Prediction of Perinatal Hypoxic Encephalopathy: Proximal Risk Factors and Short-Term Complications

Abstract

Background: To determine the proximal risk factors associated with perinatal hypoxic encephalopathy signs and its short-term complications. Methods: This is a prospective study conducted in women in labor with medical and obstetrics risk factors at King Abdulaziz University Hospital, Jeddah, Saudi Arabia from May 1, 2010 to May 1, 2011. The abnormal umbilical arterial base deficit levels ( ≥ 12 mmol/L), compared with a normal base deficit level ( < 12 mmol/L) and the neonatal outcomes were studied in both groups. Results: The frequency of fetal acidosis with a cord pH ≤ 7 or a base deficit level of ≥ 12 mmol/L at birth was 31 (5.6%) versus 59 (10.7%), respectively. The intrapartum proximal risk factors were abnormal fetal heart rate patterns (n = 18, 30.5%); prolonged labor duration, vacuum delivery (n = 12, 20.3%); pregnancy-induced hypertension (n = 10, 17%); fetal growth restriction (n = 4, 6.8%); and abruptio placentae (n = 3, 5.1%). The neonatal encephalopathy signs with an abnormal base deficit and proximal risk factors were umbilical arterial cord blood pH (n = 24, 40.7%); low Apgar score at 5 minutes (n = 10, 17%); admission to the neonatal intensive care unit (n = 20, 33.9%); and intubation (n = 9, 15.3%). Conclusion: Fetal metabolic acidemia may predict neonatal encephalopathy signs in association with intrapartum proximal risk factors. J Clin Gynecol Obstet. 2014;3(3):97-104 doi: http://dx.doi.org/10.14740/jcgo267w