Risk Factors and Short Term Outcome of Hypoxic Ischemic Encephalopathy in Term Neonates with Perinatal Asphyxia

Abstract

Objectives: to determine the risk factors and short term outcome (till discharge) of neonates with perinatal asphyxia at RMMCH, Chidambaram. Material and Methods: A prospective (case-control) study was conducted between January 2015 and July 2016 in the Neonatal Intensive Care Unit, Department of Paediatrics, Rajah Muthiah Medical College & Hospital. Venous blood collected from 50 term asphyxiated neonates comprising cases & 50 healthy neonates comprising controls constituted the material for study. Details of mother and baby were collected and compared between cases and controls. Results: There is no statistical significant difference in the age, parity status, gestational age of mother, birth weight and mode of delivery between cases and control newborns. Antepartum risk factors were maternal age of 20 to 25 years, Pre eclampsia (16%), Anemia (8%), primigravidity (58%). Intra partum risk factors were breech presentation (4%), prolonged second stage of labour (44%), meconium staind amniotic fluid (26%) and cord around the neck (6%). Among the babies, 48% had stage 2 HIE& there is statistically positive correlation between stages of HIE & short term outcome with NRBC count. Conclusion: Early identification of high risk mothers and timely referral to tertiary care center can reduce the mortality. Furthermore, there is need to carefully evaluate and monitor the babies with perinatal asphyxia immediately after birth. NRBC count can serve as simple and cost effective test in evaluating perinatal asphyxia thus reducing mortality and morbidity.