The Impact of The Neonatology Improving Projects on Neonatal Services In Bisha City During Covid 19 Pandemic
Main Article Content
Keywords
COVID-19, NICU, perinatology, infrastructure, manpower
Abstract
Introduction: It is thought of as a necessary service to provide high-quality care during pregnancy, labour, and the postpartum period. The fields of obstetrics/midwifery and neonatology, which are generally referred to as perinatology, have reduced maternal and newborn mortality and morbidity globally, but the COVID-19 pandemic brought on by the SARS-CoV-2-related COVID-19 virus posed a threat to the security of healthcare.
Materials and Methods: A prospective comparative study was conducted in a tertiary care hospital, Bisha city. I want to compare the outcome for 2 years (July 2020-June 2022) after shifting to the new unit with previous 2 years before shifting (July 2018 -June 2020) in different aspect: The days on the mechanical ventilation, The IVH rate, The Mortality rate. In this study, I want to compare neonatal services outcomes (for preterm babies less than 37 weeks gestational age) after developing the infrastructure, manpower, Supplies and Policies after the shifting to the new department.
Results: This is a prospective comparative study conducted in the department of neonatology, in a tertiary care hospital, Bisha city. Mean gestational age in before shifting to new unit, after shifting were 31, 33.34 respectively. Average weight were 1496, 1565 in before shifting to new unit, after shifting respectively. In our study, Average days on the mechanical ventilation were 14.78 days in before shifting to new unit group. Average days on the mechanical ventilation were 4.33 days in after shifting to new unit group.
Conclusion: The provision of high quality and evidence-based perinatal care must remain a priority, even in the face of a pandemic. Restructuring in health care facility with New advance mechanical ventilators supporting Volume‐targeted ventilation, 9 single rooms isolation for septic babies, T-piece resuscitator (in all OR suits, Delivery suits and ER), Total parental nutrition and also the all NICU policies updated especially for Caffeine citrate and fluconazole administration to preterm babies according to the AAP guidelines. Also all the department stuff completed the NRP and STABLE provider course as mandatory requirement to work in the NICU department. IVH rate, mortality rate was drastically reduced after shifting to the new unit than before shifting to new unit. Hence hospital restructuring in neonatology plays a crucial role to reduce mortality rate.
References
2. London V, McLaren R Jr, Stein J, et al. Caring for pregnant patients with COVID-19: practical tips getting from policy to practice. Am J Perinatol. 2020;37(8):850–3.
3. Fischhoff B. Making decisions in a COVID-19 world. JAMA. 2020;324(2):139–40.
4. Bauer ME, Bernstein K, Dinges E, et al. Obstetric anesthesia during the COVID-19 pandemic. Anesth Analg. 2020;131(1):7–15.
5. Chua M, Lee J, Sulaiman S, Tan HK. From the frontline of COVID-19 - how prepared are we as obstetricians? A commentary. BJOG. 2020;127(7):786–8.
6. Dashraath P, Wong JLJ, Lim MXK, et al. Coronavirus disease 2019 (COVID-19) pandemic and pregnancy. Am J Obstet Gynecol. 2020;222(6):521–31.
7. Ng PC. Infection control measures for COVID-19 in the labour suite and neonatal unit. Neonatology. 2020;117(2):141-3.
8. Boelig RC, Manuck T, Oliver EA, et al. Labor and delivery guidance for COVID-19. Am J Obstet Gynecol MFM. 2020;2(2):100110.
9. Kang Y, Deng L, Zhang D, et al. A practice of anesthesia scenario design for emergency cesarean section in patients with COVID-19 infection based on the role of standard patient. Biosci Trends. 2020;14(3):222–6.
10. Rasmussen SA, Jamieson DJ. Caring for women who are planning a pregnancy, pregnant, or postpartum during the COVID-19 pandemic. JAMA. 2020;324(2):190–1.