Etiology and Clinical feature of neonatal pneumothorax in inborn and outborn NICU settings in rural tertiary care hospital.
Abstract
Background: Neonatal pneumothorax (NP) is a critical condition characterized by air accumulation in the pleural space, leading to lung collapse and respiratory distress. Its incidence varies, with risk factors including prematurity, mechanical ventilation, meconium aspiration syndrome (MAS), congenital pneumonia, and birth asphyxia. Objective: This study aimed to analyze the etiology and clinical presentation of neonatal pneumothorax in inborn and outborn neonates admitted to NICUs of a rural tertiary care hospital. Methods: A descriptive, longitudinal observational study was conducted over two years (December 2020–December 2022) at Dr. Balasaheb Vikhe Patil Rural Medical College, Loni. A total of 60 neonates diagnosed with pneumothorax were included. Clinical history, diagnostic methods (transillumination and chest X-ray), and management strategies were documented. Statistical analysis was performed to assess associations between etiology and outcomes. Results: Out of 60 neonates, 63.3% were inborn, and 36.7% were outborn. The most common etiologies included congenital pneumonia (51.7%), MAS (38.3%), birth asphyxia (25%), and post-surfactant administration in RDS cases (58.3%). Right-sided pneumothorax was more frequent (48.3%), followed by left-sided (28.3%) and bilateral (23.3%). Spontaneous pneumothorax occurred in 26.7% of cases. Mortality was 56.6%, with higher rates among inborn cases (60.5%) than outborn (50%). Conclusion: Neonatal pneumothorax remains a significant challenge in NICU settings, with congenital pneumonia and MAS being the primary causes. Early recognition, prompt intervention, and improved resuscitation techniques, particularly in outborn cases, may reduce mortality. Further research incorporating advanced ventilation strategies like high-frequency oscillatory ventilation (HFOV) is recommended.
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