Abstract
Birth asphyxia is a serious clinical problem worldwide. It claims approximately 9 million deaths each year. It can lead to serious neurological sequaele, such as cerebral palsy, mental retardation, and epilepsy. All babies admitted in College of Medical Sciences Teaching Hospital, Chiwan, Nepal, NICU from January 2013 to December 2013 with a diagnosis of birth asphyxia (5 min Apgar<7 or those with no spontaneous respirations after birth) were included in the study (n=125). This was a descriptive observational study. Clinical information was collected (gravida, hour at presentation, mode of delivery, sex of baby, gestational age of the baby, requirement of resuscitation). Neonates were admitted to NICU, observed for complications and managed as per hospital protocol. Among the 722 neonates admitted to NICU, 125 had perinatal asphyxia (17.3%). Babies with Hypoxic ischemic encephalopathy(HIE) Grade I had a very good outcome but HIE III was associated with a poor outcome. Outborn neonates had higher grades of perinatal asphyxia as compared to inborns (p=0.018). Term gestation, Males and Multigravida were associated with a higher rate of birth asphyxia. 22.4% neonates were delivered via caesarean section and 74.4% required bag and mask ventilation at birth. Birth asphyxia was one of the commonest causes of admission NICU. Babies with HIE Grade III had a very poor prognosis. Outborn neonates with birth asphyxia had a higher mortality. Males were frequently affected than females.
Highlights
Birth asphyxia is a serious clinical problem worldwide
The objectives of the study were to assess the clinical profile of neonates with perinatal asphyxia and severity of birth asphyxia with hypoxic ischemic encephalopathy (HIE) in terms of mortality
Among which 125 cases were of birth asphyxia and accounted for 17.3 % of NICU admissions
Summary
Birth asphyxia is a serious clinical problem worldwide. It claims approximately 9 million deaths each year. Birth asphyxia is defined as the failure to initiate and sustain breathing at birth It accounts for an estimated 900,000 deaths each year and is one of the primary causes of early neonatal mortality.1Guidelines for neonatal resuscitation, such as those endorsed by WHO and the American Academy of Pediatrics, represent a standard practice set that improves outcomes in asphyxiated newborns. These algorithms stress the importance of drying, stimulating and warming babies in distress, as well as clearing their airways. In the face of persistent apnoea or bradycardia, ventilation with the use of bag-and-mask or equivalent device is indicated, and is felt by many to constitute the critical step in managing asphyxiated infants.[2]
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