and duration of hospital stay and mortality.

Results: It is observed that 16 (29.63%) cases required mechanical ventilation whereas 28 (50.91%) preterm neonatesin the control group needed mechanical ventilation. There was a statistically significant difference between the two groups (p < 0.05).

The duration of stay in NICU in neonates with early CPAP was significantly less when compared to the controlled group. 30(76.9%) neonates were discharged within 14 days among cases and 16 (48.48%) neonates among control group.

There is no difference in mortality between the 2 groups.

Conclusions : The following conclusions could be drawn out of the present study on preterm neonates.

1. The early administration of CPAP in the delivery room in preterm neonates developing respiratory distress decreases the need for mechanical ventilation.

2. The duration of stay in NICU in neonates with early CPAP was significantly less.

3. There is no difference in mortality between the two groups.