Authors:
Dr Aisha Siddiqua
, Dr Huma Waqar
Abstract
BACKGROUND :
Neonatal surgical emergencies can have varying outcome depending upon condition , promptness of diagnosis, intervention and presence of other anomalies in neonates. Neonates born with birth defects need to addressed surgically but cultural norms hinder delayed treatment modalities in developing countries. Disease processes are often well advanced when patients received in emergency department after traditional remedies have failed at home . Immediate and appropriate surgical intervention is not available in developing countries.
OBJECTIVES:
The study was conducted to explore the factors influence the outcome in neonates having surgical emergencies depend upon the early recognition , timely diagnosis, stabilization , early timely referral and multidisciplinary care . By understanding these factors and providing prompt , high quality care , health care providers can improve the outcome for neonates with surgical emergencies in Emergency department and significantly reducing the morbidity and mortality in neonates.
MATERIAL AND METHODS :
It is a Retrospective electronic health system record study conducted at child life foundation organization.This study accomplished over 1 year data from 1st June 2024 to 31 June 2025 , all neonates presenting with surgical emergencies irrespective of gender,triage category both P1,P2 included .Variables include Age 1st day of life to 28 days of life ,Gender Male , Female
Result :This study included a total of 1066 neonates out of which males were 627 (58.8% ) , females were 439 (41.1%)=
Diagnosis Number of cases / %
Imperforate Anus 11 (1%)
Intestinal obstruction 250 (23.4%)
Omphalocele 8 (0.75%)
Tracheoesophageal fistula 223(20.9%)
Diaphragmatic hernia 21(1.96%)
Necrotizing enterocolitis 337( 31.6%)
Hydrocephalus 18(1.68%)
Meningomyelocele 132(12.3%)
Spina bifida 35 (3.2%)
Gastroschisis 7(0.65%
hydrocele 6(0.56%)
Inguinal hernia 5(0.46%)
Anorectal malformation 3(0.28%)
Hirshsprung disease 6(0.56%)
Encephalocele 4(0.37%)
OUTCOME
Admission 697(65.3%)
Reffered 119(11.1%)
LAMA 96(9%)
Expired 154(14.4%)
CONCLUSION:
Neonatal surgical emergencies in our setup is associated with moderate mortality and morbidity. To overcome the difficulties and challenges in our Emergency department steps need to be taken are early recognition , timely diagnosis , stabilization , timely referral and admission in Surgical department for further management including multidisciplinary care. To uplift the neonatal emergency services to a satisfactory level with a limited resources environment requires a rightful allocation of the resources to develop neonatal friendly infrastructure in our emergency department.
References:
1. World Health Organization. (2016). Birth defects: WHO report.
2. Bawa, M.,&Kumar, M. (2018). Neonatal surgical emergencies in a developing country: A retrospective analysis. Journal of Pediatric Surgery, 53(4), 648-652.
3. Liu, L., et al. (2020). Global, regional, and national causes of under-5 mortality in 2000-19: An updated systematic analysis. The Lancet Global Health, 8(3), e352-e365.
4. Wright, N. J., et al. (2019). Pediatric surgical care in low-resource settings: Guidelines for management. Pediatric Surgery International, 35(11), 1231-1241.
5. Kumar, A., et al. (2017). Outcomes of neonatal surgery in a tertiary care center: A retrospective study. Journal of Neonatal Surgery, 6(2), 21-26.
Keywords: "Neonatal surgical emergencies, birth defects, delayed treatment, cultural norms, developing countries, prompt diagnosis, intervention, multidisciplinary care, mortality, morbidity, Imperforate Anus, Intestinal obstruction, Omphalocele, Tracheoesophageal fistula, Necrotizing enterocolitis, Hydrocephalus, Meningomyelocele, Spina bifida, Gastroschisis, emergency department, Child Life Foundation"
