Majid Kapra

Incidence of NRDS more among babies delivered via LSCS mode, claim experts

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Srinagar: In Kashmir, the risk of Newborn Respiratory Distress Syndrome (NRDS), according to the health professionals, is higher in neonates born via Lower Segment Cesarean Section (LSCS)—the most common mode of delivery—than in the babies delivered via Normal Spontaneous Vaginal Delivery (NSVD).

The hospital-based prospective observational research conducted by the Department of Pediatrics at the associated hospitals of Government Medical College (GMC), revealed a significant rate of respiratory distress and NICU hospitalizations among infants delivered via caesarean section prior to the commencement of spontaneous labor.

The fetus absorbs about one-third of the fetal lung fluid during NSVD, but appropriate fetal lung fluid absorption is not attained in infants born after a caesarean section, they argued, making caesarean sections a risk factor for respiratory distress syndrome.

Neonates born via caesarean, they claimed, are more likely to have breathing disorders with high chances to be admitted to the special care nursery for a period of time.

The most frequent reason for a newborn to be admitted to the intensive care unit (NICU) is respiratory distress, which has various etiologies but similar clinical presentations, according to a study conducted last year by Drs. Gaurav, Suhail Ahmad Naik, and Syed Tariq Ahmad of the Department of Pediatrics.

“Early diagnosis of specific causes for respiratory distress is very important as different etiologies have different specific treatment and require altogether different ventilatory strategies. Objectives were to study the demographic and etiological profile of neonatal respiratory distress,” the study reveals.

Respiratory distress was more common in males — 56.30 percent, frequency of prematurity was 68 percent, and most common mode of delivery lower section caesarean section (LSCS) 69.10 percent.

Different maternal risk factors associated with adverse outcome — premature rupture of membranes (PROM) 37.7 percent, meconium-stained amniotic fluid (MSAF) 34.60 percent, maternal hypertension 31.50 percent and gestational diabetes mellitus (GDM) 26.9 percent.

Common causes for respiratory distress in neonates were transient tachypnea of newborn (TTN) 22.0 percent, respiratory distress syndrome (RDS) 20 percent, meconium aspiration syndrome (MAS) 16.90 percent, sepsis 14 percent and perinatal asphyxia 12 percent.

Early diagnosis of specific causes for respiratory distress is very important as different etiologies have different specific treatment and require altogether different ventilatory strategies. The TTN was the most common cause of distress in term newborns, followed by perinatal asphyxia, meconium aspiration, neonatal sepsis, and congenital heart diseases (CHD). Therefore, timely diagnosis and management of these conditions is very imperative to discharge an intact neonate from the NICU.

Senior Consultant Physician at GMC Srinagar, Dr. Suhail Naik said as newborn babies with RDS come and go, it is not possible to maintain a thorough record of such a prevalent condition. As such, no absolute data on newborns with RDS is available.

RDS, according to Dr Naik, results from the baby’s lack of surfactant, a fluid produced in the lungs at around 26 weeks of pregnancy. The more fetuses develop, the more lungs produce surfactant.

Newborns can have a variety of breathing issues, including pneumonia, apnea, meconium aspiration syndrome, bronchopulmonary dysplasia (BPD), chronic pulmonary hypertension and transitory tachypnea, Dr Naik added.

Another possible cause of neonatal RDS is genetic lung development issues. The majority of RDS instances affect newborns delivered before 37 to 39 weeks. The likelihood of RDS after birth increases with the baby’s preterm, he said.

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