Abstract
Introduction: Perinatal asphyxia, a major topic in neonatology, is a severe condition which has a high impact on neonatal mortality and morbidity and neurological and intellectual development of the infant. It is defined by WHO as "failure to initiate and sustain breathing at birth". It is estimated that around four million babies are born asphyxiated and among those one million die and an equal number of babies develop serious neurological consequences ranging from cerebral palsy and mental retardation to epilepsy. This study was done to identify the occurrence, clinical profile and, immediate outcome of perinatal asphyxia in Lumbini Medical College Teaching Hospital.
 
 Methods: It was a retrospective study where 82 cases who fulfilled the inclusion criteria were included between December 2014 to November 2015. Inclusion criteria included newborns with: a) Apgar score equal to or less than six at five minutes, b) requirement of more than one minute of positive pressure ventilation, c) signs of fetal distress (heart rate of less than 100 beats per minute, late decelerations).
 
 Results: Out of total 425 neonatal intensive care unit (NICU) admissions, 82 (19.3%) cases were of asphyxia among which 56 were inborn and 26 were referred from outside. Of those 82 cases, 47 (57.3%) cases developed hypoxic ischemic encephalopathy (HIE); HIE stage I had good outcome with survival rate of 95% and HIE stage III had poor outcome with survival rate of only 25%.
 
 Conclusion: Despite advances in management of neonates, perinatal asphyxia is still the leading cause of neonatal intensive care unit admission and mortality and morbidity in neonates.
Highlights
Perinatal asphyxia, a major topic in neonatology, is a severe condition which has a high impact on neonatal mortality and morbidity and neurological and intellectual development of the infant, despite many advances in perinatal care.[1]
The standard for defining an intrapartum hypoxic-ischemic event (HIE) sufficient enough to produce moderate to severe neonatal encephalopathy which subsequently leads to cerebral palsy has been established in three consensus statements
It is estimated that around four million babies are born asphyxiated per year among which 900,000 die and similar number i.e. one million develop serious neurological consequences like cerebral palsy, mental retardation, and epilepsy.[4]
Summary
A major topic in neonatology, is a severe condition which has a high impact on neonatal mortality and morbidity and neurological and intellectual development of the infant. A major topic in neonatology, is a severe condition which has a high impact on neonatal mortality and morbidity and neurological and intellectual development of the infant, despite many advances in perinatal care.[1] Hypoxemia may be defined as the "diminished amount of oxygen in the blood supply", while cerebral ischemia is defined as the "diminished amount of a - Lecturer b - Resident c - Associate Professor d - Department of Pediatrics, Lumbini Medical College Teaching Hospital, Palpa, Nepal. The cornerstone of all these three statements is the presence of severe metabolic acidosis (pH < seven and base deficit equal to or more than 12 mmol/L) at birth in a newborn exhibiting early signs of moderate or severe encephalopathy.[1]
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