Abstract
Objective: To assess the efficacy of intravenous (IV) magnesium sulphate in treating birth asphyxia and improving short term neurological outcome. Method: A prospective study was conducted in Onake Obavva Women and Children Hospital from February 2015 to March 2016. A sample size of 100 term neonates (50 study group and 50 control group) with perinatal asphyxia were included in the study. Congenitally malformed babies and babies born to mothers who received general anaesthesia, magnesium sulphate and drugs likely to depress the baby were excluded from study. Routine protocol for asphyxiated babies in the neonatal intensive care unit (NICU) was followed in all 100 neonates. In addition, babies in the study group were given IV magnesium sulphate 250 mg/kg/dose within 6 hours of birth, after 24 hours of birth and at 48 hours of birth. During their stay in the NICU all 100 neonates were neurologically assessed. Results: Each group comprised 50 neonates. Seizure control with a single anticonvulsant was significantly greater in the study group compared with the control group (p Conclusions: Postnatal IV magnesium sulphate infusion is effective in improving short term outcomes for infants with perinatal asphyxia when it is given early (within 6 hours). (Keywords: Perinatal asphyxia, neonates, magnesium sulphate, anticonvulsant, hypoxic ischaemic encephalopathy) Sri Lanka Journal of Child Health , 2017; 46 (2): 148-151
Highlights
Perinatal asphyxia is a major cause of neonatal mortality and morbidity[1]
Seizure control with a single anticonvulsant was significantly greater in the study group compared with the control group (p
In the study group 18.5% neonates had seizure continued at 24 hours as compared to 34.4% in the control group (p
Summary
Perinatal asphyxia is a major cause of neonatal mortality and morbidity[1]. Glutamate, the main excitatory aminoacid neurotransmitter, is released in increased concentrations into the extracellular compartment of the brain. One is rapid cell death initiated by glutamate receptor activation. The second is initiated principally by activation of the N-methyl D-aspartate (NMDA) receptor. Magnesium is a naturally occurring NMDA receptor antagonist which is recommended for clinical use to combat glutamate toxicity and brain damage[4,5,6]. Literature regarding postnatal magnesium therapy after birth asphyxia revealed beneficial effects in some and no beneficial effects in others[7,8,9,10,11]
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