Our NICU is one of the largest in Turkey, provides expert newborn care for seriously ill babies. Expert nursing staff are in the team. Our NICU has 58 beds for the smallest and sickest infants.
The NICU cares for babies:
Who are extremely premature
Serious inherited disorders
Birth asphyxia
Major life threatening conditions
Polyclinic
In the polyclinics unit of our hospital, there are two newborn polyclinics. For the outpatient care of infants at risk for developmental delay or ongoing medical problems the patients are examined in Wednesday and Friday in our Premature and Risky Newborn Clinic. Our second polyclinic is for well newborn care for 5 days in a week. Neonatologists are working in Premature and Risky Newborn Clinic.
Neonatal Intensive Care Unit
Our clinic is located on the 2nd and 3rd floors of the Intensive Care Building of our hospital and is a unit which has a total of 58 beds, 30 of tham are Level 4, 10 of tham are Level 2 and 8 of tham are the mother-infant bonding rooms (Level 1). Bonding helps mothers feel connected to her baby.
2nd level Intensive Care Unit (C1-C2); initially accepts infants who do not require severe respiratory and circulatory insufficiency and who do not require entubation; or it is the department where patients who are discharged from 3rd level but who are not yet eligible to be followed up with mother .
The 4th level Neonatal Intensive Care Unit consists of 4 halls (A1-A2-B1-B2) and contains two isolation rooms. These departments both take over the babies who are out of the follow-up criteria at the 2nd level while treated on the 2nd level and accept the babies from the external centers who have severe respiratory and circulatory insufficency and / or need ventilator therapy. According to the clinical condition of the babies the levels at which they are followed may vary. In our Neonatal Intensive Care Unit, full service is provided with sufficient number of life support units and trained staff.
In 2017, totally, 1492 neonatal infants were hospitalized and 9000 neonatal infants were followed up in Neonatal / Premature and Risky Infant Monitoring Polyclinics.
Emergency Services
In the neonatal policlinic, all newborns who are under 30-day-old and apply to the pediatry polyclinics of our hospital are admitted directly to the NICU depending on availability in case of urgency. If there is no availability, the patient's condition is stabilized in the NICU and then the necessary arrangements are made for the transfer to the appropriate unit. Other emergency referrals are accepted through the system by means of 112 with the mutual information between relevant institutions. The main patient group who are accepted to the emergency service of neonatal clinic are the ones that have the respiratory distress, cardiac pathologies, infectious diseases, congenital malformations that require urgent intervention.
Educational Research Activities
In our clinic, within the scope of in-clinic training programs, meetings are held every day involving morning case discussions. Both trainers and the subbbranch assistants make presentations twice a month, current scientific studies are evaluated once a week and file discussions are made at least once a week. The patients who are followed with other clinics are discussed in councils. In our clinic, many clinical studies are performed and they contribute to the literature of Turkey and the world. Some of the most common diseases observed in the clinic are given below.
Diseases
Respiratory distress syndrome:
It is a disease characterized by the inability of the baby to provide adequate respiration due to insufficiency of the so-called surfactant in the lungs due to the birth of the baby before lung development. Respiratory Distress Syndrome (RDS) ; is common in preterm infants and these infants need close follow-up by a neonatologist or by an experienced pediatrist in the 3rd step intensive care unit. Incidence and severity of RDS are expected to increase in small gestational weeks. Incidence of RDS is 90% at 23- 25 weeks’ gestation, 88% at 26- 27 weeks’ gestation, 74% at 28- 29 weeks’ gestation, and %52 at 30- 31 weeks’ gestation.
Necrotizing enterocolitis:
It is an important digestive system disease characterized by disruption of the blood supply of the intestines, partially or completely. It can develop in about 10% of the infants followed up in Newborn Intensive Care Units. Although it is mainly seen in premature infants, 10% of the patients are term infants.
Nutrition and nutrition problems:
Many sick newborn infants especially premature infants cannot obtain adequate nutrition over the GI tract initially and, thus, require parenteral nutritional support. In some, GI function is adequate to allow a small amount of feedings. In others, the GI tract may not function for days to weeks (e.g., necrotizing enterocolitis, bowel anomalies), so the infant receives all nutrition parenterally for a long time. In these babies nutrition support is parenterally initiated with a central venous catheter. Total Parenteral Nutrition solution is available to start in our unit for these patients. Nutrients and vitamins are supported begining from the first day of life in these infants.
Intracranial bleeding:
Newborn babies tend to have intracranial hemorrhage due to the nature of the cerebral vessels in preterm infants, or due to difficulties during labour. The risk and severity of neonatal brain hemorrhage are inversely related to the gestational age and weight at time of birth: there is a 1% incidence in human infants born between 38 and 43 weeks, and a 50% incidence between 24-30 weeks. Intracranial hemorrhage is more common in preterm babies <1500g (20%).
Periventricular leukomalacia:
Periventricular leukomalacia (PVL) is characterized by the death or damage and softening of the white matter. Although it is generally due to premature birth, oxygenation and bleeding in the brain and exposure to infections prenatally womb before and during birth are held responsible.
Retinopathy of prematurity (Disorder of retinal layer in premature infants):
In low birth weight or preterm infants (below 1500 grams and/or 32 weeks), it is characterized by abnormal vascular development due to birth without completion of the development of vessels in the retina layer in the eye. In some cases, premature birth alone is a sufficient risk factor. Although not yet certain, exposure to excessive oxygen, some certain complications of the mother, respiratory arrest, blood gas disorders, intracranial hemorrhage, anemia, blood transfusions and infections may be additional risk factors. Although the early stages of the disease are very common (80% in the infants under 1000 grams), advanced stages requiring treatment are rare. It can also be seen in preterm infants without any clinical findings.
Sepsis ve infection:
Infection and sepsis in newborn infants are morre different and more severe than other children and adults,and death risk is higher. In preterm and low birth weight infants, these possibilities and risks have increased much more. In addition, premature membrane rupture
, multiple pregnancies, difficult births, all kinds of intensive intervention to the baby (such as catheter insertion, tube placement to lung or entubation) increase risk of infections .
Patent ductus arteriosus:
A vascular structure called ductus arteriosus, which is normally open in utero and carries blood to the lungs, is spontaneously closed within the first days after birth. This structure which is seen in premature infants with respiratory distress syndrome (80% in those under 1000 grams) remains open, and is called patent ductus arteriosus (PDA). As it increases the lung blood flow, respiratory distress will be worsen.
Jaundice:
In 60% of term babies and 80% of preterm babies jaundice will develop in the first days of life. Although neonatal jaundice is often harmless and self-recovering, jaundice may increase over a certain level resulting in permanent damage to the brain and may cause hearing loss. Phototherapy is applied according to the according to jaundice levels. In higher bilirubin levels there is a risk of causing brain damage and blood exchange can be applied to the baby.
Temporary tachypnea of the newborn:
It is a self-limited, neonatal lung disease that occurs as a result of delay in absorption of the fluid that fills the baby's lungs in the early postnatal period. In these babies, symptoms such as rapid and frequent breathing, bruising and groaning occur within a few hours after birth.
Contact Numbers of the Clinic
Neonatal Intensive Care Unit
(0232) 411 60 00
A1 –A2: 2171 - 2177
B1-B2: 2160 – 2165
C1- C2: 2300 -2199
Clinical Education and Management Officer: 2186
Clinic Chief Nurse A – B: 2168 - 2184
Clinic Chief Nurse C: 2197
Clinical Service Secretary : 2196 - 2168
Clinic Specialist Doctor's Room -1 : 2180
Clinic Specialist Doctor's Room -2 : 2310 - 2182
Polyclinic secretary: 6349
Polyclinic examination room: 6141