Morbidity and Mortality of Newborns with Gastrointestinal Surgical Pathology Admitted to the Neonatology Service of the Vicente Corral Moscoso Hospital

Abstract

Morbidity and mortality in newborns with gastrointestinal malformations are high, even more so in low- and middle-income countries due to the need for immediate surgical care. However, the literature on these anomalies is scarce in Ecuador. This research aims to increase the registered data on the morbidity and mortality of newborns with gastrointestinal surgical pathology in Cuenca, Ecuador. A descriptive and cross-sectional study was carried out, involving 63 newborns with gastrointestinal surgical pathology admitted to the neonatology service of the Vicente Corral Moscoso Hospital. Data collection was done by reviewing medical records, using a form. The results showed that the mortality rate was higher in 2020. The majority of live newborns had esophageal atresia, they were male, born at term, with middle-aged mothers from urban areas. Of the deceased, the majority had a congenital diaphragmatic hernia, they were children of mothers from rural areas, and half died within 24 hours of being born, mainly from septic shock. In conclusion, the results of this study should not be considered definitive due to the omission of 23 clinical histories; moreover, a low mortality rate is evidenced. It was also observed that they died mainly from septic shock, a preventable cause of mortality from the first level of care with the detection of maternal risk factors.


Keywords: morbidity, mortality, malformation, surgical neonate.


Resumen


Antecedentes: la morbimortalidad en recién nacidos con malformaciones gastrointestinales es elevada, más aún en países de ingresos medios y bajos debido a la necesidad de atención quirúrgica inmediata, sin embargo la literatura sobre estas anomalías es escasa en el Ecuador. Objetivos: incrementar los datos registrados sobre la morbimortalidad de recién nacidos con patología quirúrgica gastrointestinal en Cuenca, Ecuador. Métodos: se realizó un estudio descriptivo y transversal, participaron 63 recién nacidos con patología quirúrgica gastrointestinal ingresados en el servicio de neonatología del Hospital Vicente Corral Mosoco. La recolección de datos se realizó mediante la revisión de historias clínicas, empleando un formulario. Resultados: la tasa de mortalidad fue mayor, en el año 2020. La mayoría de recién nacidos vivos tenían atresia esofágica, eran hombres, nacidos a término, con madres de edad media, procedentes de zonas urbanas. De los fallecidos, la mayoría tenía hernia diafragmática congénita, eran hijos de madres procedentes de zonas rurales, la mitad murió a las 24 horas de nacido, principalmente de shock séptico. Conclusiones: los resultados de este estudio no deben considerarse como definitivos, debido a la omisión de 23 historias clínicas, se evidencia una baja tasa de mortalidad. También se observó que fallecieron principalmente de shock séptico, una causa de mortalidad prevenible desde el primer nivel de atención con la detección de factores de riesgo maternos.


Palabras Clave: Morbilidad. Mortalidad. Malformación. Neonato quirúrgico.

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