English

Abstract

BACKGROUND: Perinatal asphyxia is a condition during the first and second stage of labour in which impaired gas exchange leads to fetal hypoxia and hypercarbia. Perinatal asphyxia is a common cause of mortality and morbidity in neonatal intensive care units. Although many studies are there but no such study was available from the studied area. So this study was conducted to know the clinical correlations of perinatal asphyxia in this area. AIMS: This study was conducted to study various maternal and neonatal risk factors for perinatal asphyxia and to study the various clinical features of perinatal asphyxia with special reference to central nervous system and to grade the encephalopathy as per Sarnat and Sarnat staging. SETTINGS: Neonatal intensive care unit of MRA Medical College Ambedkar Nagar. DESIGN: Observational study. MATERIAL AND METHODS: Neonates admitted in NICU with history of perinatal asphyxia as per the definition by WHO. RESULTS: Various feto-maternal factors were associated with asphyxiated neonates. Those observed to be significantly associated with asphyxia (in decreasing order of risk) included no antenatal check- ups (50%), home delivery (40%),fetal distress (25%), meconium stained liquor (23.3%), prolonged labour (20%), prolonged rupture of membranes(16.7%) antepartum haemorrhage (13.3%),severe anemia (10%), eclampsia(8.3%),premature rupture of membrane (6.6%), obstructed labour (5%).In many of the cases more than one risk factor was associated. Of the total 120 asphyxiated neonates 80 (66.6%) had encephalopathy. As per Sarnat and Sarnat staging 24(20%) were in stage 1, 36(30%) were in stage 2 and 20(16.6%) were in stage 3 of Hypoxic Ischemic Encephalopathy. Other than neurological dysfunction symptoms which were also associated in asphyxiated newborn were feeding difficulties(75%), respiratory distress (25%), meconium aspiration syndrome(13.3%),acute renal Failure(8.3%),apnea(4.2%). CONCLUSION: Perinatal asphyxia is a common cause of morbidity and mortality. Many cases are due to poor antenatal checkups and home delivery. We recommend that more and more expectant mother to be motivated for antenatal examination to detect any pregnancy complication at its earliest and to promote more and more of institutional deliveries.