INTRAVENTRICULAR HAEMORRHAGE IN PREMATURE BABIES AT DR
GEORGE MUKHARI HOSPITAL,
PRETORIA
By
TIISETSO LENAKE LENTSOANE
19818782
Submitted in partial fulfilment of the requirements for the degree of
MASTER OF MEDICINE (MMed)
in
DIAGNOSTIC RADIOLOGY AND IMAGING
in the
SCHOOL OF MEDICINE
at the
UNIVERSITY OF LIMPOPO
SUPERVISORS: Prof. MPB Mawela
Dr. C Minne
CO-SUPERVISOR: Prof N Ebrahim
2011
TABLE OF CONTENTS
DEDICATION.......................................................................................................................... IIIV
DECLARATION.......................................................................................................................... V
ACKNOWLEDGEMENTS ..................................................................................................... VII
ABSTRACT……………………………………………………………....................................VII
CHAPTER 1: BACKGROUND OF THE STUDY .................................................................... 1
1.1
1.2
1.3
1.4
1.5
1.6
INTRODUCTION .................................................................................................................... 1
THE STUDY PROBLEM ........................................................................................................... 2
RESEARCH QUESTION ........................................................................................................... 2
PURPOSE OF THE STUDY ....................................................................................................... 2
OBJECTIVES OF THE STUDY .................................................................................................. 3
SIGNIFICANCE OF PROPOSED RESEARCH ............................................................................... 3
CHAPTER 2: LITERATURE REVIEW ................................................................................... 4
2.1
2.2
2.3
2.4
2.5
2.6
2.7
2.8
INTRODUCTION .................................................................................................................... 4
FRAGILITY OF GERMINAL MATRIX VASCULATURE ................................................................ 5
DISTURBANCES IN THE CEREBRAL BLOOD FLOW .................................................................. 5
PLATELET AND COAGULATION DISORDERS .......................................................................... 6
THE INCIDENCE OF INTRAVENTRICULAR HAEMORRHAGE ..................................................... 6
TIMING OF HAEMORRHAGE .................................................................................................. 7
RISK FACTORS ...................................................................................................................... 7
ANTERIOR FONTANELLE VERSUS POSTERIOR FONTANELLE SCREENING................................ 9
CHAPTER 3: METHODOLOGY ............................................................................................ 10
3.1 INTRODUCTION .................................................................................................................. 10
3.2 SETTING ............................................................................................................................. 10
3.3 STUDY DESIGN ................................................................................................................... 10
3.4 STUDY POPULATION ......................................................................................................... 111
3.5 SAMPLING TECHNIQUE AND SAMPLE SIZE CALCULATION ................................................... 11
3.6 DATA COLLECTION .......................................................................................................... 122
3.7 DATA ANALYSIS ............................................................................................................... 133
3.8 RELIABILITY, VALIDITY AND OBJECTIVITY ....................................................................... 13
3.9 BIAS ................................................................................................................................... 13
3.10 ETHICAL CONSIDERATIONS .............................................................................................. 144
3.10.1 Permission ........................................................................................................... 144
3.10.2 Informed consent ................................................................................................ 144
3.10.3 Confidentiality .................................................................................................... 144
CHAPTER 4: RESULTS AND INTERPRETATION OF THE RESULTS ....................... 155
4.1
4.2
4.3
4.4
INTRODUCTION ................................................................................................................ 155
DEMOGRAPHIC INFORMATION OF THE MOTHER ................................................................ 155
DEMOGRAPHIC INFORMATION OF THE BABY .................................................................... 200
INCIDENCE OF INTRAVENTRICULAR HEMORRHAGE .......................................................... 211
i
4.5 TIMING OF INTRAVENTRICULAR HEMORRHAGE ............................................................... 222
4.6 MATERNAL RISK FACTORS FOR INTRAVENTRICULAR HEMORRHAGE ................................ 233
4.7 BABY’S RISK FACTORS FOR INTRAVENTRICULAR HEMORRHAGE ...................................... 244
CHAPTER 5: DISCUSSION OF RESULTS ......................................................................... 255
5.1 INTRODUCTION ................................................................................................................ 255
5.2 DEMOGRAPHIC INFORMATION OF THE MOTHERS .............................................................. 255
5.3 DEMOGRAPHIC INFORMATION OF THE BABIES .................................................................. 255
5.4 INCIDENCE OF INTRAVENTRICULAR HEMORRHAGE .......................................................... 266
5.5 TIMING OF INTRAVENTRICULAR HEMORRHAGE ................................................................ 266
5.6 MATERNAL RISK FACTOR FOR INTRAVENTRICULAR HEMORRHAGE .................................. 277
5.7 BABY’S RISK FACTORS FOR INTRAVENTRICULAR HEMORRHAGE ...................................... 277
5.7.1 Baby’s weight ......................................................................................................... 277
5.7.2 Gestational age ........................................................................................................ 288
5.7.3 Inotropes ................................................................................................................. 288
5.8 ANTERIOR FONTANELLE VERSUS POSTERIOR FONTANELLE SCREENING.............................. 29
CHAPTER 6: CONCLUSION AND RECOMMENDATIONS ........................................... 300
6.1
6.2
6.3
6.4
INTRODUCTION ................................................................................................................ 300
CONCLUSION ................................................................................................................... 300
LIMITATIONS OF THE STUDY ............................................................................................ 311
RECOMMENDATIONS ........................................................................................................ 311
REFERENCES ........................................................................................................................................................ 323
APPENDIX 1: DATA COLLECTION SHEET A ................................................................................................ 388
APPENDIX 2: STATISTICIAN FORM ................................................................................................................ 400
APPENDIX 3: MREC CERTIFICATE ................................................................................................................ 411
APPENDIX 4: CONSENT FORM ......................................................................................................................... 422
APPENDIX 5: INFORMATION LEAFLET ........................................................................................................ 444
APPENDIX 6: CLINICAL DATA SHEET B ....................................................................................................... 488
APPENDIX 7: HAEMORRHAGE DATA………………………………………………………………………108
LIST OF TABLES
TABLE 1: RISK FACTORS.......................................................................................................................................8
TABLE 2: MATERNAL AGE ............................................................................................................................... 166
TABLE 3: ANC ........................................................................................................................................................ 177
TABLE 4: PARITY ................................................................................................................................................. 188
TABLE 5: MODE OF DELIVERY ......................................................................................................................... 19
TABLE 6: BABY’S CHARACTERISTICS, N=60 ............................................................................................... 200
TABLE 7: INCIDENCE AND SEVERITY OF IVH ............................................................................................ 211
TABLE 8: INCIDENCE AND SEVERITY OF IVH BY BABY’S WEIGHT AND GESTATIONAL AGE .. 211
TABLE 9: TIME OF BLEEDING ......................................................................................................................... 222
TABLE 10: MATERNAL RISK FACTORS FOR INTRAVENTRICULAR HEMORRHAGE ..................... 233
ii
TABLE 11: BABY’S RISK FACTOR FOR INTRAVENTRICULAR HEMORRHAGE................................ 244
LIST OF FIGURES
FIGURE 1: PERCENTAGE DISTRIBUTION OF MATERNAL AGE .............................................................. 16
FIGURE 2: PERCENTAGE DISTRIBUTION OF ANTENATAL CARE ATTENDANCE ........................... 167
FIGURE 3: PERCENTAGE DISTRIBUTION OF PARITY .............................................................................. 178
FIGURE 4: PERCENTAGE DISTRIBUTION OF MODE OF DELIVERY ...................................................... 19
FIGURE 5: PERCENTAGE DISTRIBUTION FOR THE TIME OF BLEEDING............................................ 22
iii
DEDICATION
I dedicate this dissertation to my lover and best friend, Lesiba. My love for you grows each day.
Thanks for being a great husband and father, 143 always. To my lovely children, Mpho and
Tshegofatso, thoughts of you sustained me and brought a smile to my face. I love you. To my
parents and brother you are the best and I love you. Thanks for everything, may God continue to
bless you. Above all I thank God for my lovely family and for his grace that has sustained them.
iv
DECLARATION
I declare that INTRAVENTRICULAR HAEMORRHAGE IN PREMATURE BABIES AT DR
GEORGE MUKHARI HOSPITAL, PRETORIA is my own work and that all the sources that I
have used or quoted have been indicated and acknowledged by means of complete references and
that this work has not been submitted before for any other degree at any other institution.
TL LENTSOANE
30/09/2011
19818782
v
ACKNOWLEDGEMENTS
I want to thank the following persons for their respective contributions to this dissertation:

My husband, Lesiba, for his unconditional love, support and encouragement.

My two children, Mpho and Tshegofatso, for their support and understanding.

A special thank you to my supervisors, Prof. Mawela, Dr. C Minne, for their guidance,
support and encouragement.

My Co-supervisor, Prof. N Ebrahim, for her support and guidance.

To Prof. LDR Tsatsi for his support and encouragement.

My colleague, Dr. NZ Makhanya for their willingness to participate in this study.

To the Paediatric doctors for informing me about new admissions.

My statistician Mr S Ntuli, for his valuable input.

All mothers who gave consent for their babies to participate in the study.

To the management of Dr George Mukhari Hospital for granting permission for the study.
vi
INTRAVENTRICULAR HAEMORRHAGE IN PREMATURE BABIES AT DR GEORGE
MUKHARI HOSPITAL, PRETORIA
KEYWORDS:
Intraventricular hemorrhage, prematurity, hydrocephalus, gestational age
ABSTRACT
Background:
Intraventricular hemorrhage (IVH) is a known complication occurring in the
first week of life in premature neonates. The exact time of its occurrence and
the ideal time to perform diagnostic imaging investigation remain
controversial.
Objectives:
1.
To determine the incidence of intraventicular hemorrhage in premature babies at Dr George
Mukhari Hospital, Pretoria.
2. To determine the timing at which bleeding occurs.
3. To determine if the rate of diagnosing intraventicular hemorrhage improves when performing
ultrasound via the posterior fontanelle.
4. To determine the risk factors for intraventricular haemorrhage
Materials and methods: The study included 60 premature babies of gestational age of less than 32
weeks that were admitted to our neonatal Intensive Care Unit over a two months period and screened
for IVH. They were grouped into three categories according to their weight at birth, and according to
their gestational age. All babies had a cranial ultrasound on day 1, 3 and 7.
Results: We found that the overall incidence of IVH among premature babies was 28%. Although it
did not reach statistical significance, the incidence was found to be inversely related to the birth
weight and gestational age. The majority of the bleeds occurred within the first day of life and were
mostly grade I and II according to Papile’s classification. The use of inotropes was found to be
significantly associated with development of IVH. We also found that scanning through the posterior
fontanelle did not significantly increase the rate of diagnosis for IVH.
vii
CHAPTER 1: BACKGROUND OF THE STUDY
1.1
Introduction
Intraventricular haemorrhage (IVH) is one of the most common complications occurring in
premature babies and is associated with high mortality and morbidity (Kadri, 2006:22). Sequelae
of IVH include life-long neurological deficits such as cerebral palsy, developmental delay,
learning disabilities, vision problems and seizures (Annibale, 2010). There are many risk factors
associated with the development of IVH in neonates, prematurity being the most important risk
factor. Other factors as outlined in the literature include – low Apgar scores, blood transfusion,
mode of delivery, hypoxia and bicarbonate infusion. IVH is rarely seen in premature babies born
after 32 weeks gestation (Thorp, 1999:11). The severity of IVH is graded from I to IV, from least
to most severe according to the Papile’s classification: Grade I is limited to the germinal matrix;
grade II intraventricular haemorrhage; grade III intraventricular haemorrhage with ventricular
dilatation; grade IV intraparenchymal and intraventricular haemorrhage (Papile, 1978:92).
The day of life on which most of the bleeding episodes occur remains controversial. Literature
reveals that bleeding may occur within 24-48 hours of birth and that the majority occur during
the first 4 days of life (Kadri, 2006:22). Thorp et al. (1999:11) conforms to the first few days.
IVH is readily diagnosed using ultrasound. The advantages include the easy availability of
ultrasound, no associated radiation and quick acquisition time. The disadvantages however is that
it is operator dependant (Eber, 1991:2)
IVH is associated with a high mortality and morbidity based on the severity of the haemorrhage.
Short term sequelae of IVH include post-haemorrhagic hydrocephalus and periventricular
leukomalacia (Ballabh, 2010:67; McCrea, 2008:35). Life-long neurological deficits include
cerebral palsy, developmental delay, and seizures. The majority of the infants are asymptomatic
and the diagnosis is based on screening cranial ultrasound (Ballabh, 2010:67).
Early screening is very important as complications can be prevented. Cranial imaging of infants
by ultrasound is routinely done via the anterior fontanelle. In a study done by Anderson et al.
1
(1994:6), it was found that scanning via the posterior fontanelle improved the chances of
detecting IVH. In his study of 259 neonates, 23 had IVH diagnosed via the anterior fontanelle
views and when the posterior fontanelle views where done, 11 more were diagnosed with IVH.
In view of the study done by Anderson et al. (1994:6) it then becomes very important that scans
be done via both fontanelles. If ultrasound imaging is done via the anterior fontanelle only, it is
possible that IVH might have been missed in some of the babies. It becomes interesting to know
whether the studies done by other researches where done via the anterior fontanelle only or via
both fontanels.
1.2
The study problem
The incidence of intraventricular haemorrhage in premature babies at Dr George Mukhari
Hospital, Pretoria is unknown. Furthermore very few similar studies have been done. The
incidences in studies done overseas may be of limited value in our setting due to a number of
differences in the characteristics of the population, availability of resources and other risk factors
associated with prematurity. This study sets out to determine the incidence of IVH in premature
babies born at Dr George Mukhari Hospital.
1.3
Research question
What is the incidence of intraventricular haemorrhage in premature babies born at Dr George
Mukhari Hospital, Pretoria?
1.4
Purpose of the study
The purpose of the study is to investigate intraventricular haemorrhage in premature babies born
at Dr George Mukhari Hospital, Pretoria from October to November 2009.
2
1.5
Objectives of the study
1. To determine the incidence of intraventricular haemorrhage in premature babies at Dr George
Mukhari Hospital. Pretoria.
2. To determine the time when bleeding occurs.
3. To determine if the rate of diagnosing intraventricular haemorrhage improves when
performing ultrasound via the posterior fontanelle.
4. To determine risk factors for intraventricular haemorrhage.
1.6
Significance of proposed research
Early diagnosis and prevention of IVH is an important component in caring for premature
babies. Identification of the risk factors in our setting will enable us to be expectant of IVH and
hence early intervention and screening will be instituted. Our study will indicate whether doing
ultrasound through the posterior fontanelle results in improved rates of diagnosis.
3
CHAPTER 2: LITERATURE REVIEW
2.1
Introduction
Intraventricular haemorrhage (IVH) is a major complication of prematurity. It typically initiates
in the germinal matrix which is located on the head of the caudate nucleus and underneath the
ventricular ependyma. The germinal matrix is a highly vascular collection of glial and neuronal
precursor cells. The periventricular region is selectively vulnerable to haemorrhage in premature
infants predominantly in the first 48hours of life. When the haemorrhage in the germinal matrix
is substantial, the ependyma breaks and the ventricles fill up with blood. The majority of the
infants are asymptomatic and the diagnosis is based on a screening cranial ultrasound. Some
infants manifest with subtle abnormalities in the level of consciousness, movement, tone,
respiration and eye movement. Uncommonly they present with decerebrate posturing,
generalised tonic seizure and quadriparesis (Ballabh, 2010:67).
IVH reduces the survival of premature infants and enhances the risk of neurological sequelae. A
high mortality rate in premature infants is seen in those with severe IVH compared to infants
without (Whitelaw, 2001:6). Premature infants with moderate to severe IVH (grade 3 – 4) are at
high risk of developing post-haemorrhagic hydrocephalus cerebral palsy and mental retardation
while infants with mild IVH (grade 1-2) are at risk of developmental disabilities (Murphy,
2002:87; Pinto-Martin, 1999:41). About 45-85% of premature infants with moderate to severe
IVH develop major cognitive deficits and approximately 75% of these infants need special
education in school (Vohr, 2003:111).
Recent studies have shown better functional outcome of surviving preterm infants with
periventricular haemorrhagic infarction at school age than previously thought (Roze, 2009:123).
The pathogenesis of IVH is multifactorial and is commonly due to a) the inherent fragility of the
germinal matrix vasculature, b) disturbance in the cerebral blood flow (CBF) and c) platelet and
4
coagulation disorders. A number of risk factors have been mentioned in the literature and induce
IVH by disturbing the cerebral blood flow. Others such as thrombocytopenia contribute to IVH
by causing haemostatic failure (Ballabh, 2010:67).
2.2
Fragility of germinal matrix vasculature
Premature infants primarily bleed into the germinal matrix and not into the cortical mantle or
white matter. This suggests that there is an intrinsic weakness in the germinal matrix vasculature
compared to other parts of the brain. Endothelial tight junctions, basement membrane, pericytes
and astrocyte end-feet ensheathing the blood vessels constitute the blood brain barrier.
Immaturity or weakness of any of these components can cause fragility of germinal matrix
vasculature (Ballabh, 2004:56; Ballabh, 2005:58; El-Khoury, 2006:59; Xu, 2008:86; Braun,
2007:27; Ballabh, 2007:13).
2.3
Disturbances in the cerebral blood flow
Fluctuating CBF is associated with the development of IVH (Tsuji, 1998:44; Perlman, 1983:309;
Perlman, 1985:312). Doppler technique has been used to measure CBF velocity in premature
infants with respiratory distress syndrome, who are on mechanical ventilator on the first day of
life. Two patterns of CBF velocity are delineated: a stable or a fluctuating CBF pattern. Stable
CBF pattern consists of equal peak and trough of systolic and diastolic flow velocity, while
fluctuating CBF pattern comprises of continuous alteration in systolic and diastolic flow
velocity. The neonates with fluctuating CBF velocity have higher incidence of IVH compared to
infants with stable CBF pattern (Perlman, 1983:309). Van Bel et al. (1987:29) reported similar
findings. Other clinical conditions including hypercarbia, hypotension, patent ductus arteriosus
and restlessness also contribute to the fluctuation in cerebral blood flow and hence the
development of IVH (Van Bel, 1987:29; Mullaart, 1994:37; Coughtrey, 1997:47).
There is disagreement on the pathogenetic role of rapid infusion of sodium bicarbonate or
hyperosmolar fluids in IVH (Wigglesworth, 1976:51; Anderson, 1976:1). These factors can
potentially contribute to IVH by causing episodic increase in the CBF. A rapid sodium
5
bicarbonate infusion can result in high arterial CO2 that can cause cerebral vasodilatation and
hence altering cerebral hemodynamics (Ballabh, 2010:67).
2.4
Platelet and coagulation disorders
A number of studies have shown that thrombocytopenia is a risk for IVH (Andrew, 1987:110;
Lupton, 1988:142) however the role of coagulopathy in the pathogenesis of IVH has not been
proved (Shirahata, 1990:57).
2.5
The incidence of intraventricular haemorrhage
The majority of cases with IVH are mild and therefore have minimal negative prognosis. The
reported incidence of IVH in the literature varies. Khodapanahandeh et al. (2007:50) reports an
overall decrease in the incidence of IVH. He reports a decrease from 40% to 50% in the 1980s
down to 20% to 25% in the 1990s. In a study done by Kadri et al. (2006:22) the incidence of
IVH was found to be 44.68%. He studied 282 premature babies of gestation less than 37weeks
admitted to neonatal ICU. He divided them into 4 subgroups, the 1st group less than 1000g, 2nd
group between 1000g-1500g, 3rd group between 1500g – 2500g, 4th group greater than
2500g.Ultrasound scans were done daily in the first week, once in the second and third week.
Kadri reported that the incidence was inversely related to the weight at birth. In those less than
1000g the incidence was 68.84%, in group 2 the incidence was 49.18%, group 3 had an
incidence of 42.86% and 17.24% for group 4. Other studies reported an incidence of 50-62% in
group 1 (Schellinger, 1988:150; Staneva, 2002:206; Trounce, 1986:61). Szymonowiz et al.
(1986:22) reported a smaller figure of 49%. The incidence according to the severity of bleeding
was found in the same study to be; Grade I 52.4%, Grade II 30.95%, Grade III 11.9%, and Grade
IV 4.76%. Papile also reported similar results while Batton et al. (1986:3) reported 11 and 7%
for Grade III and IV respectively. Leech et al. (1974:77) reported 10% for grade IV.
Koksal et al. (2002:69) reported an incidence of 15%. He studied premature infants with low
birth weight of 1500g and less. Fifty percent (50%) were Grade I, 17% were Grade II, 11% were
6
Grade III, and 22% were Grade IV. Seventy eight percent occurred in the first week of life.
Significant risk factors and protective factors were similar to those mentioned by other studies.
In a study done at Baragwanath hospital by Sandler et al. (1994:84), they reported an incidence
of 53% for infants weighing less than 1500g at birth and 52% for infants born less than 35weeks
gestation. Twelve percent had either Grade III or Grade IV IVH haemorrhages. The prevalence
and severity if IVH was increased with both decreasing birth weight and decreasing gestational
age and was also predicted by the need for active resuscitation at birth, mechanical ventilation
and the development of pneumothorax.
2.6
Timing of haemorrhage
Many studies showed that the haemorrhages occur during the first week of life (Chen, 1993:34;
Paneth, 1993:137). The majority of the published literature agrees that IVH in premature infants
does not occur immediately after birth but it occurs within 24-48hours after delivery (Jaeger,
2004:176; Tsiantos, 1974:85). Kadri (2006:22) and Thorp (1999:11) conform to bleeding
occurring in the 1st few days of life.
2.7
Risk factors
A number of risk factors have been proposed for the development of IVH (Table 1).
7
TABLE 1: RISK FACTORS
BABIES RISK FACTORS
Low gestational age and low birth-weight
Gender (Controversial)
REFERENCES
Wells, 1995:42; Vohr, 1996:44;
Heuchan, 2002:86
Oh, 1996:39; Shankaran, 1996:150;
Verma, 1997:176
Gleissner, 2000:28; Weintraub, 2001:85
Shankaran, 1996:150; Gleissner,
2000:28; Synnes, 2001:138
Low Apgar
Ballabh, 2010:67; Ertan, 2006:127
The presence of respiratory distress syndrome
Gleissner, 2000:28; Hansen, 1999:181
Birth asphyxia
Levene, 1982:57
Mechanical ventilation
Cools, 1999:25; Levene, 1982:57
Hypoxia, metabolic acidosis and administration of
sodium bicarbonate bolus
Synnes, 2001:138; Volpe, 2008:25;
Ertan, 2006:127
Anaemia and a need for transfusion
Levene, 1982:57
Inotropes
Lee, 2010:25
MATERNAL RISK FACTORS
Mode of delivery (Controversial)
Shankaran, 1996:150; Synnes, 2001:138
Hansen, 1999:181; Ment, 1995:172;
Shaver, 1992:80
Maternal age, maternal infection, multiple
pregnancy
Levene, 1982:57
Premature rupture of membranes (PROM)
Premature labour and smoking
Ballabh, 2010:67
Low-dose indomethacin, caesarean section,
surfactant administration, antenatal steroids,
prenatal tocolytic therapy
Ballabh, 2010:67
8
2.8
Anterior fontanelle versus posterior fontanelle screening
It is not always stipulated in the studied literature whether the ultrasound scans were done via the
anterior or posterior fontanelle. In a study done by Anderson et al. (1994:163), it is found that
additional scanning via the posterior fontanelle improved the chances of detecting IVH. In his
study of 259 neonates, 23 had IVH diagnosed via the anterior fontanelle views and when the
posterior fontanelle views where done, additional 11 were diagnosed with IVH.
In view of the study done by Anderson et al. (1994:163) it becomes important to know whether
the studies done by other researchers were done via the anterior fontanelle only or via both
fontanels. If they were done via the anterior fontanelle, it is possible that IVH might have been
missed in some of the babies. The value of performing posterior fontanelle ultrasounds has not
been determined yet.
9
CHAPTER 3: METHODOLOGY
3.1
Introduction
The study methods are outlined in this chapter. These include the setting of the study, study
design, study population, exclusion and inclusion criteria and sampling. The procedure for data
collection and analysis, reliability, validity, bias and ethical considerations are also included in this
chapter.
3.2
Setting
The study was performed at Dr George Mukhari Hospital. It is a tertiary academic hospital
attached to the University of Limpopo (MEDUNSA Campus). It is situated 31 kilometres north of
Pretoria. It serves as a referral hospital for the surrounding clinics and hospitals from the North
West, Mpumalanga and Limpopo provinces. The Neonatal unit at Dr George Mukhari hospital has
fifty five beds and admits 1800 patients per annum. The majority of patients are admitted for
prematurity related complications.
3.3
Study design
This was a descriptive prospective study of premature babies admitted in the neonatal ICU at Dr
George Mukhari Hospital. Convenience sampling was done for a period of two months (October to
November 2009). Sixty babies were enrolled and studied.
10
3.4
Study population
Babies with gestation less than 37weeks on admission, whose mothers were available and willing
to give informed consent, were enrolled. Neonates excluded from the study were those whose
mothers were not available, those whose mothers were unable to communicate with the
researchers, those whose mothers were not willing to participate and those with major congenital
abnormalities.
3.5
Sampling technique and sample size calculation
All premature babies admitted in the ICU during the period of the study were selected to allow
the largest possible sample size.
The sample size of the study was calculated based on the following formula:
Z 2 p (1  p )
n
d2
n – sample size, which is the number of babies needed for the study, Z - confidence interval
(90% ), p – proportion of babies with bleeds – estimated ( 30%), (1 – P) – those without bleed,
d is the sampling error (10%). A sample size of 60 was used.
11
3.6
Data Collection
Materials, apparatus and instruments
The following instruments were used in the study:

A high resolution sector transducer, 7. 5MHz, Mindray DC 6 machine was used.

Compact Discs (CD) with the baby’s hospital number.

Data sheets - Two data collection sheets were used (See Appendix 1 and 6). Data sheet A
is a radiological ultrasound sheet to record all information obtained from the ultrasound
scan and data sheet B is a clinical history sheet to record information about the mother and
baby.
From the beginning of October 2009 until the end of November 2009, 60 preterm infants with
gestation of less than 37weeks admitted to the neonatal intensive care unit at Dr George Mukhari
Hospital had screening ultrasounds done on day 1, day 3, and day 7 of life. Scans were done in
the coronal and sagittal views via the anterior fontanelle examining the following areas: lateral
ventricles on the left and right, 3rd and 4th ventricles and via the posterior fontanelle examining
the occipital horns. Sonographicaly brain haemorrhages appear as localised areas of high echodensity.
Images were recorded on CD and those with haemorrhages were categorized in one of the four
grades according to Papile et al. (1978:92) classification. To exclude variance, all findings were
checked by a consultant radiologist.
The presence or absence of bleeds was later recorded on a data sheet (See Appendix 1). Infants
included in the study underwent gestational age assessment that included a Ballard score on
admission. The demographic and clinical data was abstracted from the patients’ medical records
and the neonatal unit database. The following variables were recorded: infant- sex, birth weight,
12
gestational age, Apgar score (1 and 5 min), mode of delivery and whether the delivery was
assisted or not, resuscitation at birth. The admission diagnosis was recorded with particular
reference to the presence of respiratory distress syndrome, birth asphyxia, surfactant
administration,
hypoxia,
metabolic
acidosis,
anaemia
and
a
need
for
transfusion,
thrombocytopenia, and administration of sodium bicarbonate bolus, indomethacin and inotropes.
Maternal variables included: age, parity, antenatal history (See Appendix 2).
3.7
Data analysis
Data for the study was entered and analysed using Microsoft Excel and EpiInfo 2002
respectively. Descriptive statistics was used to analyse data. Absolute numbers and percentages
were used to interpret the data. Kruskal-Wallis test and Fisher exact test were used to determine
the association between categorical variables and Mann-Whitney test for continuous variables. A
p-value of less than 0.05 was considered statistically significant.
3.8
Reliability, Validity and Objectivity
Reliability in this study was increased by using two readers and cases where interpretation
between the readers was different were referred to a third reader whose decision was final hence
validating the results of the study. The data collection form was piloted before the actual
collection of data.
3.9
Bias
No clinical history was available to the readers including the researcher to limit interpretive bias
in the reader. One consultant from the department of Radiology at Dr George Mukhari Hospital
acted as a second reader to counter the bias created by the researcher from the knowledge gained
from the literature review. Readers were not allowed to do the neonatal brain ultrasound scans at
the same time.
13
3.10 Ethical considerations
3.10.1 Permission
Permission was sought from the superintendent of Dr George Mukhari Hospital, the Head of
department of Paediatrics and Child Health, the Head of department of Diagnostic Radiology as
well as the MEDUNSA Research and Ethics committee (MREC). A clearance certificate no:
MREC/M/120/2009: PG was issued by MREC (See Appendix 3).
3.10.2 Informed consent
Doctors in the neonatal Intensive Care Unit (ICU) were informed about the research. Informed
consent was obtained by the researcher from the mothers and information leaflets translated into
the local language were made available to mothers whose neonates fitted the inclusion criteria of
the study (See Appendix 4 and 5). Ancillary treatment was provided when scans demonstrated
bleeding.
3.10.3 Confidentiality
All data was confidential. Identities did not appear on the data collection sheets or CDs used to
record the ultrasound images.
14
CHAPTER 4: RESULTS AND INTERPRETATION OF THE RESULTS
4.1
Introduction
In this chapter the results and the interpretation of the findings are presented. The chapter is
divided into the following sections:

Demographic information of the mother;

Demographic information of the baby;

Incidence of intraventricular hemorrhage;

Association between severity of IVH and baby’s weight and gestation age;

Timing of intraventricular hemorrhage;

Maternal and baby’s risk factor for intraventricular hemorrhage.
4.2
Demographic information of the mother
A total of 50 women who gave birth to premature babies were selected for the study. Of these
women, (10) ten gave birth to twins. The median age of these women was 24 years range from
16 to 39 years. The majority (37%) of women were in the age group 20-24 years, followed by
31% aged 30 years and above (Figure 1). Thirty two (65%) women attended antenatal care
(ANC) during their period of pregnancy (Figure 2). The majority (36%) of the women had two
babies (Figure 3). More than fifty percent of women had normal vaginal deliveries (Figure 4).
15
TABLE 2: MATERNAL AGE
Age
Percentage
< 20
16
20 - 24
37
25 - 29
16
> 30
31
Maternal age
40
37
35
31
percentage
30
< 20
25
20
16
16
20 - 24
15
25 - 29
10
> 30
5
0
Age Group in Years
Figure 1: Percentage distribution of maternal age.
16
TABLE 3: ANC
Attendance
Number
Percentage
Booked
32
65
Unbooked
18
35
ANC
35%
Booked
Unbooked
65%
Figure 2: Percentage distribution of ANC attendance.
17
TABLE 4: PARITY
Parity
Number
Percentage
1
15
30
2
18
36
>3
17
34
Parity
38
36
36
Percentage
34
34
1
32
2
30
30
>3
28
26
No. of pregnancy
Figure 3: Percentage distribution of parity.
18
TABLE 5: MODE OF DELIVERY
Mode of delivery
Percentage
Caesarean section
49
Normal delivery
51
Mode of delivery
49%
51%
Caesarean section
Normal delivery
Figure 4: Percentage distribution of mode of delivery.
19
4.3
Demographic information of the baby
TABLE 6: BABY’S CHARACTERISTICS, n=60
No
%
Male
Female
Gestational age (weeks)
27
33
45
55
<30
30-33
34-36
Weight (grams)
<1000
13
35
12
22
58
20
9
15
1000-1499
1500-2499
27
24
45
41
Length (cm)
Skull circumference (cm)
Apgar score (median, range)
1 min.
5 min.
41 (33 to 47)
29 (24 to 35)
Length of Stay (days)
Baby outcomes
Alive
Died
23 (2 to 330)
Gender
6 (1 to 9)
8 (2 to 9)
52
8
87
13
Sixty premature new born babies were included in this study. Of these, 55% were female. The
median gestation age of these infants was 32 weeks with a range from 26 to 37 weeks. Forty five
percent of the infants weighed 1000-1499 g, 41% weighing 1500-2499 g. Only 15% (9/60)
weighed less than 1000 g. The median Apgar score at one minute was 6 (range from 1 to 9) and
at five minutes was 8 (range from 2 to 9) minutes. The infant length had a median of 41 cm,
ranging from 33 to 47 cm, while the skull had a median circumference of 29 ranging from 24 to
35 cm. The median length of stay in the hospital was 23 days ranging from 2 to 330 days. About
20
13% of the babies died during the period of the study. Of the babies who died, 7 were alive
beyond day 7 and 1 died on day 4 (Table 6).
4.4
Incidence of intraventricular hemorrhage
Twenty eight percent (17/60) of new born babies had intraventricular hemorrhage (IVH) during
the period of study. The majority 65% (11/17) was Grade I, 17% (3/17) were Grade II, 6% (1/17)
were Grade III and 12% (2/17) were Grade IV (Table 7).
TABLE 7: INCIDENCE AND SEVERITY OF IVH
No
11
3
1
2
Grade I
Grade II
Grade III
Grade IV
%
65
17
6
12
TABLE 8: INCIDENCE AND SEVERITY OF IVH BY BABY’S WEIGHT AND
GESTATIONAL AGE
Weight
<1000 g
1000-1499 g
1500-2500 g
Gestational age
<30
30-33
34-36
Grade I
Grade II
Grade III
Grade IV
p-value
2(20%)
4(30%)
5(50%)
2(67%)
1(33%)
-
1(100%)
-
2(100%)
-
0.23
2(10%)
7(70%)
2(20%)
1(33%)
2(67%)
-
1(100%)
-
2(100%)
-
0.34
p-value < 0.05
The severity of intraventricular hemorrhage was associated with baby’s weight (p=0.230) and
gestation age (p=0.340) but did not reach statistical significance. Of the babies with IVH Grade I,
50% had
weight between 1500-2500 grams and more than 50% had a gestation age of 30-33
weeks. The majority of bleeds were seen among infants with a birth weight of 1000-1499g and
gestational age of 30-33 weeks. Only babies of gestation less than 30 weeks had Grade IV IVH.
21
4.5
Timing of intraventricular hemorrhage
TABLE 9: TIME OF BLEEDING
Day of bleeding
Percentage
24hrs
94
72hrs
6
Bleeding
100
94
Percentage
80
60
24hrs
40
72hrs
20
0
6
Time of bleeding
Figure 5: Percentage age distribution for the time of bleeding.
The findings of this study revealed that, 94% (16/17) of bleeding occurred within 24 hours of
admission and 6% (1/17) occurred on the third day of admission. No new bleeds were seen on
day seven. Of the 16 bleeds which occurred on the first day of admission, 69% (11/16) were seen
through the anterior fontanelle and 31% (5/16) were seen from both fontanels. No new bleeds
were seen through the posterior fontanelle (Figure 5).
22
4.6
Maternal risk factors for intraventricular hemorrhage
Maternal age was highly associated with IVH (p<0.05) and IVH was more prevalent among the
younger age group. Parity and antenatal care were insignificantly associated with IVH (p>0.05).
Although, 69% of the baby’s with IVH had normal vaginal delivery, mode of delivery was not
significantly associated with IVH (Table 10). We also noted that only 1 pair of twins was
without IVH, in the other pairs, at least one (1) had IVH. It may be difficult to associate IVH
with multiple pregnancies in this study.
TABLE 10: MATERNAL RISK FACTORS FOR INTRAVENTRICULAR
HEMORRHAGE
Age
Parity
ANC
Booked
Unbooked
Mode of delivery
Caesarean section
Normal vaginal delivery
IVH
22 (16 to 38)
2 (1 to 5)
No-IVH
25 (17 to 39)
2 (1 to 5)
p-value
0.041
0.099
8(53%)
7(47%)
31(63%)
18(37%)
0.117
5(31%)
11(69%)
23(53%)
20(47%)
0.077
23
4.7
Baby’s risk factors for intraventricular hemorrhage
Table 11: shows the association between IVH and baby’s characteristics. No significant
association was observed with regard to gestation age, gender, Apgar score, RDS, birth asphyxia,
SGA, hypoxia, metabolic acidosis, anemia, blood transfusion, Bolus, IPPV, and nCPAP
(p>0.05). The use of inotropes is significantly associated with bleeding (p<0.05).
TABLE 11: BABY’S RISK FACTOR FOR INTRAVENTRICULAR HEMORRHAGE
Gestational age
IVH
31 (27 to 35)
No-IVH
32 (26 to 37)
p-value
0.154
Gender
Male
Female
6(35%)
11(65%)
21(49%)
22(51%)
0.187
Apgar score
1 min.
5 min.
7 (2 to 9)
8 (2 to 9)
6 (1 to 9)
8 (3 to 9)
0.597
0.709
RDS
Birth Asphyxia
SGA
Hypoxia
Metabolic acidosis
Anemia
Blood transfusion
*Bolus
Inotropes
IPPV
nCPAP
11(23%)
1(100%)
3 (14%)
10(60%)
9(60%)
8(46%)
9(53%)
11(71%)
5(33%)
4(20%)
6(40%)
35(81%)
3(30%)
4(9%)
28(64%)
24(57%)
23(55%)
26(58%)
29(65%)
3(8%)
9(21%)
23(52%)
0.514
0.364
0.472
0.501
0.548
0.405
0.488
0.465
0.028
0.611
0.301
24
CHAPTER 5: DISCUSSION OF RESULTS
5.1
Introduction
IVH is the most common complication in premature infants. 20 – 25% of all premature infants
will have IVH in the neonatal period. About 10 – 15% of neonates of less than 1500g birth
weight have the more severe grades of hemorrhage, and over three quarters of these develop
mental retardation and/or cerebral palsy in later life. (McCrea, 2008:35).
5.2
Demographic information of the mothers
The median age of mothers on this study was 24 years with a range from 16 to 39 years. The
majority (38%) of women were in the age group 20-24 years. Sixty six percent of women
attended antenatal care during their period of pregnancy. More than fifty percent of women
delivered via normal vaginal delivery.
5.3
Demographic information of the babies
In our study, 53% of the babies admitted were female. The median gestation age was 32 weeks
with a range from 26 to 37 weeks and the median Apgar score at first minute was 6 (range from
1 to 9) Koksal et al, (2002:69) in their study report a mean gestation of 30 weeks and the first
minute Apgar score of 5. The first minute Apgar score in this study was marginally higher than
in other studies.
The infant length had a median of 41 cm, ranging from 33 to 47 cm, while the skull
circumference had a median circumference of 29 ranging from 24 to 35 cm. The majority (43%)
of the infants weighed 1000-1499g.
25
The median length of stay in the hospital was 23 days, with a range from 2 to 330 days. About
13% of the babies died during the period of the study, mostly the extremely low birth weight
babies.
5.4
Incidence of intraventricular hemorrhage
The reported incidence of IVH in the literature varies from 20 to 59% (Harke, 1972:37; Jaeger,
2004:176; Leech, 1974:77; Papile, 1978:92; Philip, 1989:84; Takashima, 1983:5). In our study
28% of the babies had intraventricular hemorrhage (IVH). Lee et al. (2010:25) reported an
incidence of 27.8% which was similar to our study. Kadri et al. (2006:22) and Morals et al.
(1986:68) in their studies reported IVH incidence of 44.68% and 43%, respectively which was
higher than the one observed in our study.
Our study demonstrated that the majority (65%) of IVH were Grade I, followed by Grade II
(17%), 6% for grade III and 12% for grade IV. Lee et al. (2010:25) reported an incidence of
79.9% for Grade I, 6.9% for Grade II, 4.8% for Grade III and 8.6% for Grade IV which was
comparable to our results. Kadri et al. (2006:22), observed (52%) Grade I and (31%) Grade II
intraventricular hemorrhage among premature babies, while Koksal et al. (2002:69) reported
50% Grade I and 17% Grade II which were slightly lower compared to our results.
5.5
Timing of intraventricular hemorrhage
Most studies show that hemorrhage occurs in the first few days of life. Levene et al. (1982:57)
in their study report that 24% of the hemorrhages occurred in the first 24 hours of life, while
78% occurred within 72 hours. Other studies reported that 50% of bleeds occurred within the
first day and 90% by the third and fourth days (Paneth, 1993:137; Partridge, 1983:102; Perlman,
1986:140). Tsiantos et al. (1974:85) reported 16% of infants he studied to have developed IVH
within 24 hours, while Emerson et al. (1977:52) reported IVH to have occurred between 3 and 96
hours. In our study 94% of the bleeds occurred within 24 hours, while 6% occurred on the third
day. No new bleeds were seen on day seven.
26
5.6
Maternal risk factor for intraventricular hemorrhage
The results of our study indicated no significant association between intraventricular hemorrhage
and mode of delivery. Although, 73% of baby’s with intraventricular hemorrhage had a normal
vaginal delivery. There is no consistency in the literature on whether any mode of delivery is
associated with IVH. Some studies indicate that mode of delivery has no influence on the
incidence of IVH (Thorp, 1999:11; Lee, 2010:25). In contrast, Berger et al. (1997:75) reports a
higher incidence of IVH after caesarean section. Koksal et al. (2002:69) in their study illustrated
that caesarean section was significant protective factor against IVH. Hansen et al. (2001:181)
reported similar findings.
In our study, maternal age was associated with intraventricular hemorrhage; most of the babies
with IVH were born to younger mothers. However Lee found no significant association between
maternal age and IVH (Lee, 2010:25).
5.7
Baby’s risk factors for intraventricular hemorrhage
5.7.1 Baby’s weight
In our study, there was a correlation between intraventricular hemorrhage and baby’s weight.
The majority (50%) of Grade I IVH occurred in babies 1500-2500 g and 67% of Grade II had
IVH occurred in babies of 1000 g or less. Khodapanahandeh et al. (2008:50) found a similar
trend in his study. Koksal et al. (2002:69) reported an incidence of 56% in those with weight less
than 1000g and 7% in babies with birth weight 1500 g or less. On contrary to our study the
incidence of those less than 1000g was 27%. In a study done Sandler et al. (1994:84) at
Baragwanath hospital IVH was found in 53% of infants weighing less than 1500g at birth, no
data available for those weighing less than a 1000g and 12% were found to have either Grade III
or Grade IV hemorrhages. Furthermore they reported that IVH increased with both decreasing
birth weight and decreasing gestational age.
27
5.7.2 Gestational age
Several studies indicated that increase in gestational age is statistically protective against IVH
(Koksal, 2002:69; Berger, 1997; Khodapanahandeh, 2008:50). Similar findings were observed in
this study.
5.7.3 Inotropes
Our study revealed that the use of inotropes was significantly associated with IVH. Lee et al.
(2010: 25) reported similar findings.
No significant association was observed to IVH with regard to, gender, Apgar score, RDS, birth
asphyxia, SGA, hypoxia, metabolic acidosis, and anemia, resuscitation, and the use of sodium
bicarbonate infusion.
Several other studies reported different findings. Khodapanahandeh et al. (2008:50) indicated
that low 5- minute Apgar and RDS were statistically significant. They also reported that
mechanical ventilation was significantly associated with IVH, a finding which was also found in
similar studies. (Cools, 1999:80; Garcia-Prats, 1982:71). Morals et al. in his study reported that
asphyxia and RDS were associated with IVH. Levene et al. (1982:57) reported that there was a
strong association between RDS, IPPV, gestational age, acidosis and IVH. He also reported that
RDS and severe acidosis were best predictors of IVH with IPPV and gestational age to a lesser
effect. Dykes et al. (1980:66) reported that acidosis was not significantly associated with IVH
which was also the case in our study. Previous studies also show that the administration of base
is associated with intracranial hemorrhage (Anderson, 1976:1; Dykes, 1980:66).
28
5.8
Anterior fontanelle versus posterior fontanelle screening
The majority of the reviewed literature makes no mention as to whether the cranial ultrasounds
were done through both fontanels or via the anterior fontanelle only. Anderson et al. (1994:163),
it was found that scanning via the posterior fontanelle improved the chances of detecting IVH. In
their study of 259 neonates, 23 had IVH diagnosed via the anterior fontanelle views and when
the posterior fontanelle views where done, 11 more were diagnosed with IVH. In our study the
majority of the bleeds were seen through the anterior fontanelle, 5(29.4%) were seen through
both fontanels. Ultrasound through the posterior fontanelle may enhance the rate of finding IVH
and where feasible should be done routinely.
29
CHAPTER 6: CONCLUSION AND RECOMMENDATIONS
6.1
Introduction
On the basis of the findings of the study and literature review, certain conclusions which will be
outlined in this chapter were reached. Furthermore recommendations are made to the Neonatal
Intensive Care Unit of Dr George Mukhari Hospital. Limitations of the study are also outlined in
this chapter.
6.2
Conclusion
The incidence of IVH in our study was slightly lower in comparison to other similar studies.
However, in terms of the classification according to Papile, our results were comparable to other
studies in general. The results indicate that lower gestational age and birth weight as well as the
administration of inotropes increase the risk for IVH. Consequently prevention of prematurity
would be the most effective means of treatment of IVH.
During the study 8 babies whose birth weight was less than 1000 g died. The premature babies
studied in the literature were bigger in comparison to our study population. The majority of
patients had their intracranial bleeds within 24 hours of delivery.
We can also conclude that scanning through the posterior fontanelle did not significantly
increase the rate of diagnosing IVH.
30
6.3
Limitations of the Study
The major limitation was the short duration of the study and hence the small sample size. The
exclusion criteria also had an effect on the sample size. Some of the files could not be retrieved
for analysis.
6.4
Recommendations
All premature babies admitted to the neonatal ICU must have a screening cranial ultrasound
within 24hours of admission.
A program for prevention of prematurity must be instituted which will emphasize early
identification of women at risk, education concerning causes of prematurity, early diagnosis and
transfer to a perinatal center specializing in high risk deliveries.
A larger follow up study on IVH in prematurity needs to be done to inform the unit protocol on
screening for IVH.
31
REFERENCES
1. Kadri H, Mawla A. A, Kazah J. The incidence, timing, and predisposing factors of germinal
matrix and Intraventricular hemorrhage in preterm neonates. Childs Nerv Syst 2006;
22:1086-109.
2. Annibale DJ. Periventricular Hemorrhage-Intraventricular Hemorrhage. 2010;
3. Thorp JA, Robert D. White. Intracranial Hemorrhage in Premature Neonates: Epidemiology
and Prevention. CNS Drugs 1999; 11:421-433.
4. Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subepedymal and
Intraventricular hemorrhage: a study of infants with birth weights less than 1500gm. J Pediatr
1978; 92(4):529-534.
5. Eber J, Villasenor C. Ultrasound: advantages, disadvantages and controversies: Nurse Pract
Forum 1991 Dec; 2(4):239-242. [PubMed: 1840986]
6. Ballabh P. Intraventricular Hemorrhage in Premature Infants: Mechanism of Disease.
Peadiatr Res 2010; 67(1):1-13.
7.
McCrea HJ, Ment LR. The Diagnosis, Management and Postnatal Prevention of
Intraventricular Hemorrhage in the Preterm Neonate. Clin Perinatol 2008; 35(4):777-vii.
8. Anderson N, Allan R, Darlow B, Malpas, Tim. Diagnosis of Intraventricular Hemorrhage in
the Newborn: Value of Sonography via the Posterior fontanelle. AJR 1994; 163:893-896.
9. Whitelaw
A.
Intraventricular
hemorrhage
and
posthaemorrhagic
hydrocephalus:
pathogenesis, prevention and future interventions. Semin Neonatol 2001; 6:135-146.
[PubMed: 11483019]
10. Murphy BP, Inder TE, Rooks V, Taylor GA, Anderson NJ, Mogridge N, Horwood LJ, Volpe
JJ. Posthaemorrhagic ventricular dilatation in the premature infant: natural history and
predictors of outcome. Arch Dis Child Fetal Neonatal Ed 2002; 87:F37-F41. [PubMed:
12091289]
11. Pinto-Martin JA, Whitaker AH, Feldman JF, Van Rossem R, Paneth N. Relation of cranial
ultrasound abnormalities in low-birth weight infants to motor or cognitive performance at
ages 2, 6 and 9 years. Dev Med Child Neurol 1994; 41:826-833. [PubMed: 10619281]
32
12. Vohr BR, Allan WC Westerveld M, Schneider KC, Katz KH, Makuch RW, Ment LR.
School-age outcomes of very low birth weight infants in the intraventricular hemorrhage
prevention trial. Pediatrics 2003; 111:e340-e346. [PubMed: 12671149]
13. Roze E, Van Braeckel KN, van der Veere CN, Maathuis CG, Martijn A, Bos AF. Functional
outcome at school age of preterm infants with Intraventricular hemorrhagic infarction.
Pediatrics 2009; 123:1493-1500. [PubMed: 19482759]
14. Ballabh P, Braun A, Nedergaard M. Anatomic analysis of blood vessels in germinal matrix,
cerebral cortex, and white matter in developing infants. Paediatr Res 2004; 56:117-124.
[PubMed: 15128918]
15. Ballabh P, Hu F, Kumarasiri M, Braun A, Nedergaard M. Development of tight junction
molecules in blood vessels of germinal matrix, cerebral cortex and white matter. Pediatr Res
2005; 58:791-798. [PubMed: 16189211]
16. El-Khoury N, Braun A, Hu F, Pandey M, Nedergaard M,
Lagamma EF,
Ballabh P.
Astrocyte endfeet in germinal matrix, cerebral cortex, white matter in developing infants.
Pediatr Res 2006; 59:673-679. [PubMed 16627880]
17. Xu H, Hu F, Sado Y Ninomiya Y, Borza DB, Ungvari Z, Lagamma EF, Csiszar A,
Maturational changes in laminin, fibronectin, collagen IV, and perlecan in germinal matrix,
cortex, and white matter and effect of betamethasone. J Neurosci Res 2008; 86:1482-1500.
[PubMed : 18214989]
18. Braun A, Xu H, Hu F, Kocherlakota P, Siegel D, Chander P, Ungvari Z, Csiszar A,
Nedergaard M, Ballabh P. Paucity of pericytes in germinal matrix vasculature of premature
infants. J Neurosci 2007; 27:12012-12024. [PubMed: 17978043]
19. Ballabh P, Xu H, Hu F, Braun A, Smith K, Rivera A, Lou N, Ungvari Z, Goldman SA,
Csiszar A, Nedergaard M. Angiogenic inhibition reduces germinal matrix hemorrhage. Nat
Med 2007; 13:477-485. [PubMed: 17401377]
20. Tsuji M, duPlessis A, Taylor G, Crocker R, Volpe JJ. Near infrared spectroscopy detects
cerebral ischemia during hypotension in piglets. Pediatr Res 1998; 44:591-595. [PubMed:
9773851]
21. Perlman JM, Goodman S, Kreusser KL, Volpe JJ. Fluctuating cerebral blood-flow velocity in
respiratory distress syndrome. Relation to the development of Intraventricular hemorrhage. N
Engl J Med 1983; 309:204-209. [PubMed 6866033]
33
22. Perlman JM, Goodman S, Kreusser KL, Volpe JJ. Reduction in intraventricular hemorrhage
by elimination of fluctuating cerebral blood-flow velocity in preterm infants with respiratory
distress syndrome. N Engl J Med 1985; 312:1353-1357. [PubMed: 3887165]
23. Van Bel F, Van de Bor M, Stijnen T, Baan J, Ruys JH. Etiological role of cerebral blood –
flow alterations in development and extension of peri-intraventricular hemorrhage. Dev Med
Child Neurol 1987; 29:601-614. [PubMed: 3311857]
24. Mullaart RA, Hopman JC, Rotteveel JJ, Daniels O, Stoelinga GB, De Haan AF. Cerebral
blood flow fluctuation in neonatal respiratory distress and periventricular hemorrhage. Early
Hum Dev 1994; 37:179-185. [PubMed: 7925076]
25. Coughtrey H, Rennie JM, Evans DH. Variability in cerebral blood flow: observation over
one minute in preterm babies. Early Hum Dev 1997; 47:63-70. [PubMed: 9118830]
26. Wigglesworth JS, Keith IH, Girling DJ, Slade SA. Hyaline membrane disease, alkali, and
Intraventricular hemorrhage. Arch Dis Child 1976; 51:755-762. [PubMed: 1008580]
27. Anderson JM, Bain AD, Brown JK, Cockburn F, Forfar JO, Machin GA, Turner TL. Hyaline
membrane disease, alkaline buffer treatment, and cerebral intraventicular hemorrhage. Lancet
1976; 1:117-119. [PubMed: 54636]
28. Andrew M, Castle V, Saigal S, Carter C, Kelton JG. Clinical impact of neonatal
thrombocytopenia. J Pediatr 1987; 110:457-464. [PubMed: 3819949]
29. Lupton BA, Hill A, Whitefield MF, Carter CJ, Wadsworth LD, Roland EH. Reduced platelet
count as a risk factor for intraventicular hemorrhage. Am J Dis Child 1988; 142:1222-1224.
[PubMed: 3177331]
30. Shirahata A, Nakamura T, Shimono M, Kaneko M, Tanaka S. Blood coagulation findings
and the efficacy of factor XIII concentrate in premature infants with intracranial
hemorrhages. Thromb Res 1990; 57:755-763. [PubMed: 2339368]
31. Khodapanahandeh F, Khosravi N, Larijani T. Risk factors for intraventicular hemorrhage in
very low birth weight infants in Tehran, Iran. Turk J Pediatr 2008; 50:247-252.
32. Schellinger D, Grant EG, Manz HJ, Patronas NJ. Intraparenchymal hemorrhage in preterm
neonates: a broadening spectrum. Am J Roentgenol 1988; 150(5):1109-1115.
33. Staneva KN, Hartmann S, Uhlemann M, Dietz H, Reschke E, Koepcke E, Sadenwasser W,
Kulz T. Neonatal ultrasonagraphic cerebral findings: association with risk factor for cerebral
palsy. Z Geburtshilfe Neonatol 2002; 206(4):142-150.
34
34. Trounce JQ, Rutter N, Levene MI. Periventricular leukomalacia and Intraventricular
hemorrhage in the preterm neonate. Arch Dis Child 1986; 61(12):1196-1202.
35. Szymonowicz W, Yu VY. Periventricular hemorrhage and leukomalacia in extremely low
birth weight infants. Aust Paediatr J 1986; 22(3):207-210.
36. Batton DG, DeWitte DB, Boal DK, Nardis EE, Maisels MJ (1986) Incidence and severity of
intraventricular hemorrhage: 1981-1984. Am J Perinatol. 3(4):353-356.
37. Leech RW, Kohnen P. Sub-ependymal and Intraventricular hemorrhages in the newborn. Am
J Pathol 1974; 77(3):465-475.
38. Koksal N, Baytan B, Bayram Y, Nacarkucuk E. Risk factors for intraventicular hemorrhage
in very low birth weight infants. Indian J pediatr 2002; 69(7):561-564.
39. Sandler DL, Cooper PA, Bolton KD, Bental RY, Simchowitz ID. Periventricularintraventricular hemorrhage in low-birth-weight at Baragwanath Hospital. S Afr Med J 1994;
84(1):26-29.
40. Chen CH, Wang TM, Wu KH, Chi CS. Intraventricular hemorrhage in preterm neonates—a
two-year experience. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi 1993; 34(5):343348.
41. Paneth N, Pinto-Martin J, Gardiner J, Wallenstein S, Katsikiotis V, Hegyi T, Hiatt IM,
Susser. Incidence and timing of germinal matrix/Intraventricular hemorrhage in low birth
weight infants. Am J Epidemiol 1993; 137(11):1167-1176.
42. Jaeger M, Grussner SE, Omwandho CO, Klein K, Tinneberg HR, Klingmuller V. Cranial
sonography for newborn screening: a 10-year retrospective study in 11,887 newborns. Rofo
2004; 176(6):852-858.
43. Tsiantos A, Victorin L, Relier JP, Dyer N, Sundell H, Brill AB, Stahlman M. Intracranial
hemorrhage in the prematurely born infant: timing of clots and evaluation of clinical signs
and symptoms. J Pediatr 1974; 85(6):854-859.
44. Wells JT, Ment LR. Prevention of Intraventricular hemorrhage in pre-term infants. Early
Hum Dev 1995; 42:209-233.
45. Vohr B, Ment LR. Intraventricular hemorrhage in the preterm infant. Early Hum Dev 1996;
44:1-16.
35
46. Heuchan AM, Evans N, Henderson Smart DJ, Simpson JM. Perinatal risk factors for major
Intraventricular hemorrhage in the Australian and New Zealand Neonatal Network, 19951997. Arch Dis Child Fetal Neonatal Ed 2002; 86:86-90.
47. Oh W, Fanaroff AA, Verter J, et al. Neonatal mortality and morbidity in very low birth
weight (VLBW) infants: a seven year trend analysis of the Neonatal Research Network data.
Pediatr Res 1996; 39:235A.
48. Shankaran S, Bauer CR, Bain R, et al. Prenatal and Perinatal risk and protective factors for
neonatal intracranial hemorrhage. Arch Pediatr Adolesc Med 1996; 150:491-497.
49. Verma U, Tejani N, Klein S, et al. Obstetric antecedents of intraventricular hemorrhage and
periventricular leukomalacia in the very low-birth-weight neonate. Am J Obstet Gynecol
1997; 176:275-281.
50. Gleissner M, Jorch G, Avenerius S. Risk factors for intravetricular hemorrhage in a birth
cohort of 3721 premature infants. J Perinat Med 2000; 28:104-110.
51. Weintraub Z, Solovechick M, Reichman B et al. Effect of maternal tocolysis on the incidence
of severe periventricular/Intraventricular hemorrhage in very low birth weight infants. Arch
Dis Child Fetal Neonatal Ed 2001; 85:F13-F17.
52. Synnes AR, Chein LY, Peliowski A et al. Variations in intraventricular hemorrhage
incidence rates among Canadian neonatal intensive care units. J Pediatr 2001; 138:525-531.
53. Ertan AK, Tanriverdi HA, et al. Perinatal risk factors for neonatal intracerebral hemorrhage
in preterm infants. European Journal of Obstetrics and Gynaecology and Reproductive
Biology 2006; 127:29-34.
54. Hansen A, Leviton A. Labor and delivery characteristics and risks of cranial ultrasonographic
abnormalities among very low birth weight infants. Am J Obstet Gynecol 1999; 181:9971006.
55. Levene MI, Fawer CL, Lamont RF. Risk factors in the development of Intraventricular
hemorrhage in the preterm neonate. Arch Dis in Child 1982; 57:410-417.
56. Cools F, Offringa M Meta-analysis of elective high frequency ventilation in preterm infants
with respiratory distress syndrome. Arch Dis Fetal Neonatal Ed 1999; 80:F15-F20.
57. Volpe JJ. Intraventricular hemorrhage in premature infant: current concepts part II. Ann
Neurol 1989; 25:109-116.
36
58. Lee JY, Kim SK, et al. Risk factors for periventricular-intraventricular hemorrhage in
premature infants. J Korean Med Sci 2010; 25(3):418-424.
59. Ment LR, Oh W, Ehrenkranz RA, et al. Antenatal steroids, delivery mode and
Intraventricular hemorrhage in preterm infants. Am J Obstet Gynacol 1995; 172:795-800.
60. Shaver DC, Bada HS, Korones SB, et al. Early and late intraventricular hemorrhage: the role
of obstetric factors. Obstet Gynecol 1992; 80:831-837.
61. Harke HT, Haeye RI, Storch A et al. Perinatal Cerebral hemorrhage. J Pediatr 1972; 37:80.
62. Phillip AG, Allan WC, Tito AM, Wheeler LR. Intraventricular hemorrhage in preterm
infants: declining incidence in the 1980’s. Pediatrics 1989; 84(5):797-801.
63. Takashima S, Becker LE. Intraventricular and subependymal hemorrhage in infants dying
within 10 hours of birth. Brain Dev 1983; 5(1):9-13.
64. Morals WJ, Koerten J. Obstetric management and Intraventricular hemorrhage in very-lowbirth-weight infants 1986; 68(1):35-40.
65. Partridge JC, Babcock DS, Steichen JJ, Han BK. Optimal timing for diagnostic cranial
ultrasound in low birth-weight infants: detection of intracranial hemorrhage and ventricular
dilation. J Pediatr 1983; 102(2):281-287.
66. Perlman JM, Volpe JJ. Intraventricular hemorrhage in extremely small premature infants.
Am J Dis Child 1986; 140(11):1122-1124.
67. Emerson P, Fujimura M, Howat P, et al. Timing of Intraventricular hemorrhage. Arch Dis
Child 1977; 52:183-187.
68. Berger R, Bender S, Sefkow S, Klingmuller V, Kunzel W, Jensen A. Peri/Intraventricular
hemorrhage: a cranial ultrasound study on 5286 neonates. Euro J Obstet Gynecol 1997;
75:191-203.
69. Garcia-Prats JA, Porcianoy RS, Adams JM, Rudolph AJ. The hyaline membrane diseaseintraventricular hemorrhage in very low birth weight infants: perinatal aspects. Acta Paediatr
Scand 1982; 71:79-84.
70. Dykes FD, Lazzara A, Ahmann P, Blumenstein B, Schwartz J, Brann AW. Intraventricular
hemorrhage: a prospective evaluation on etiogenesis. Pediatrics 1980; 66:42-49.
37
APPENDIX 1: Data collection sheet A
Anterior fontanelle
Time
Colour of the bleed
Echogenic
Hypoechoic
Echogenic
Hypoechoic
Echogenic
Hypoechoic
Echogenic
Hypoechoic
Echogenic
Hypoechoic
Echogenic
Hypoechoic
Echogenic
Hypoechoic
Heterogeneous
Heterogeneous
Heterogeneous
Heterogeneous
Heterogeneous
Heterogeneous
Heterogeneous
Speckled (mixed density)
Speckled (mixed density)
Speckled (mixed density)
Speckled (mixed density)
Speckled (mixed density)
Speckled (mixed density)
Speckled (mixed density)
Cysts
Cysts
Cysts
Cysts
Cysts
Cysts
Cysts
3 days
Anterior horn
Body
Posterior horn
Temporal horn
Trigone
Parafalx
Other
Echogenic
Echogenic
Echogenic
Echogenic
Echogenic
Echogenic
Echogenic
Hypoechoic
Hypoechoic
Hypoechoic
Hypoechoic
Hypoechoic
Hypoechoic
Hypoechoic
Heterogeneous
Heterogeneous
Heterogeneous
Heterogeneous
Heterogeneous
Heterogeneous
Heterogeneous
Speckled (mixed density)
Speckled (mixed density)
Speckled (mixed density)
Speckled (mixed density)
Speckled (mixed density)
Speckled (mixed density)
Speckled (mixed density)
Cysts
Cysts
Cysts
Cysts
Cysts
Cysts
Cysts
7 days
Anterior horn
Body
Posterior horn
Temporal horn
Trigone
Parafalx
Other
Echogenic
Echogenic
Echogenic
Echogenic
Echogenic
Echogenic
Echogenic
Hypoechoic
Hypoechoic
Hypoechoic
Hypoechoic
Hypoechoic
Hypoechoic
Hypoechoic
Heterogeneous
Heterogeneous
Heterogeneous
Heterogeneous
Heterogeneous
Heterogeneous
Heterogeneous
Speckled (mixed density)
Speckled (mixed density)
Speckled (mixed density)
Speckled (mixed density)
Speckled (mixed density)
Speckled (mixed density)
Speckled (mixed density)
Cysts
Cysts
Cysts
Cysts
Cysts
Cysts
Cysts
24 hour
Anatomical
Anterior horn
Body
Posterior horn
Temporal horn
Trigone
Parafalx
Other
LT
RT
38
APPENDIX 1: Data collection sheet A
Time after delivery
24hours
3days
7days
Anatomical
Region
Left posterior
horn
Right posterior
horn
Other
Left posterior
horn
Right posterior
horn
Other
Left posterior
horn
Right posterior
horn
Other
Posterior fontanelle
Colour of the bleed
Echogenic
Hypoechoic
Heterogeneous
Echogenic
Hypoechoic
Heterogeneous
Echogenic
Hypoechoic
Heterogeneous
Echogenic
Hypoechoic
Heterogeneous
Echogenic
Hypoechoic
Heterogeneous
Echogenic
Hypoechoic
Heterogeneous
Echogenic
Hypoechoic
Heterogeneous
Echogenic
Hypoechoic
Heterogeneous
Echogenic
Hypoechoic
Heterogeneous
Speckled( mixed
density)
Speckled( mixed
density
Speckled( mixed
density
Speckled( mixed
density
Speckled( mixed
density
Speckled( mixed
density
Speckled( mixed
density
Speckled( mixed
density
Speckled( mixed
density
Cyst
Cyst
Cyst
Cyst
Cyst
Cyst
Cyst
Cyst
Cyst
39
APPENDIX 2
STATISTICAL ANALYSES
The Chairperson,
Medunsa Campus Research and Ethics Committee (MCREC),
Box ______________
UNIVERSITY OF LIMPOPO
Medunsa Campus
Dear Sir/Madam
STATISTICAL ANALYSES
I have studied the research protocol of
DR TL LENTSOANE
__________________________________________________________________________________
INTRAVENTRICULAR HEAMORRHAGE IN PREMATURE BABIES AT DR
Titled: _____________________________________________________________________________
GEORGE MUKHARI HOSPITAL, PRETORIA
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
and I agree to assist with the statistical analyses.
Yours sincerely,
______________________________________
Signature: Statistician
SAM NTULI
_______________________________________
Name in block letters
20 /07/2011
Date
*
Please delete which is not applicable. If you do not agree to assist with the statistical analyses, please
provide reasons on a separate sheet.
40
APPENDIX 3
41
APPENDIX 4
UNIVERSITY OF LIMPOPO (Medunsa Campus) ENGLISH CONSENT FORM
Statement concerning participation in a Clinical Trial/Research Project*.
Name of Project / Study / Trial*
........................................................................................................................................................................... …….
...................................................................................................................................................................................
...................................................................................................................................................................................
I have read the information on */heard the aims and objectives of* the proposed study and was provided the
opportunity to ask questions and given adequate time to rethink the issue. The aim and objectives of the study are
sufficiently clear to me. I have not been pressurized to participate in any way.
I understand that participation in this Clinical Trial / Study / Project* is completely voluntary and that I may withdraw
from it at any time and without supplying reasons. This will have no influence on the regular treatment that holds for
my condition neither will it influence the care that I receive from my regular doctor.
I know that this Trial / Study / Project* has been approved by the Medunsa Campus Research and Ethics (MREC),
University of Limpopo (Medunsa Campus) / Dr George Mukhari Hospital. I am fully aware that the results of this
results of this Trial / Study / Project* will be used for scientific purposes and may be published. I agree to this,
provided my privacy is guaranteed.
I hereby give consent to participate in this Trial / Study / Project*.
............................................................
Name of patient/volunteer
........................................................
Signature of patient or guardian.
................................
....................................
................................................
Place.
Date.
Witness
___________________________________________________________________________
Statement by the Researcher
I provided verbal and/or written* information regarding this Trial / Study / Project*
I agree to answer any future questions concerning the Trial / Study / Project* as best as I am able.
I will adhere to the approved protocol.
....................................... ....................................
Name of Researcher
Signature
*Delete whatever is not applicable.
...............……
Date
Place
42
APPENDIX 4
UNIVERSITY OF LIMPOPO (Medunsa Campus) SETSWANA CONSENT FORM
Seteitemente se se ka ga go tsaya karolo mo Tekopatlisisong / Porojeke ya Patlisiso*.
Leina la Porojeke / Patlisiso / Tekelelo*
........................................................................................................................................................................... …….
...................................................................................................................................................................................
...................................................................................................................................................................................
Ke buisitse tshedimosetso mo */ke utlwile maitlhomo le maikemisetso a* patlisiso e e tshitshintsweng mme ke filwe
tšhono ya go botsa dipotso le go fiwa nako e e lekaneng ya go akanya gape ka ntlha e. Maitlhomo le maikemisetso a
patlisiso e a tlhaloganyega sentle. Ga ke a patelediwa ke ope ka tsela epe go tsaya karolo.
Ke tlhaloganya gore go tsaya karolo mo Tekopatlisisong e / Patlisiso / Porojeke* ke boithaopo le gore nka ikgogela
morago mo go yona ka nako nngwe le nngwe kwa ntle ga go neela mabaka. Se ga se kitla se nna le seabe sepe mo
kalafong ya me ya go le gale ya bolwetsi jo ke nang le jona e bile ga se kitla se nna le tlhotlheletso epe mo
tlhokomelong e ke e amogelang mo ngakeng ya me ya go le gale.
Ke a itse gore Tekopatlisiso / Patlisiso / Porojeke* e e rebotswe ke Patlisiso le Molao wa Maitsholo tsa Khampase ya
Medunsa (MREC), Yunibesithi ya Limpopo (Khampase ya Medunsa) / Bookelo jwa Ngaka George Mukhari. Ke itse
ka botlalo gore dipholo tsa Tekelelo / Patlisiso / Porojeke* di tla dirisetswa mabaka a saentifiki e bile di ka nna tsa
phasaladiwa. Ke dumelana le seno, fa fela go netefadiwa gore se e tla nna khupamarama.
Fano ke neela tumelelo ya go tsaya karolo mo Tekelelong / Patlisiso / Porojeke* e.
............................................................
Leina ka molwetse/moithaopi
........................................................
Tshaeno ya molwetse kgotsa motlamedi.
................................
....................................
................................................
Lefelo.
Letlha.
Paki
___________________________________________________________________________
Seteitemente ka Mmatlisisi
Ke tlametse tshedimosetso ka molomo le/kgotsa e e kwadilweng malebana le Tekelelo / Patlisiso / Porojeke* e.
Ke dumela go araba dipotso dingwe le dingwe mo nakong e e tlang tse di amanang le Tekelelo / Patlisiso / Porojeke*
ka moo nka kgonang ka teng.
Ke tla tshegetsa porotokolo e e rebotsweng.
....................................... ....................................
...............……
Leina la Mmatlisisi
Tshaeno
Letlha
Lefelo
*Phimola sengwe le sengwe se se seng maleba.
43
APPENDIX 5
PARTICIPANT INFORMATION AND INFORMED CONSENT
INTRAVENTRICULAR HEMORRHAGE IN PREMATURE BABIES AT DR GEORGE
MUKHARI HOSPITAL, PRETORIA
PARTICIPANT INFORMATION
INTRODUCTION
I invite you and your baby to volunteer for a research study. This information sheet is to help you
decide if you would like to participate. Before you agree to take part in this study you should
fully understand what is involved. If you have any questions, which are not fully explained in
this leaflet, please ask the interviewer. You should not agree to take part unless you are
completely happy about the study.
THE PURPOSE OF THIS STUDY
Your baby has been born before the expected due date and may develop a bleed in the brain. We
will be taking pictures of the brain using a machine that will not cause any harm but may be a
little uncomfortable. This will help us to identify the bleed early and prevent complications.
WHAT DOES THE STUDY INVOLVE?
If you agree for your baby to take part, you will be one of approximately 60 mothers who gave
birth to a premature baby.
The following will be done:
Your baby’s file will be studied and all problems encountered while being admitted, procedures
done and medication given will be written down on a recording sheet.
44
This information will help in identifying the predisposing factors. Ultrasound scans will be
performed on all premature babies within 24hours, on day 3 and on day 7 to identify any
bleeding.
Advantages of ultrasound scans: it is not harmful, no radiation, no side effects, easily available,
the investigation will be done at the bed side in the ward. Your doctor will be informed of the
results and should you wish to know the results these will be given to you.
ETHICAL APPROVAL
Approval has been obtained from MREC, clearance certificate no……………….
YOUR RIGHTS AS A PARTICIPANT
Your baby’s participation in this study is entirely voluntary and you can refuse for your baby to
participate or stop at any time without stating any reason. The treatment your child obtains will
not be affected at all if you decide not to participate or if you want to stop participating at any
time.
CONFIDENTIALITY
All information obtained during this study is strictly confidential. Identifies will not appear on
the data collection sheet however the identities of the babies must be known so that appropriate
treatment may be delivered as part of the standard of care.
Any concerns or questions can be directed to Dr TL. Lentsoane, Department of Diagnostic
Radiology,
MEDUNSA. Tel: 0827466779
Email: lenake@webmail.co.za
Postal: Box 2417
Medunsa
0204
45
APPENDIX 5
TSHEDIMOSETSO YA MOTSAYAKAROLO LE TUMELELO E E IKAEGILENG KA
TSHEDIMOSETSO
TIRAGALO YA GO DUTLA MADI MO TENG GA BENTERIKELE MO MASEENG A
A TSHOLWANG PELE GA NAKO KWA BOOKELONG JWA GEORGE MUHARI,
PRETORIA
TSHEDIMOSETSO YA MOTSAYAKAROLO
MATSENO
Ke laletsa wena le ngwana wag ago go ithaopa go nna karolo ya patlisiso. Tsebe e ya
tshedimosetso e go thusa gore e tseye tshwetso ya gore a o tla rata ge ngwana a tsaya karolo. Pele
ga o dumela gore ngwana a tsaye karolo o tshwanetse go tlhaloganya ka botlalo gore seno ke ka
ga eng. Fa o na le dipotso dingwe, tse di sa tlhalosiwang ka botlalo mo tsebeng e, ke kopa o
botse motho yo o go botsang dipotso. Ga o a tshwanela go tsaya karalo ntle le fa o itumelela
patlisiso e ka gotlhe.
MAIKEMISETSO A ITHUTO E
Lesea la gago le tshotswe pele ga nako e go neng go solofetswe la ka tsholwa ka yona, ka jalo go
nale kgonagalo ya gore a katswe a na le madi mo booking jwa gagwe. Re tsile go dirisa motshini
oo ka se mo ameng ka gope, go tsaya ditshwantsho tsa booko jwa gagwe, fela a ka nne a se
nnisege mo go ona.
ITHUTO E KA GA ENG?
Fa o tsaya tshwetso gore ngwana a tsaye karalo o tla nna mongwe wa bomme b aba
lekanyetswang go 60 ba ba belegeng bana pele ga nako.
46
Go tla dirwa tse di lateng:
Faele ya ngwana wag ago e tla ithutiwa, mathata otlhe a gagwe a tla kwala mo go yona ka nako e
a tla beng a rabadiwa mo bookelong , sengwe se se tla diriwang mo go ena, le meleme yotlhe e a
tla e newang, di tla kwalwa mo letlakaleng lele matshwanedi. Se, se tla re thusa mo go go itsing
gore (matsapa di a tsaya kae) ke mabaka mafeng aa ka bong a na le maikarabelo a a tsisang madi
mo bookong. Go leba setshwantsho sa mo teng ga karolo nngwe ya mmele go tla dirwa mo
baneng botlhe b aba tshotsweng pele ga nako mo diureng tse 24, ka letsatsi la bo 3, le ka letsatsi
la 7 go lemoga fa go na le madi mangwe a a dutlang. Mesola ya go leba setshwantsho sa mo teng
ga karolo nngwe ya mmele: ga go kotsi, ga go na phasalalagote, ga go na ditlamorago, go
fitlhelelwa bonolo, bana ba tla direlwa mo dikubikeleng tsa bona.
TETLELELO GO YA KA NGWAO
Tetlelelo ya go dira se, re e abetswe ke ba MREC, clearance no…………..
DITSHWANELO TSA GAGO JAAKA MOTSAYAKAROLO
Go tsaya karolo ga ngwana wag ago mo ithutong e ke ka go ithaopa mme a ka nna wa gana gore
ngwana a tsaye karolo kgotsa wa emisa nako nngwe le nngwe kwa ntle ga go tlhalosa mabaka.
Kalafi e ngwana wagago a e amogelang ga e kitla e amega ka gope fa o tsaya tshwetso ya go se
tseye karolo kgotsa fa o batla go emisa go tsaya karolo ka nako nngwe le nngwe.
KHUPAMARAMA
Tshedimosetso e e amogetsweng ka nako ya ithuto e ke khupamarama. Ditshupo tsa batho ga di
kitla di tlhagelela mo tsebeng ya tshedimosetso mme ditshupo tsa bana di tshwanetse go itsiwe
gore ba fiwe kalafi e e maleba jaaka ya maemo a tlhokomelo.
Batho ba o ka ikgolaganyang nabo: Ngaka TL. Lentsoane, Lefapha la Tupo ya Radioloji
MEDUNSA, Mogala: 0827466779
47
1
APPENDIX 6: Clinical Data Sheet B
Date of admission
18
dd
/
10
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
17
yrs.
Antenatal history
X
Parity
2
Booked
Gravidity
1
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Resuscitation
Oxygen
Bag & Mask
Apgar score
1 min
5 min
10 min
X
No
X
Unknown
ETT
Unknown
Unknown
BABY DATA
Gender
Male
Gestation age
28wks
Birth weight
Length
38cm
Skull Circumference
Admission diagnosis
X
950
Female
grams
25cm
X
X
X
RDS
SGA
LGA
Anemia
Hypoxia
Surfactant therapy
X
IPPV
Oxygen prongs
nCPAP
Respiratory support
Management
X
X
Blood Transfusion
X
Bolus
Bolus repeat
X
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Prematurity
Curosurf
Survanta
Indomethacin
Inotropes
Yes
No
Sodabic infusion
X
Yes
No
Outcome
X
Died
Alive
48
APPENDIX 6: Clinical Data Sheet B
2
Date of admission
18
dd
/
10
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
17
yrs.
Antenatal history
X
Parity
2
Booked
Gravidity
1
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Resuscitation
Oxygen
Bag & Mask
Apgar score
1 min
5 min
10 min
X
No
X
Unknown
ETT
Unknown
Unknown
BABY DATA
Gender
Male
Gestation age
28wks
Birth weight
Length
38cm
Skull Circumference
Admission diagnosis
X
X
X
1000
Female
grams
27cm
RDS
SGA
LGA
Anemia
Hypoxia
X
Surfactant therapy
Respiratory support
X
IPPV
Oxygen prongs
nCPAP
Management
X
Bolus
Bolus repeat
Blood Transfusion
X
X
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Prematurity/PDA
X
Curosurf
Survanta
Indomethacin
Inotropes
Yes
No
Sodabic infusion
X
Yes
No
Outcome
X
Died
Alive
49
3
APPENDIX 6: Clinical Data Sheet B
Date of admission
22
dd
/
09
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
30
yrs.
Antenatal history
Parity
Booked
3
X
Gravidity
3
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
No
X
Unknown
ETT
6
8
BABY DATA
Gender
Male
Gestation age
27
Birth weight
Length
35cm
Skull Circumference
Admission diagnosis
X
X
X
RDS
SGA
LGA
Anemia
Hypoxia
X
IPPV
Oxygen prongs
nCPAP
Respiratory support
Management
Bolus
Bolus repeat
Blood Transfusion
Yes
No
Sodabic infusion
Yes
No
Outcome
X
X
950
Female
grams
24cm
X
X
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Prematurity/PDA
X
Curosurf
Survanta
Indomethacin
Inotropes
Died
Alive
50
4
APPENDIX 6: Clinical Data Sheet B
Date of admission
02
dd
/
11
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
22
yrs.
Antenatal history
Parity
Booked
2
Gravidity
X
Unbooked
2
LABOUR AND DELIVERY DATA
Mode of Delivery
NVD
X
C/S
Assisted delivery
Yes
X
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
Unknown
ETT
8
8
BABY DATA
Gender
Male
Gestation age
34wks
Birth weight
Length
38cm
Skull Circumference
Admission diagnosis
X
X
RDS
SGA
LGA
Anemia
Hypoxia
X
IPPV
Oxygen prongs
nCPAP
Respiratory support
Management
Blood Transfusion
Bolus
Bolus repeat
X
Sodabic infusion
X
1360
Female
grams
30cm
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Prematurity
Surfactant therapy
X
Curosurf
Survanta
Indomethacin
Inotropes
Yes
No
Yes
No
Outcome
X
Died
Alive
51
5
APPENDIX 6: Clinical Data Sheet B
Date of admission
18
dd
/
10
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
34
yrs.
Antenatal history
X
Parity
Gravidity
Booked
2
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
NVD
X
C/S
Assisted delivery
Yes
X
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Resuscitation
Oxygen
Bag & Mask
Apgar score
1 min
5 min
10 min
X
Unknown
ETT
4
6
BABY DATA
Gender
X
Male
Gestation age
30wks
Birth weight
Length
35cm
Skull Circumference
Admission diagnosis
X
X
Respiratory support
X
RDS
SGA
LGA
Anemia
Hypoxia
IPPV
Oxygen prongs
nCPAP
Management
X
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
Sodabic infusion
X
Yes
No
Outcome
X
Female
1140
grams
29cm
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Prematurity/PDA
Surfactant therapy
X
Curosurf
Survanta
Indomethacin
Inotropes
Died
Alive
52
6
APPENDIX 6: Clinical Data Sheet B
Date of admission
26
dd
/
10
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
33
yrs.
Antenatal history
X
Parity
3
Booked
Gravidity
3
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
No
X
Unknown
ETT
3
7
BABY DATA
Gender
Male
Gestation age
30wks
Birth weight
Length
34cm
Skull Circumference
Admission diagnosis
X
X
X
X
RDS
SGA
LGA
Anemia
Hypoxia
X
IPPV
Oxygen prongs
nCPAP
Respiratory support
Management
X
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
Sodabic infusion
X
920
Female
grams
26cm
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Prematurity
X
Curosurf
Survanta
Indomethacin
Inotropes
Yes
No
Outcome
X
Died
Alive
53
7
APPENDIX 6: Clinical Data Sheet B
Date of admission
26
dd
/
10
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
33
yrs.
Antenatal history
X
Parity
3
Booked
Gravidity
3
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
No
X
Unknown
ETT
4
6
BABY DATA
Gender
Male
Gestation age
29wks
Birth weight
Length
36cm
Skull Circumference
Admission diagnosis
X
X
X
Respiratory support
Management
X
X
Blood Transfusion
Sodabic infusion
X
920
Female
grams
24cm
RDS
SGA
LGA
Anemia
Hypoxia
X
IPPV
Oxygen prongs
nCPAP
Surfactant therapy
Bolus
Bolus repeat
X
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Prematurity
X
Curosurf
Survanta
Indomethacin
Inotropes
Yes
No
X
Outcome
X
Yes
No
Died
Alive
54
8
APPENDIX 6: Clinical Data Sheet B
Date of admission
20
dd
/
10
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
18
yrs.
Antenatal history
X
Parity
1
Booked
Gravidity
1
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Unknown
Resuscitation
Oxygen
Bag & Mask
ETT
Apgar score
1 min
5 min
10 min
Unknown
Unknown
BABY DATA
Gender
Male
Gestation age
32
Birth weight
Length
43cm
Skull Circumference
Admission diagnosis
X
X
RDS
SGA
LGA
Anemia
Hypoxia
X
IPPV
Oxygen prongs
nCPAP
Respiratory support
Management
X
Bolus
Bolus repeat
Blood Transfusion
Yes
No
Sodabic infusion
Yes
No
Outcome
X
X
1480
Female
grams
29cm
X
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Prematurity
Surfactant therapy
X
Curosurf
Survanta
Indomethacin
Inotropes
Died
Alive
55
9
APPENDIX 6: Clinical Data Sheet B
Date of admission
27
dd
/
10
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
36
yrs.
Antenatal history
X
Parity
4
Booked
Gravidity
4
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
No
X
Unknown
ETT
7
8
BABY DATA
Gender
X
Male
Gestation age
28
Birth weight
Length
38cm
Skull Circumference
Admission diagnosis
X
X
X
RDS
SGA
LGA
Anemia
Hypoxia
X
IPPV
Oxygen prongs
nCPAP
Respiratory support
Management
Bolus
Bolus repeat
Blood Transfusion
Yes
No
Sodabic infusion
X
Outcome
X
Female
880
grams
26cm
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Prematurity
X
Curosurf
Survanta
Indomethacin
Inotropes
Yes
No
Died
Alive
56
10
APPENDIX 6: Clinical Data Sheet B
Date of admission
19
dd
/
10
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
18
yrs.
Antenatal history
X
Parity
2
Booked
Gravidity
2
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Resuscitation
Oxygen
Bag & Mask
Apgar score
1 min
5 min
10 min
X
No
X
Unknown
ETT
4
6
BABY DATA
Gender
X
Male
Gestation age
33wks
Birth weight
Length
44cm
Skull Circumference
Admission diagnosis
X
X
RDS
SGA
LGA
Anemia
Hypoxia
X
IPPV
Oxygen prongs
nCPAP
X
Respiratory support
Management
Bolus
Bolus repeat
Blood Transfusion
Yes
No
Sodabic infusion
X
Yes
No
X
Died
Alive
Outcome
Female
2260
grams
34cm
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Prematurity
Surfactant therapy
X
Curosurf
Survanta
Indomethacin
Inotropes
57
11
APPENDIX 6: Clinical Data Sheet B
Date of admission
19 /
dd
10
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
28
yrs.
Antenatal history
X
Parity
3
Booked
Gravidity
3
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
NVD
X
C/S
Assisted delivery
Yes
X
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
Unknown
ETT
8
9
BABY DATA
Gender
X
Male
Gestation age
33wks
Birth weight
Length
43cm
Skull Circumference
Admission diagnosis
RDS
SGA
LGA
Anemia
Hypoxia
Respiratory support
IPPV
Oxygen prongs
nCPAP
Management
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
X
Yes
No
X
Died
Alive
Sodabic infusion
Outcome
Female
1650
grams
31cm
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Prematurity
Curosurf
Survanta
Indomethacin
Inotropes
58
12
APPENDIX 6: Clinical Data Sheet B
Date of admission
09
dd
/
11
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
22
yrs.
Antenatal history
Parity
Booked
2
Gravidity
X
Unbooked
2
LABOUR AND DELIVERY DATA
Mode of Delivery
NVD
X
C/S
Assisted delivery
Yes
X
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
X
Unknown
Resuscitation
Oxygen
Bag & Mask
X
ETT
Apgar score
1 min
5 min
10 min
3
2
BABY DATA
Gender
X
Male
Gestation age
32wks
Birth weight
Length
42cm
Skull Circumference
Admission diagnosis
grams
31cm
X
X
Surfactant therapy
X
IPPV
Oxygen prongs
nCPAP
X
Blood Transfusion
X
Sodabic infusion
1630
RDS
SGA
LGA
Anemia
Hypoxia
Respiratory support
Management
Female
X
Outcome
X
Bolus
Bolus repeat
X
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Prematurity
X
Curosurf
Survanta
Indomethacin
Inotropes
Yes
No
Yes
No
Died
Alive
59
13
APPENDIX 6: Clinical Data Sheet B
Date of admission
28
dd
/
09
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
21
yrs.
Antenatal history
Parity
Booked
1
X
Gravidity
1
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Resuscitation
Oxygen
Bag & Mask
Apgar score
1 min
5 min
10 min
X
No
X
Unknown
ETT
2
4
BABY DATA
Gender
Male
Gestation age
30wks
Birth weight
Length
41cm
Skull Circumference
Admission diagnosis
X
X
X
Respiratory support
X
Management
X
1330
Female
grams
28cm
RDS
SGA
LGA
Anemia
Hypoxia
X
IPPV
Oxygen prongs
nCPAP
Surfactant therapy
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
Sodabic infusion
X
Yes
No
Outcome
X
Died
Alive
X
X
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Prematurity
Curosurf
Survanta
Indomethacin
Inotropes
60
14
APPENDIX 6: Clinical Data Sheet B
Date of admission
15
dd
/
11
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
28
yrs.
Antenatal history
X
Parity
3
Booked
Gravidity
3
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
NVD
X
C/S
Assisted delivery
Yes
X
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
Unknown
ETT
7
8
BABY DATA
Gender
X
Male
Gestation age
32wks
Birth weight
Length
41cm
Skull Circumference
Admission diagnosis
X
X
X
RDS
SGA
LGA
Anemia
Hypoxia
X
IPPV
Oxygen prongs
nCPAP
Respiratory support
Management
X
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
Sodabic infusion
X
Yes
No
Outcome
X
Female
1510
grams
30cm
X
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Prematurity
X
Curosurf
Survanta
Indomethacin
Inotropes
Died
Alive
61
15
APPENDIX 6: Clinical Data Sheet B
Date of admission
11
dd
/
10
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
39
yrs.
Antenatal history
X
Parity
4
Booked
Gravidity
3
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
NVD
X
C/S
Assisted delivery
Yes
X
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
Unknown
ETT
4
6
BABY DATA
Gender
Male
Gestation age
33wks
Birth weight
Length
42cm
Skull Circumference
Admission diagnosis
X
X
Respiratory support
X
grams
34cm
X
IPPV
Oxygen prongs
nCPAP
Surfactant therapy
X
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
Sodabic infusion
X
Yes
No
X
1740
Female
RDS
SGA
LGA
Anemia
Hypoxia
Management
Outcome
X
X
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Prematurity
X
Curosurf
Survanta
Indomethacin
Inotropes
Died
Alive
62
16
APPENDIX 6: Clinical Data Sheet B
Date of admission
11
dd
/
10
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
39
yrs.
Antenatal history
X
Parity
4
Booked
Gravidity
3
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
NVD
X
C/S
Assisted delivery
Yes
X
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
Unknown
ETT
3
4
BABY DATA
Gender
X
Male
Gestation age
33wks
Birth weight
Length
42cm
Skull Circumference
Admission diagnosis
X
X
Respiratory support
Management
X
X
Blood Transfusion
X
Sodabic infusion
X
Outcome
X
RDS
SGA
LGA
Anemia
Hypoxia
IPPV
Oxygen prongs
nCPAP
Bolus
Bolus repeat
Female
1660
grams
30cm
X
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Prematurity
Surfactant therapy
X
Curosurf
Survanta
Indomethacin
Inotropes
Yes
No
Yes
No
Died
Alive
63
17
APPENDIX 6: Clinical Data Sheet B
Date of admission
14
dd
/
10
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
23
yrs.
Antenatal history
Parity
Booked
3
X
Gravidity
2
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Resuscitation
Oxygen
Bag & Mask
Apgar score
1 min
5 min
10 min
X
No
X
Unknown
ETT
7
8
BABY DATA
Gender
X
Male
Gestation age
32wks
Birth weight
Length
38cm
Skull Circumference
Admission diagnosis
X
X
X
X
RDS
SGA
LGA
Anemia
Hypoxia
Respiratory support
X
IPPV
Oxygen prongs
nCPAP
Management
X
Bolus
Bolus repeat
Blood Transfusion
Sodabic infusion
Female
980
grams
26cm
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Prematurity/PDA
X
Curosurf
Survanta
Indomethacin
Inotropes
Yes
No
X
Outcome
X
Yes
No
Died
Alive
64
18
APPENDIX 6: Clinical Data Sheet B
Date of admission
14
dd
/
10
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
23
yrs.
Antenatal history
Parity
Booked
3
X
Gravidity
2
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Resuscitation
Oxygen
Bag & Mask
Apgar score
1 min
5 min
10 min
X
No
X
Unknown
ETT
6
8
BABY DATA
Gender
Male
Gestation age
33wks
Birth weight
Length
39cm
Skull Circumference
Admission diagnosis
X
X
Respiratory support
X
RDS
SGA
LGA
Anemia
Hypoxia
IPPV
Oxygen prongs
nCPAP
Management
X
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
Sodabic infusion
X
Yes
No
Outcome
X
X
1130
Female
grams
27cm
X
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Prematurity
Surfactant therapy
X
Curosurf
Survanta
Indomethacin
Inotropes
Died
Alive
65
APPENDIX 6: Clinical Data Sheet B
19
Date of admission
11
dd
/
10
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
25
yrs.
Antenatal history
Parity
Booked
2
Gravidity
X
Unbooked
2
LABOUR AND DELIVERY DATA
Mode of Delivery
NVD
X
C/S
Assisted delivery
Yes
X
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
X
Unknown
Resuscitation
Oxygen
Bag & Mask
X
ETT
Apgar score
1 min
5 min
10 min
3
6
BABY DATA
Gender
X
Male
Gestation age
29wks
Birth weight
Length
38cm
Skull Circumference
Admission diagnosis
X
X
X
Respiratory support
X
grams
28cm
X
IPPV
Oxygen prongs
nCPAP
Surfactant therapy
X
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
Sodabic infusion
X
Yes
No
X
1400
RDS
SGA
LGA
Anemia
Hypoxia
Management
Outcome
Female
X
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Prematurity
X
Curosurf
Survanta
Indomethacin
Inotropes
Died
Alive
66
20
APPENDIX 6: Clinical Data Sheet B
Date of admission
4 /
dd
11
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
25
yrs.
Antenatal history
Parity
Booked
2
X
Gravidity
2
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Resuscitation
Oxygen
Bag & Mask
Apgar score
1 min
5 min
10 min
X
Unknown
ETT
Unknown
Unknown
BABY DATA
Gender
X
Male
Gestation age
34wks
Birth weight
Length
37cm
Skull Circumference
Admission diagnosis
X
X
RDS
SGA
LGA
Anemia
Hypoxia
X
IPPV
Oxygen prongs
nCPAP
Respiratory support
Management
X
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
Sodabic infusion
Female
1150
grams
29cm
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Prematurity
Curosurf
Survanta
Indomethacin
Inotropes
Yes
No
Outcome
X
Died
Alive
67
21
APPENDIX 6: Clinical Data Sheet B
Date of admission
23 / 10
dd
/
2009
mm
yy
MATERNAL DEMOGRAPHIC DATA
Age
21
yrs.
Antenatal history
X
Parity
1
Booked
Gravidity
1
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
NVD
X
C/S
Assisted delivery
Yes
X
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Resuscitation
Oxygen
Bag & Mask
Apgar score
1 min
5 min
10 min
X
Unknown
ETT
8
8
BABY DATA
Gender
X
Male
Gestation age
28wks
Birth weight
Length
36cm
Skull Circumference
Admission diagnosis
X
X
Respiratory support
X
RDS
SGA
LGA
Anemia
Hypoxia
IPPV
Oxygen prongs
nCPAP
Management
X
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
Sodabic infusion
X
Yes
No
Outcome
X
Female
1100
grams
28cm
X
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Prematurity/PDA
Surfactant therapy
X
Curosurf
Survanta
Indomethacin
Inotropes
Died
Alive
68
22
APPENDIX 6: Clinical Data Sheet B
Date of admission
14
dd
/
10
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
28
yrs.
Antenatal history
X
Parity
2
Booked
Gravidity
4
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
NVD
Assisted delivery
Yes
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
C/S
X
Unknown
ETT
7
8
BABY DATA
Gender
X
Male
Gestation age
26wks
Birth weight
Length
33cn
Skull Circumference
Admission diagnosis
X
X
X
RDS
SGA
LGA
Anemia
Hypoxia
X
IPPV
Oxygen prongs
nCPAP
Respiratory support
Management
X
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
Sodabic infusion
X
Yes
No
Outcome
X
Female
900
grams
29cm
X
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Prematurity/PDA
X
Curosurf
Survanta
Indomethacin
Inotropes
Died
Alive
69
23
APPENDIX 6: Clinical Data Sheet B
Date of admission
02
dd
/
11
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
18
yrs.
Antenatal history
X
Parity
2
Booked
Gravidity
1
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
NVD
X
C/S
Assisted delivery
Yes
X
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Resuscitation
Oxygen
Bag & Mask
Apgar score
1 min
5 min
10 min
X
Unknown
ETT
6
7
BABY DATA
Gender
Male
Gestation age
32wks
Birth weight
Length
37cm
Skull Circumference
Admission diagnosis
X
X
RDS
SGA
LGA
Anemia
Hypoxia
Respiratory support
IPPV
Oxygen prongs
nCPAP
Management
Bolus
Bolus repeat
Blood Transfusion
X
Sodabic infusion
1360
Female
grams
28cm
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Prematurity
Curosurf
Survanta
Indomethacin
Inotropes
Yes
No
X
Yes
No
X
Died
Alive
Outcome
X
70
24
APPENDIX 6: Clinical Data Sheet B
Date of admission
02
dd
/
11
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
18
yrs.
Antenatal history
X
Parity
2
Booked
Gravidity
1
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
NVD
X
C/S
Assisted delivery
Yes
X
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Unknown
Oxygen
Bag & Mask
ETT
Resuscitation
X
Apgar score
1 min
5 min
10 min
5
6
BABY DATA
Gender
Male
Gestation age
31wks
Birth weight
Length
41cm
Skull Circumference
Admission diagnosis
X
X
RDS
SGA
LGA
Anemia
Hypoxia
X
IPPV
Oxygen prongs
nCPAP
Respiratory support
Management
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
X
Yes
No
X
Died
Alive
Sodabic infusion
Outcome
X
1130
Female
grams
27cm
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Prematurity
Surfactant therapy
X
Curosurf
Survanta
Indomethacin
Inotropes
71
25
APPENDIX 6: Clinical Data Sheet B
Date of admission
06
dd
/
10
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
32
yrs.
Antenatal history
Parity
Booked
4
X
Gravidity
4
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
No
X
Unknown
ETT
3
7
BABY DATA
Gender
Male
Gestation age
27wks
Birth weight
Length
34cm
Skull Circumference
Admission diagnosis
X
X
RDS
SGA
LGA
Anemia
Hypoxia
X
IPPV
Oxygen prongs
nCPAP
Respiratory support
Management
Bolus
Bolus repeat
Blood Transfusion
X
X
810
Female
grams
24cm
X
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Prematurity
X
Curosurf
Survanta
Indomethacin
Inotropes
Yes
No
Sodabic infusion
X
Yes
No
Outcome
X
Died
Alive
72
26
APPENDIX 6: Clinical Data Sheet B
Date of admission
08
dd
/
11
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
16
yrs.
Antenatal history
Parity
Booked
1
X
Gravidity
1
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
Unknown
ETT
6
7
BABY DATA
Gender
Male
Gestation age
33wks
Birth weight
Length
42cm
Skull Circumference
Admission diagnosis
X
X
Respiratory support
X
Management
Blood Transfusion
RDS
SGA
LGA
Anemia
Hypoxia
IPPV
Oxygen prongs
nCPAP
Bolus
Bolus repeat
X
Sodabic infusion
1420
Female
grams
29cm
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Prematurity
Surfactant therapy
X
Curosurf
Survanta
Indomethacin
Inotropes
Yes
No
X
Yes
No
X
Died
Alive
Outcome
X
73
27
APPENDIX 6: Clinical Data Sheet B
Date of admission
28
dd
/
09
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
24
yrs.
Antenatal history
X
Parity
2
Booked
Gravidity
2
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
No
X
Unknown
ETT
6
8
BABY DATA
Gender
Male
Gestation age
30wks
Birth weight
Length
39cm
Skull Circumference
Admission diagnosis
X
X
X
X
RDS
SGA
LGA
Anemia
Hypoxia
X
IPPV
Oxygen prongs
nCPAP
Respiratory support
Management
X
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
Sodabic infusion
X
Yes
No
Outcome
X
Died
Alive
X
800
Female
grams
24cm
X
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
X
Prematurity
Curosurf
Survanta
Indomethacin
Inotropes
74
28
APPENDIX 6: Clinical Data Sheet B
Date of admission
18
dd
/
10
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
20
yrs.
Antenatal history
X
Parity
1
Booked
Gravidity
1
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
No
X
Unknown
ETT
7
8
BABY DATA
Gender
X
Male
Gestation age
31wks
Birth weight
Length
42cm
Skull Circumference
Admission diagnosis
X
X
Respiratory support
X
Management
Blood Transfusion
RDS
SGA
LGA
Anemia
Hypoxia
IPPV
Oxygen prongs
nCPAP
Bolus
Bolus repeat
X
Sodabic infusion
1360
grams
28cm
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Prematurity
Surfactant therapy
X
Curosurf
Survanta
Indomethacin
Inotropes
Yes
No
X
Yes
No
X
Died
Alive
Outcome
Female
75
29
APPENDIX 6: Clinical Data Sheet B
Date of admission
19
dd
/
10
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
21
yrs.
Antenatal history
Parity
Booked
1
X
Gravidity
1
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
No
X
Unknown
ETT
5
7
BABY DATA
Gender
Male
Gestation age
29wks
Birth weight
Length
38cm
Skull Circumference
Admission diagnosis
RDS
SGA
LGA
Anemia
Hypoxia
Respiratory support
IPPV
Oxygen prongs
nCPAP
Management
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
X
Yes
No
X
Died
Alive
Sodabic infusion
Outcome
X
1380
Female
grams
29cm
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Prematurity
Curosurf
Survanta
Indomethacin
Inotropes
76
APPENDIX 6: Clinical Data Sheet B
30
Date of admission
17
dd
/
11
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
42
yrs.
Antenatal history
X
Parity
3
Booked
Gravidity
3
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
NVD
X
C/S
Assisted delivery
Yes
X
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
Unknown
ETT
9
9
BABY DATA
Gender
X
Male
Gestation age
34wks
Birth weight
Length
47cm
Skull Circumference
Admission diagnosis
X
X
Respiratory support
X
Management
RDS
SGA
LGA
Anemia
Hypoxia
IPPV
Oxygen prongs
nCPAP
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
X
Yes
No
X
Died
Alive
Sodabic infusion
Outcome
Female
2240
grams
34cm
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Prematurity
Curosurf
Survanta
Indomethacin
Inotropes
77
APPENDIX 6: Clinical Data Sheet B
31
Date of admission
30
dd
/
09
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
18
yrs.
Antenatal history
X
Parity
2
Booked
Gravidity
2
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
No
X
Unknown
ETT
8
8
BABY DATA
Gender
Male
Gestation age
32wks
Birth weight
Length
44cm
Skull Circumference
Admission diagnosis
X
Respiratory support
X
Management
RDS
SGA
LGA
Anemia
Hypoxia
IPPV
Oxygen prongs
nCPAP
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
X
Yes
No
X
Died
Alive
Sodabic infusion
Outcome
X
1780
Female
grams
34cm
X
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Prematurity
X
Curosurf
Survanta
Indomethacin
Inotropes
78
32
APPENDIX 6: Clinical Data Sheet B
Date of admission
20
dd
/
10
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
22
yrs.
Antenatal history
X
Parity
1
Booked
Gravidity
1
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
No
X
Unknown
ETT
6
7
BABY DATA
Gender
Male
Gestation age
30wks
Birth weight
Length
44cm
Skull Circumference
Admission diagnosis
X
X
X
Respiratory support
X
Management
Blood Transfusion
RDS
SGA
LGA
Anemia
Hypoxia
IPPV
Oxygen prongs
nCPAP
Bolus
Bolus repeat
X
Sodabic infusion
1370
Female
grams
28cm
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Prematurity
X
Curosurf
Survanta
Indomethacin
Inotropes
Yes
No
X
Yes
No
X
Died
Alive
Outcome
X
79
APPENDIX 6: Clinical Data Sheet B
33
Date of admission
16
dd
/
11
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
27
yrs.
Antenatal history
Parity
Booked
1
Gravidity
X
Unbooked
3
LABOUR AND DELIVERY DATA
Mode of Delivery
NVD
X
C/S
Assisted delivery
Yes
X
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Resuscitation
Oxygen
Bag & Mask
Apgar score
1 min
5 min
10 min
X
Unknown
ETT
8
9
BABY DATA
Gender
X
Male
Gestation age
35wks
Birth weight
Length
44cm
Skull Circumference
Admission diagnosis
RDS
SGA
LGA
Anemia
Hypoxia
Respiratory support
IPPV
Oxygen prongs
nCPAP
Management
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
X
Yes
No
X
Died
Alive
Sodabic infusion
Outcome
Female
1710
grams
30cm
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Prematurity
Curosurf
Survanta
Indomethacin
Inotropes
80
34
APPENDIX 6: Clinical Data Sheet B
Date of admission
17
dd
/
11
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
22
yrs.
Antenatal history
X
Parity
2
Booked
Gravidity
2
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
No
X
Unknown
ETT
8
9
BABY DATA
Gender
X
Male
Gestation age
33wks
Birth weight
Length
41cm
Skull Circumference
Admission diagnosis
RDS
SGA
LGA
Anemia
Hypoxia
Respiratory support
IPPV
Oxygen prongs
nCPAP
Management
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
X
Yes
No
X
Died
Alive
Sodabic infusion
Outcome
Female
1730
grams
30cm
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Prematurity
Curosurf
Survanta
Indomethacin
Inotropes
81
35
APPENDIX 6: Clinical Data Sheet B
Date of admission
28
dd
/
10
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
38
yrs.
Antenatal history
X
Parity
5
Booked
Gravidity
4
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Resuscitation
Oxygen
Bag & Mask
Apgar score
1 min
5 min
10 min
X
No
X
Unknown
ETT
Unknown
Unknown
BABY DATA
Gender
X
Male
Gestation age
34wks
Birth weight
Length
42cm
Skull Circumference
Admission diagnosis
RDS
SGA
LGA
Anemia
Hypoxia
Respiratory support
IPPV
Oxygen prongs
nCPAP
Management
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
X
Yes
No
X
Died
Alive
Sodabic infusion
Outcome
Female
1700
grams
32cm
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Prematurity
Curosurf
Survanta
Indomethacin
Inotropes
82
36
APPENDIX 6: Clinical Data Sheet B
Date of admission
28
dd
/
10
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
38
yrs.
Antenatal history
X
Parity
5
Booked
Gravidity
4
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Resuscitation
Oxygen
Bag & Mask
Apgar score
1 min
5 min
10 min
X
Unknown
ETT
Unknown
Unknown
BABY DATA
Gender
X
Male
Gestation age
34wks
Birth weight
Length
43cm
Skull Circumference
Admission diagnosis
X
X
RDS
SGA
LGA
Anemia
Hypoxia
X
IPPV
Oxygen prongs
nCPAP
Respiratory support
Management
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
X
Yes
No
X
Died
Alive
Sodabic infusion
Outcome
Female
2020
grams
32cm
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Prematurity
Surfactant therapy
X
Curosurf
Survanta
Indomethacin
Inotropes
83
37
APPENDIX 6: Clinical Data Sheet B
Date of admission
29
dd
/
09
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
23
yrs.
Antenatal history
Parity
Booked
2
X
Gravidity
1
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Resuscitation
Oxygen
Bag & Mask
Apgar score
1 min
5 min
10 min
X
No
X
Unknown
ETT
6
8
BABY DATA
Gender
Male
Gestation age
32wks
Birth weight
Length
38cm
Skull Circumference
Admission diagnosis
X
X
X
X
RDS
SGA
LGA
Anemia
Hypoxia
X
IPPV
Oxygen prongs
nCPAP
Respiratory support
Management
X
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
Sodabic infusion
X
Yes
No
Outcome
X
X
1390
Female
grams
30cm
X
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Prematurity
Surfactant therapy
X
Curosurf
Survanta
Indomethacin
Inotropes
Died
Alive
84
38
APPENDIX 6: Clinical Data Sheet B
Date of admission
29
dd
/
09
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
23
yrs.
Antenatal history
Parity
Booked
2
X
Gravidity
1
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
No
X
Unknown
ETT
7
8
BABY DATA
Gender
Male
Gestation age
32wks
Birth weight
Length
40cm
Skull Circumference
Admission diagnosis
X
X
Respiratory support
RDS
SGA
LGA
Anemia
Hypoxia
X
IPPV
Oxygen prongs
nCPAP
Management
X
X
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
Sodabic infusion
X
Yes
No
Outcome
X
X
1400
Female
grams
29
X
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Prematurity
Surfactant therapy
X
Curosurf
Survanta
Indomethacin
Inotropes
Died
Alive
85
39
APPENDIX 6: Clinical Data Sheet B
Date of admission
14
dd
/
10
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
24
yrs.
Antenatal history
Parity
Booked
2
Gravidity
X
Unbooked
1
LABOUR AND DELIVERY DATA
Mode of Delivery
NVD
X
C/S
Assisted delivery
Yes
X
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
Unknown
ETT
1
3
BABY DATA
Gender
Male
Gestation age
32wks
Birth weight
Length
41cm
Skull Circumference
Admission diagnosis
X
X
1490
Female
grams
28cm
X
X
X
RDS
SGA
LGA
Anemia
Hypoxia
Surfactant therapy
X
IPPV
Oxygen prongs
nCPAP
Respiratory support
Management
X
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
Sodabic infusion
X
Yes
No
X
Died
Alive
Outcome
X
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Prematurity
Curosurf
Survanta
Indomethacin
Inotropes
86
40
APPENDIX 6: Clinical Data Sheet B
Date of admission
12
dd
/
10
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
24
yrs.
Antenatal history
Parity
Booked
2
Gravidity
X
Unbooked
1
LABOUR AND DELIVERY DATA
Mode of Delivery
NVD
X
C/S
Assisted delivery
Yes
X
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Resuscitation
Oxygen
Bag & Mask
Apgar score
1 min
5 min
10 min
X
Unknown
ETT
3
4
BABY DATA
Gender
Male
Gestation age
32wks
Birth weight
Length
41cm
Skull Circumference
Admission diagnosis
X
X
1310
Female
grams
30cm
X
X
X
RDS
SGA
LGA
Anemia
Hypoxia
Surfactant therapy
X
IPPV
Oxygen prongs
nCPAP
Respiratory support
Management
X
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
Sodabic infusion
X
Yes
No
X
Died
Alive
Outcome
X
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Prematurity
X
Curosurf
Survanta
Indomethacin
Inotropes
87
41
APPENDIX 6: Clinical Data Sheet B
Date of admission
03
dd
/
11
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
18
yrs.
Antenatal history
X
Parity
1
Booked
Gravidity
1
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
NVD
X
C/S
Assisted delivery
Yes
X
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Resuscitation
Oxygen
Bag & Mask
Apgar score
1 min
5 min
10 min
X
Unknown
ETT
9
9
BABY DATA
Gender
Male
Gestation age
30wks
Birth weight
Length
43cm
Skull Circumference
Admission diagnosis
X
RDS
SGA
LGA
Anemia
Hypoxia
Respiratory support
IPPV
Oxygen prongs
nCPAP
Management
Bolus
Bolus repeat
Blood Transfusion
X
Sodabic infusion
X
Outcome
X
X
1400
Female
grams
29cm
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Prematurity
Curosurf
Survanta
Indomethacin
Inotropes
Yes
No
Yes
No
Died
Alive
88
42
APPENDIX 6: Clinical Data Sheet B
Date of admission
09
dd
/
11
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
30
yrs.
Antenatal history
X
Parity
4
Booked
Gravidity
3
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Resuscitation
Oxygen
Bag & Mask
Apgar score
1 min
5 min
10 min
X
No
X
Unknown
ETT
Unknown
Unknown
BABY DATA
Gender
X
Male
Gestation age
33wks
Birth weight
Length
43cm
Skull Circumference
Admission diagnosis
RDS
SGA
LGA
Anemia
Hypoxia
Respiratory support
Management
IPPV
Oxygen prongs
nCPAP
X
Blood Transfusion
X
Sodabic infusion
X
Outcome
X
Bolus
Bolus repeat
Female
1810
grams
32cm
X
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Prematurity
Curosurf
Survanta
Indomethacin
Inotropes
Yes
No
Yes
No
Died
Alive
89
APPENDIX 6: Clinical Data Sheet B
43
Date of admission
09
dd
/
11
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
30
yrs.
Antenatal history
X
Parity
4
Booked
Gravidity
3
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Resuscitation
Oxygen
Bag & Mask
Apgar score
1 min
5 min
10 min
X
No
X
Unknown
ETT
Unknown
Unknown
BABY DATA
Gender
X
Male
Gestation age
33wks
Birth weight
Length
42cm
Skull Circumference
Admission diagnosis
X
X
RDS
SGA
LGA
Anemia
Hypoxia
X
IPPV
Oxygen prongs
nCPAP
Respiratory support
Management
Bolus
Bolus repeat
Blood Transfusion
X
Sodabic infusion
X
Outcome
X
Female
1540
grams
30cm
X
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Prematurity
Surfactant therapy
X
Curosurf
Survanta
Indomethacin
Inotropes
Yes
No
Yes
No
Died
Alive
90
44
APPENDIX 6: Clinical Data Sheet B
Date of admission
09
dd
/
11
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
39
yrs.
Antenatal history
X
Parity
1
Booked
Gravidity
1
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
NVD
X
C/S
Assisted delivery
Yes
X
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
Unknown
ETT
9
9
BABY DATA
Gender
Male
Gestation age
34wks
Birth weight
Length
43cm
Skull Circumference
Admission diagnosis
RDS
SGA
LGA
Anemia
Hypoxia
Respiratory support
IPPV
Oxygen prongs
nCPAP
Management
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
X
Yes
No
X
Died
Alive
Sodabic infusion
Outcome
X
2300
Female
grams
32cm
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Prematurity
Curosurf
Survanta
Indomethacin
Inotropes
91
45
APPENDIX 6: Clinical Data Sheet B
Date of admission
10
dd
/
11
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
21
yrs.
Antenatal history
Parity
Booked
2
X
Gravidity
2
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
No
X
Unknown
ETT
6
6
BABY DATA
Gender
X
Male
Gestation age
33wks
Birth weight
Length
37cm
Skull Circumference
Admission diagnosis
X
X
RDS
SGA
LGA
Anemia
Hypoxia
X
IPPV
Oxygen prongs
nCPAP
Respiratory support
Management
X
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
Sodabic infusion
X
Yes
No
Outcome
X
Female
1240
grams
27cm
X
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Prematurity/PDA
X
Curosurf
Survanta
Indomethacin
Inotropes
Died
Alive
92
46
APPENDIX 6: Clinical Data Sheet B
Date of admission
18
dd
/
11
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
23
yrs.
Antenatal history
X
Parity
2
Booked
Gravidity
2
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
No
X
Unknown
ETT
6
7
BABY DATA
Gender
X
Male
Gestation age
27wks
Birth weight
Length
36cm
Skull Circumference
Admission diagnosis
X
X
Respiratory support
X
Management
RDS
SGA
LGA
Anemia
Hypoxia
IPPV
Oxygen prongs
nCPAP
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
Sodabic infusion
X
Yes
No
Outcome
X
Female
1100
grams
27cm
X
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Prematurity
Surfactant therapy
X
Curosurf
Survanta
Indomethacin
Inotropes
Died
Alive
93
APPENDIX 6: Clinical Data Sheet B
47
Date of admission
27
dd
/
10
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
16
yrs.
Antenatal history
Parity
Booked
1
X
Gravidity
1
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
No
X
Unknown
ETT
7
8
BABY DATA
Gender
Male
Gestation age
32wks
Birth weight
Length
40cm
Skull Circumference
Admission diagnosis
X
X
RDS
SGA
LGA
Anemia
Hypoxia
X
IPPV
Oxygen prongs
nCPAP
Respiratory support
Management
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
X
Yes
No
X
Died
Alive
Sodabic infusion
Outcome
X
1400
Female
grams
28cm
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Prematurity
Curosurf
Survanta
Indomethacin
Inotropes
94
APPENDIX 6: Clinical Data Sheet B
48
Date of admission
23
dd
/
09
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
22
yrs.
Antenatal history
X
Parity
1
Booked
Gravidity
1
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
No
X
Unknown
ETT
8
9
BABY DATA
Gender
Male
Gestation age
31wks
Birth weight
Length
42cm
Skull Circumference
Admission diagnosis
X
X
RDS
SGA
LGA
Anemia
Hypoxia
Respiratory support
IPPV
Oxygen prongs
nCPAP
Management
Bolus
Bolus repeat
Blood Transfusion
X
Sodabic infusion
1690
Female
grams
27cm
X
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Prematurity
Curosurf
Survanta
Indomethacin
Inotropes
Yes
No
X
Yes
No
X
Died
Alive
Outcome
X
95
49
APPENDIX 6: Clinical Data Sheet B
Date of admission
19
dd
/
10
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
22
yrs.
Antenatal history
X
Parity
2
Booked
Gravidity
2
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Resuscitation
Oxygen
Bag & Mask
Apgar score
1 min
5 min
10 min
X
No
X
Unknown
ETT
2
5
BABY DATA
Gender
X
Male
Gestation age
28wks
Birth weight
Length
37cm
Skull Circumference
Admission diagnosis
X
X
X
Respiratory support
Surfactant therapy
Blood Transfusion
X
Yes
No
X
27cm
IPPV
Oxygen prongs
nCPAP
Bolus
Bolus repeat
Outcome
grams
X
X
X
1140
RDS
SGA
LGA
Anemia
Hypoxia
Management
Sodabic infusion
Female
X
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Prematurity
Curosurf
Survanta
Indomethacin
Inotropes
Yes
No
Died
Alive
96
APPENDIX 6: Clinical Data Sheet B
50
Date of admission
13
dd
/
10
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
37
yrs.
Antenatal history
X
Parity
3
Booked
Gravidity
3
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
NVD
X
C/S
Assisted delivery
Yes
X
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
Unknown
ETT
8
9
BABY DATA
Gender
Male
Gestation age
33wks
Birth weight
Length
42cm
Skull Circumference
Admission diagnosis
RDS
SGA
LGA
Anemia
Hypoxia
Respiratory support
Management
IPPV
Oxygen prongs
nCPAP
X
Blood Transfusion
Bolus
Bolus repeat
X
Yes
No
X
Yes
No
X
Died
Alive
Sodabic infusion
Outcome
X
1650
Female
grams
30cm
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Prematurity
Curosurf
Survanta
Indomethacin
Inotropes
97
APPENDIX 6: Clinical Data Sheet B
51
Date of admission
18
dd
/
11
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
32
yrs.
Antenatal history
X
Parity
3
Booked
Gravidity
5
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
NVD
X
C/S
Assisted delivery
Yes
X
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
Unknown
ETT
7
8
BABY DATA
Gender
Male
Gestation age
31wks
Birth weight
Length
41cm
Skull Circumference
Admission diagnosis
X
X
RDS
SGA
LGA
Anemia
Hypoxia
X
IPPV
Oxygen prongs
nCPAP
Respiratory support
Management
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
X
Yes
No
X
Died
Alive
Sodabic infusion
Outcome
X
1600
Female
grams
30cm
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Prematurity
Surfactant therapy
X
Curosurf
Survanta
Indomethacin
Inotropes
98
APPENDIX 6: Clinical Data Sheet B
52
Date of admission
10
dd
/
11
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
38
yrs.
Antenatal history
X
Parity
5
Booked
Gravidity
4
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
NVD
X
C/S
Assisted delivery
Yes
X
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
Unknown
ETT
4
8
BABY DATA
Gender
X
Male
Gestation age
33wks
Birth weight
Length
41cm
Skull Circumference
Admission diagnosis
Respiratory support
X
X
Management
RDS
SGA
LGA
Anemia
Hypoxia
IPPV
Oxygen prongs
nCPAP
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
Sodabic infusion
X
Yes
No
Outcome
X
Female
1620
grams
30cm
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Prematurity/PDA
Surfactant therapy
X
Curosurf
Survanta
Indomethacin
Inotropes
Died
Alive
99
APPENDIX 6: Clinical Data Sheet B
53
Date of admission
20
dd
/
10
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
26
yrs.
Antenatal history
X
Parity
3
Booked
Gravidity
3
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
NVD
X
C/S
Assisted delivery
Yes
X
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
Unknown
ETT
8
9
BABY DATA
Gender
Male
Gestation age
37wks
Birth weight
Length
44cm
Skull Circumference
Admission diagnosis
X
X
X
Respiratory support
X
Management
RDS
SGA
LGA
Anemia
Hypoxia
IPPV
Oxygen prongs
nCPAP
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
X
Yes
No
X
Died
Alive
Sodabic infusion
Outcome
X
2280
Female
grams
35cm
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Prematurity
Curosurf
Survanta
Indomethacin
Inotropes
100
APPENDIX 6: Clinical Data Sheet B
54
Date of admission
27
dd
/
09
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
27
yrs.
Antenatal history
X
Parity
1
Booked
Gravidity
1
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
NVD
X
C/S
Assisted delivery
Yes
X
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
Unknown
ETT
6
8
BABY DATA
Gender
Male
Gestation age
36wks
Birth weight
Length
45cm
Skull Circumference
Admission diagnosis
X
RDS
SGA
LGA
Anemia
Hypoxia
Respiratory support
IPPV
Oxygen prongs
nCPAP
Management
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
X
Yes
No
X
Died
Alive
Sodabic infusion
Outcome
X
1670
Female
grams
32cm
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Prematurity
Curosurf
Survanta
Indomethacin
Inotropes
101
APPENDIX 6: Clinical Data Sheet B
55
Date of admission
11
dd
/
11
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
24
yrs.
Antenatal history
X
Parity
1
Booked
Gravidity
1
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
X
NVD
C/S
Assisted delivery
Yes
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Resuscitation
Oxygen
Bag & Mask
Apgar score
1 min
5 min
10 min
X
No
X
Unknown
ETT
9
9
BABY DATA
Gender
Male
Gestation age
37wks
Birth weight
Length
44cm
Skull Circumference
Admission diagnosis
RDS
SGA
LGA
Anemia
Hypoxia
Respiratory support
Management
IPPV
Oxygen prongs
nCPAP
X
Blood Transfusion
Bolus
Bolus repeat
X
Yes
No
X
Yes
No
X
Died
Alive
Sodabic infusion
Outcome
X
1700
Female
grams
31cm
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Prematurity
Curosurf
Survanta
Indomethacin
Inotropes
102
APPENDIX 6: Clinical Data Sheet B
56
Date of admission
25
dd
/
10
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
39
yrs.
Antenatal history
X
Parity
4
Booked
Gravidity
4
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
NVD
X
C/S
Assisted delivery
Yes
X
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Oxygen
Bag & Mask
Resuscitation
X
Apgar score
1 min
5 min
10 min
X
Unknown
ETT
8
8
9
BABY DATA
Gender
Male
Gestation age
32wks
Birth weight
Length
42cm
Skull Circumference
Admission diagnosis
X
X
X
X
Respiratory support
X
RDS
SGA
LGA
Anemia
Hypoxia
IPPV
Oxygen prongs
nCPAP
Management
X
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
Sodabic infusion
X
Yes
No
X
Died
Alive
Outcome
X
1670
Female
grams
31cm
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
X
Curosurf
Survanta
Indomethacin
Inotropes
103
APPENDIX 6: Clinical Data Sheet B
57
Date of admission
26
dd
/
10
/
mm
2009
yy
MATERNAL DEMOGRAPHIC DATA
Age
34
yrs.
Antenatal history
Parity
Booked
2
Gravidity
X
Unbooked
2
LABOUR AND DELIVERY DATA
Mode of Delivery
NVD
X
C/S
Assisted delivery
Yes
X
No
If yes,
Vacuum
Forceps
Antenatal steroids
X
Yes
No
Unknown
Resuscitation
X
Oxygen
Bag & Mask
ETT
Apgar score
1 min
5 min
10 min
3
6
7
BABY DATA
Gender
Male
Gestation age
28wks
Birth weight
Length
37cm
Skull Circumference
Admission diagnosis
X
X
X
RDS
SGA
LGA
Anemia
Hypoxia
X
IPPV
Oxygen prongs
nCPAP
Respiratory support
Management
X
Bolus
Bolus repeat
Blood Transfusion
X
Yes
No
Sodabic infusion
X
Yes
No
X
Died
Alive
Outcome
X
1010
Female
grams
28cm
X
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
HMD
X
Curosurf
Survanta
Indomethacin
Inotropes
104
APPENDIX 6: Clinical Data Sheet B
58
Date of admission
/
dd
/
mm
yy
MATERNAL DEMOGRAPHIC DATA
Age
Antenatal history
yrs.
Parity
Booked
Gravidity
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
NVD
C/S
Assisted delivery
Yes
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Unknown
Resuscitation
Oxygen
Bag & Mask
ETT
Apgar score
1 min
5 min
10 min
BABY DATA
Gender
Male
Gestation age
Birth weight
Length
Skull Circumference
Admission diagnosis
RDS
SGA
LGA
Anemia
Hypoxia
Respiratory support
IPPV
Oxygen prongs
nCPAP
Management
Bolus
Bolus repeat
Blood Transfusion
Yes
No
Sodabic infusion
Yes
No
Outcome
Died
Alive
Female
grams
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Curosurf
Survanta
Indomethacin
Inotropes
105
APPENDIX 6: Clinical Data Sheet B
59
Date of admission
/
dd
/
mm
yy
MATERNAL DEMOGRAPHIC DATA
Age
Antenatal history
yrs.
Parity
Booked
Gravidity
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
NVD
C/S
Assisted delivery
Yes
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Unknown
Resuscitation
Oxygen
Bag & Mask
ETT
Apgar score
1 min
5 min
10 min
BABY DATA
Gender
Male
Gestation age
Birth weight
Length
Skull Circumference
Admission diagnosis
RDS
SGA
LGA
Anemia
Hypoxia
Respiratory support
IPPV
Oxygen prongs
nCPAP
Management
Bolus
Bolus repeat
Blood Transfusion
Yes
No
Sodabic infusion
Yes
No
Outcome
Died
Alive
Female
grams
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Curosurf
Survanta
Indomethacin
Inotropes
106
60
APPENDIX 6: Clinical Data Sheet B
Date of admission
/
dd
/
mm
yy
MATERNAL DEMOGRAPHIC DATA
Age
Antenatal history
yrs.
Parity
Booked
Gravidity
Unbooked
LABOUR AND DELIVERY DATA
Mode of Delivery
NVD
C/S
Assisted delivery
Yes
No
If yes,
Vacuum
Forceps
Antenatal steroids
Yes
No
Unknown
Resuscitation
Oxygen
Bag & Mask
ETT
Apgar score
1 min
5 min
10 min
BABY DATA
Gender
Male
Gestation age
Birth weight
Length
Skull Circumference
Admission diagnosis
RDS
SGA
LGA
Anemia
Hypoxia
Respiratory support
IPPV
Oxygen prongs
nCPAP
Management
Bolus
Bolus repeat
Blood Transfusion
Yes
No
Sodabic infusion
Yes
No
Outcome
Died
Alive
Female
grams
Birth asphyxia
AGA
Thrombocytopenia
Metabolic acidosis
Other(specify)
Surfactant therapy
Curosurf
Survanta
Indomethacin
Inotropes
107
APPENDIX 7: Haemorrhage Data
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
24hour
Anatomical
body/post/trig/other
Bleeding ant24 post24
Site
Colour
Cysts
yes
yes
yes
L Echo/Hetero yes
no
no
no
yes
yes
yes
body/post/trig/other
L
Echo
no
no
no
yes
yes
no
body
L
Echo
no
yes
no
body
L
yes
no
no
no
no
no
no
no
no
no
no
yes
no
body
L
yes
no
no
no
no
no
no
yes
yes
no
body
LR
Echo
no
no
no
yes
yes
yes
ant/body/post/tempo/trig/other LR
Echo
no
no
no
no
no
no
no
no
no
yes
yes
yes
body
LR
Echo
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
yes
yes
no
Other
R
Echo
yes
yes
no
body
LR
Echo
yes
yes
no
Other
LR
Echo
no
no
no
no
no
no
no
no
no
yes
yes
no
Ant/body/other
LR
Echo
yes
yes
yes
no
body
LR echo/other
yes
yes
no
body
L
Echo
no
no
no
no
no
no
yes
yes
no
body
R
Echo
no
no
no
no
no
no
108
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
no
no
yes
no
no
no
no
yes
no
yes
no
no
no
no
no
no
no
no
no
no
yes
yes
no
no
no
no
yes
no
yes
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
yes
no
no
no
no
no
no
no
no
no
Ant
body
LR
LR
Echo
yes
body
LR
Echo
body/posterior/trigone
LR
Echo
109
APPENDIX 7: Haemorrhage Data
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
Bleeding
yes
no
yes
no
yes
no
no
no
no
no
no
no
yes
no
yes
no
no
no
yes
no
yes
no
no
no
no
no
no
yes
yes
yes
no
no
no
yes
yes
yes
no
no
yes
no
no
no
no
ant3
yes
no
yes
no
yes
yes
no
no
no
yes
no
no
yes
no
yes
no
no
no
yes
no
yes
no
no
no
no
no
no
yes
yes
yes
no
no
no
yes
yes
yes
no
no
yes
no
no
no
yes
post3
yes
no
yes
no
no
no
no
no
no
no
no
no
no
no
yes
no
no
no
yes
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
3 days
Anatomical
body/post/trig/other
Site
L
Colour
Echo/Hetero
body/post/trig/other
L
Echo
body
body
L
L
Echo
body
L
body
LR
Echo
ant/body/post/tempo/trig/other
LR
Echo
body
LR
Echo
body
R
Echo
Other
body
body/post/trigone
R
LR
LR
Echo
Echo
Echo
other
body
body
R
L
L
Echo
Echo
Echo
body
R
Echo
Ant
LR
Cysts
yes
yes
yes
yes
yes
110
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
yes
no
no
no
no
yes
no
yes
no
no
no
no
no
no
no
no
no
yes
no
no
no
no
yes
no
yes
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
yes
no
no
no
no
no
no
no
no
no
body
LR
Echo
body
LR
Echo
Ant/body/posterior/trigone
LR
Echo
111
APPENDIX 7: Haemorrhage Data
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
Bleeding
yes
no
yes
no
yes
no
no
no
no
no
no
no
yes
no
yes
no
no
no
yes
no
yes
no
no
no
no
no
no
yes
yes
yes
no
no
no
yes
yes
yes
no
no
yes
no
no
no
no
ant7
yes
no
yes
no
yes
yes
no
no
no
no
no
no
yes
no
yes
no
no
no
yes
no
yes
no
no
no
no
no
no
yes
yes
yes
no
no
no
yes
yes
yes
no
no
yes
no
no
no
yes
post7
yes
no
yes
no
no
no
no
no
no
no
no
no
no
no
yes
no
no
no
yes
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
7 days
Anatomical
body/post/trig/other
Site
L
Colour
Echo/Hetero
body/post/trig/other
L
Echo
body
body
L
L
Echo
body
LR
Echo
ant/body/post/tempo/trig/other
LR
Echo
body
LR
Echo
body/other
LR
Echo/hetero
Other
body
ant/body/post/temporal/trigone
R
LR
LR
Echo
Echo
Echo
other
body
body
R
L
L
Echo
Echo
Echo
body
R
Echo
Ant
LR
Cysts
yes
yes
yes
yes
112
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
yes
no
no
no
no
yes
no
yes
no
no
no
no
no
no
no
no
no
yes
no
no
no
no
yes
no
yes
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
yes
no
no
no
no
no
no
no
no
no
body
LR
Echo
body
LR
Echo
temporal
L
Echo
113
114
60
115