A study on clinico-laboratory profile of newborns with perinatal asphyxia admitted to tertiary care hospital
Abstract
Introduction: Asphyxia is the single most important cause of still-births accounting for 45.1% of all cases. Although many organ systems can be affected by hypoxia, it is the nervous system that bears the brunt of perinatal asphyxia in the long run. Once the cerebral injury has occurred, the management is mainly supportive. Newer cerebro protective therapies are being tried. The present study aims at correlating the Severity of asphyxia with the severity of HIE and also to assess the perinatal factors, clinico laboratory profile and immediate outcome in asphyxiated newborns.
Materials and methods: It is a prospective, descriptive clinical study done at NICU, ASRAM medical college Eluru.92 newborn babies who fulfilled the selection criteria for perinatal asphyxia during the study period September 2015 to August 2017 formed the study group.The stage of encephalopathy was assessed according to Sarnat and Sarnat Clinical staging system. Perinatal asphyxia was graded as moderate or severe based on pH and/or Apgarscore.Chi square test and Fisher Exact test has been used to find the significant association of HIE staging and outcome and other study characteristics.
Results: Among 92 asphyxiated newborns, Pregnancy was complicated by the presence of PIH in 15 (16.3%), APH in 3 (3.3%), MSAF was present in 51 (55.4%), maternal anemia in 16 (17.4%) and PROM in 9 (9.8%). Labour was complicated by prolonged II stage in 12 (13.0%) of them and cord prolapse was seen in 1 (1.1%).HIE occurred in 59 (64.13%) out of 92 asphyxiated neonates. According to Sarnat and Sarnat clinical HIE staging, 33 (55.93%) newborns had stage I, 18 (30.51%) had stage II and 8 (13.56%) of the newborns had stage III HIE.Renal involvement occurred in 43 (46.7%) of the total asphyxiated neonates and was the most commonly involved system, next toCNS (64.13%).
Conclusion: In this study, there is a statistically significant association between severity of perinatal asphyxia and severity of HIE. Apgar score at 1 minute is inversely related to the stages of HIE. Though the neonatal factors like male sex, SGA, LGA and perinatal factors like MSAF, PROM, maternal anemia, LSCS, instrumental delivery and breech presentation are associated with the outcome of HIE (sequelae/death), there is no statistically significant association.
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