Abstract
We conducted a comparative study on sixty full-term newborn babies with cerebral edema and severe perinatal asphyxia treating with mannitol or dexamethasone in Ad-din Sakina Medical College Hospital, Jessore. The age (in hours) of the children in both groups was similar. The score for clinical condition of the children with perinatal asphyxia at 24 hours, 48 hours and 72 hours after using mannitol were significantly lower than the respective score at 24 hours, 48 hours and 72 hours after using dexamethasone (p < 0.01, p < 0.05 and p < 0.001, respectively). The score for bulging condition of anterior fontanelle of the children with perinatal asphyxia at 24 hours, 48 hours and 72 hours after using mannitol were significantly lower than the respective score at 24 hours, 48 hours and 72 hours after using dexamethasone (p < 0.05, p < 0.05 and p < 0.001, respectively). The score for clinical condition of the children with perinatal asphyxia at 24 hours, 48 hours and 72 hours after using mannitol were significantly lower than the respective score before the treatment (p < 0.05, p < 0.001 and p < 0.001, respectively). The scores at 48 hours and 72 hours after using dexamethasone were significantly lower than the respective score before the treatment (p < 0.001 and p < 0.001, respectively). The score for bulging condition of anterior fontanelle of the children with perinatal asphyxia at 24 hours, 48 hours and 72 hours after using mannitol were significantly lower than the respective score before the treatment (p < 0.001, p < 0.001 and p < 0.001, respectively). The score at 48 hours and 72 hours after using dexamethasone were significantly lower than the respective score before the treatment (p < 0.001 and p < 0.001, respectively). Mannitol seems to be more beneficial than dexamethasone in the management of severe perinatal asphyxia due to raised intracranial pressure associated with cerebral edema.Mediscope Vol. 5, No. 2: Jul 2018, Page 16-20
Highlights
Perinatal asphyxia is a common problem of neonates
Data were collected, compiled and entered in a spreadsheet (Microsoft Excel) and analyzed using Statistical Package for Social Sciences (SPSS), version 16.10 The comparison between the two treatment conditions by mannitol and dexamethasone using data at before treatment, and 24 hours, 48 hours and 72 hours points after treatment was done by Student’s t-test, and the comparison within the two treatment conditions by mannitol or dexamethasone using data at before treatment compared with 24 hours, 48 hours and 72 hours points after treatment was done by one way analysis of variance with Bonferroni correction
The score at 24 hours, 48 hours and 72 hours after using mannitol were significantly lower than the respective score at 24 hours, 48 hours and 72 hours after using dexamethasone (p < 0.01, p < 0.05 and p < 0.001, respectively)
Summary
Perinatal asphyxia is a common problem of neonates. Severe perinatal asphyxia is a major cause of morbidity and mortality in the neonatal period. Perinatal asphyxia remains a concerned issue in health circles of the developing countries. The incidence of birth asphyxia causing a cerebral disturbance is unknown but is probably in the order of 1.5 to 6 per 1000 live births. It is arguably the commonest cause of perinatal brain injury associated with a longterm neurological handicap.[1] The management of severe birth asphyxia is both
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