الفهرس | Only 14 pages are availabe for public view |
Abstract In preparing child mortality reduction strategies, it is important for our policy makers to consider the magnitude of perinatal and neonatal mortality in order to develop programs that will reduce avoidable neonatal deaths more quickly. In Egypt demographic and health survey (EDHS) 2000 fond that the NMR was 25/1000 live births (17 early and 8 late). Half the deaths occurred in the first two days of life. Neonatal causes of death were pre-maturity (39%), asphyxia (18%), infection (7%), congenital malformation (6%), and unclassified (29%). The PMR was 34/1000 births, mainly attributed to: asphyxia (44%) and prematurity(21%).The corner stone for HIE management is prevention of perinatal asphyxia through effective resuscitation. Good management of pregnancy and labor/delivery complications is the best means of preventing birth asphyxia. Attention to proper stabilization of the baby in hypoxic ischemic state is the primary goal until now as long as management of the condition it self is still under trails. Implementation of neonatal resuscitation program NRP in every hospital where delivery and cesarean section are done. Training and retraining for the physicians and nurses in all specialties attending deliveries is required including pediatrians,obstetrians, anesthesiologists. Wide spread training should include general practitioners and midwifes and we suggest to be a prerequisite for license to attend delivery. Knowledge and skills in neonatal resuscitation should start to be essential part in undergraduate curriculum of medical study. The realization that hypoxia- ischemia leads to delayed cellular injury 8 to 24 h after the initial insult, and experimental data on the mechanism of this delayed death should give new motivation to investigators and researchers in our specialty to find new modes of potential therapy . |