剖腹产后 24 小时内新生儿再次入院的原因

Hayder Abdulsalam Alnakkash, Raid Mohammed Ridha Umran, Alaa Jumaah Manji Nasrawi
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摘要

背景:根据美国儿科学会(AAP)的规定,如果母亲生下了一个健康的足月婴儿,那么她应该在医院住上尽可能长的时间,以便发现任何可能存在的问题,并让护理人员有时间让孩子(和家人)做好出院的准备。由于诊断错误或误诊以及医护人员评估不足,婴儿再次入院的风险可能会增加。为了评估婴儿出生后 24 小时内再次入院的频率和原因,本研究将对当地健康新生儿再次入院的模式进行调查。患者和方法:这项横断面研究包括 33 名剖腹产新生儿,他们出院后在 24 小时内再次入院。对新生儿的以下特征进行了研究:胎龄、出生体重、性别、初次住院时间(LOS)、婴儿喂养方式以及初次评估后新生儿出院的病房类型。还评估了以下与妊娠和分娩有关的因素:高龄产妇(大于 35 岁)、社会经济地位低下、产妇受教育程度低、高胎次(大于 2)、联合家庭、农村居民、初产妇、胎膜早破(PROM)、绒毛膜羊膜炎、先兆子痫、糖尿病、社会心理问题、甲状腺疾病和硬膜外/脊髓麻醉。结果33 名再次入院的新生儿中有 16 名男性,新生儿再次入院率为 1.34%。他们的平均出生体重和胎龄分别为(2918.2 ± 619.2)克和(36.8 ± 21.72)周。她们的分娩时间为(2.62 ± 1.83)小时,再入院时间为(7.82 ± 5.35)小时。再次入院的主要原因是呕吐和喂养不当。在产妇因素方面,硬膜外麻醉和教育程度低是最重要的风险因素。结论本研究揭示了现有出院规则和程序对护理质量造成影响的一个重要组成部分。我们得出的结论是,呕吐和喂养不当是导致婴儿在出生后 24 小时内再次入院的主要原因,因此有必要在婴儿出生后的早期进行适当干预。为减少消化道问题,应重点关注有效泌乳的早期发展。
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Causes of Neonatal Re-admission in 24 hours after Cesarean Section
Background: According to the American Academy of Pediatrics (AAP), a mother who gives birth to a healthy, term baby should stay in the hospital for as long as necessary to detect any possible issues and give caregivers time to get the child (and family) ready for release. The infant's risk of readmission may be heightened by diagnostic mistakes, or misdiagnosis, and inadequate assessment by healthcare personnel. In order to assess the frequency and cause of hospital readmissions within the first twenty-four hours of life, this study will examine the local pattern of neonatal readmissions in healthy infants. Patients and Methods: This cross-sectional study included 33 neonates who had a c-section birth, after being discharged, and readmission within 24 hours of delivery. The following newborn characteristics were examined: gestational age, birth weight, gender, duration of initial hospital stay (LOS), infant feeding method, and the type of ward from which the neonate was released following the initial evaluation. The following factors related to pregnancy and delivery were evaluated: advanced maternal age (>35 years), low socioeconomic status, low maternal education, high birth order (>2), joint family, rural area residents, primi gravida, premature rupture of membranes (PROM), chorioamnionitis, preeclampsia, diabetes, psychosocial issues, thyroid disorders, and epidural/spinal anesthesia. Results: Sixteen patients out of 33 readmitted neonates were male. the rate of neonatal readmission was 1.34%. Their average birth weight and gestational age were 2918.2 ± 619.2 gm and 36.8 ± 21.72 weeks respectively. They spent 2.62 ± 1.83 hrs. and readmitted at 7.82 ± 5.35 hrs. intervals. The main causes of readmission were vomiting and poor feeding. Regarding the maternal factors; epidural anesthesia and low education was the most significant risk factors. Conclusions: An important component of the quality-of-care consequences of existing discharge rules and procedures may be revealed by this study. We come to the conclusion that vomiting and poor feeding are the main causes of hospital readmission in the first 24 hours of life, necessitating a proper intervention in the early hours of life. The early development of efficient lactation should be the focus of efforts to lessen digestive issues.
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