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Clinical Profile of Hypoxic- Ischemic Encephalopathy in Neonates with Birth Asphyxia in a Rural Tertiary Care Hospital in Central India

Anjali Kher, Associate Professor, Department of Pediatrics, Jawaharlal Nehru Medical College, DMIMS, Sawangi (M), Wardha, Maharashtra 442004, India. , Kher Anjali M.1 , Singh Kuldeep2 , Vagha Jayant3

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Pediatric Education and Research 6(2):p 80-86, May - August 2018. | DOI: DOI: https://dx.doi.org/10.21088/per.2321.1644.6218.6

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Abstract

Context- Perinatal asphyxia and Postasphyxial hypoxic-ischemic encephalopathy (HIE) is a major cause of early neonatal mortality in India accounting for 24.3% of neonatal deaths.

Aim- To study risk factors, clinical, biochemical, Neurosonography parameters and short term outcome of neonates with HIE.

Setting and Design- Study conducted at AVBRH, Sawangi (M) after seeking IEC approval. It was a prospective observational study.

Material and method-All neonates delivered in AVBRH and admitted to NICU with birth asphyxia and HIE were included in the study. A detailed history, examination, HIE staging, cord blood ABG, Neurosonography, other investigations and short term outcome were recorded in prevalidated proforma and data was statistically analyzed using SPSS 22.0.

Results- Incidence of Birth asphyxia was 2.97%, incidence of HIE was 1.76%. Of all neonates with HIE (study group n=50) 26% were in HIE stage I, 54% were in stage II and 20% were in stage III. On umbilical cord ABG 20% neonates had severe acidemia and 80% had moderate acidemia. Neurosonography changes were seen in 4% neonates, mortality rate was 18%. All 9 neonates who died were in HIE stage III.

Conclusion-Birth asphyxia and HIE are still a major cause of neonatal morbidity and mortality. HIE stage III, severe acidemia are associated with high mortality. Preclampsia, oligohydramnios and MSAF are risk factors associated with HIE.

Keywords: Birth Asphyxia; HIE; Incidence; Mortality and Risk Factors.

 

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DOI: DOI: https://dx.doi.org/10.21088/per.2321.1644.6218.6

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