Controlled hypothermia in complex therapy for hypoxic ischemic encephalopathy in infants with birth asphyxia

2020 ◽  
Vol 5_2020 ◽  
pp. 90-97
Author(s):  
Savelyeva G.М. Savelyeva ◽  
Shalina R.I. Shalina ◽  
Аnаnkina А.А. Аnаnkina ◽  
Kunyakh Zh.Yu Kunyakh ◽  
Sichinava L.G. Sichinava ◽  
...  
Keyword(s):  
Birth Asphyxia ◽  
Hypoxic Ischemic Encephalopathy ◽  
Complex Therapy ◽  
Controlled Hypothermia ◽  
Ischemic Encephalopathy

MRI IN HYPOXIC ISCHEMIC ENCEPHALOPATHY WITH CLINICAL FOLLOW UP

2021 ◽  
pp. 43-48
Author(s):  
M R Shashikumar ◽  
Narasipur Lingaiah Rajendrakumar ◽  
Sanjay P ◽  
Nanjaraj Chakenalli Puttaraj ◽  
Shruti Shruti ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Mr Imaging ◽  
Developmental Disorders ◽  
Brain Mri ◽  
Birth Asphyxia ◽  
Hypoxic Ischemic Encephalopathy ◽  
Preterm Neonates ◽  
Diffusion Restriction ◽  
Ischemic Encephalopathy

Introduction: HIE is often clinically suspected in the setting of a known perinatal stress event arising from a complicated or difcult delivery. The most sensitive and specic imaging technique for examining infants with suspected hypoxicischemic brain injury is MR imaging. It also gives information about the timing and specic patterns of injury and also suggest diagnoses other than HIE such as metabolic disorders and developmental disorders of the brain. MRI is also a useful tool in the determination of prognosis and also follow-up of HIE. Aim: This study was undertaken to evaluate the various MRI appearances of hypoxic ischemic encephalopathy in term and preterm neonates and to correlate the MRI appearances with clinical outcome. Materials and Methods: All neonates with history of birth asphyxia, referred for MRI examination to the Department of Radio-Diagnosis, K. R. Hospital attached to Mysore Medical College and Research Institute, during January 2018 to January 2019. All MRI scans were performed on GE optima MR360 1.5 Tesla. Sequences used were T1W axial, T1 FLAIR axial, T2W axial, T2 FLAIR axial, T1W sag, T2W coronal, T2W GRE axial, DWI axial and ADC maps. Results: 30 babies with clinically suspicion of HIE and positive ndings on MR imaging were evaluated in our study. Out of 30 babies, 18 were term and 12 babies were preterm. Periventricular luecomalacia is most common MRI pattern in preterm and central pattern in term neonates. 16 babies had abnormal developmental outcome at 6 months follow up study. 16 babies with diffusion restriction in corpus callosum, 12 had abnormal outcome. 7 out of 10 babies with loss of normal signal in internal capsule had abnormal outcome. Babies with diffusion restriction in basal ganglia had gross developmental delay. Conclusion: MRI is the modality of choice for evaluation of HIE because of excellent gray – white matter resolution, well-depiction of myelination pattern and multi-planar imaging capabilities. There is a strong relation between the MRI appearances of birth asphyxia and the clinical outcome. Therefore MRI has a strong role in prognosticating lesions.

Hypoxic Ischemic Encephalopathy in Neonates with Birth Asphyxia - A Hospital Based Study

2021 ◽  
Vol 18 (2) ◽  
pp. 22-26
Author(s):  
Jyoti Adhikari ◽  
Deepak Paudel
Keyword(s):  
Birth Asphyxia ◽  
College Teaching ◽  
Hypoxic Ischemic Encephalopathy ◽  
Obstructed Labor ◽  
Female Ratio ◽  
Live Births ◽  
Normal Birth ◽  
Risk Pregnancy ◽  
Clinical Presentations ◽  
Ischemic Encephalopathy

Introduction: Each year approximately 4 million babies are born asphyxiated, which results in 1 million deaths and an equal number of serious neurological sequelae. One of the commonest organs involved in birth asphyxia is brain which may lead to a syndrome of clinical manifestation called Hypoxic Ischemic Encephalopathy (HIE). Aims: To find out possible maternal and neonatal risk factors for Hypoxic Ischemic Encephalopathy, to analyze clinical presentations and outcome of HIE in asphyxiated newborns. Methods: Hospital based observational study was carried out among fifty newborns with Apgar score less than 7 at 1 minute of life admitted in Nepalgunj Medical College Teaching Hospital, Kohalpur, Banke. Results: The incidence of birth asphyxia and birth asphyxia with HIE were 37.2 per 1000 live births and 14 per 1000 live births with male: female ratio of 1.27:1. Most of the neonates 22(44%) were in HIE stage II. Meconium stained amniotic fluid 18 (36%) was the most common intrapartum risk factor followed by maternal use of intrapartum medications 14 (28%), Premature Rupture of Membrane (PROM) 8 (16%), prolonged labor 5 (10%) and obstructed labor 6 (12%). Four (8%) asphyxiated neonates with HIE had cord prolapse and 7 (14%) had cord around the neck. The most common resuscitation done was bag and mask ventilation (56%) (P<0.05). Majority of the studied neonates were of normal birth weight (76%) and head circumference (84%) (P<0.05) with clinical presentations of respiratory distress (88%), seizures (44%), apnea (22%), bradycardia (8%), tachycardia (6%) and bulged anterior fontanel (6%). The overall mortality of neonates with HIE was 20% of which most were of HIE stage III. Conclusion: Certain measures could be taken to prevent birth asphyxia: early detection and intervention of high risk pregnancy, prompt and effective resuscitation of asphyxiates newborns.

scholarly journals Current Controversies in Newer Therapies to Treat Birth Asphyxia

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Pia Wintermark
Keyword(s):  
Brain Injury ◽  
Neurological Outcome ◽  
Mild Hypothermia ◽  
Birth Asphyxia ◽  
Hypoxic Ischemic Encephalopathy ◽  
Monitoring Technology ◽  
The Past ◽  
Neuroprotective Strategy ◽  
Ischemic Encephalopathy

Despite major advances in monitoring technology and knowledge of fetal and neonatal pathophysiology, neonatal hypoxic-ischemic encephalopathy (HIE) remains one of the main causes of severe adverse neurological outcome in children. Until recently, there were no therapies other than supportive measures. Over the past several years, mild hypothermia has been proven to be safe to treat HIE. Unfortunately, this neuroprotective strategy seems efficient in preventing brain injury in some asphyxiated newborns, but not in all of them. Thus, there is increasing interest to rapidly understand how to refine hypothermia therapy and add neuroprotective or neurorestorative strategies. Several promising newer treatments to treat birth asphyxia and prevent its devastating neurological consequences are currently being tested. In this paper, the physiopathology behind HIE, the currently available treatment, the potential alternatives, and the next steps before implementation of these other treatments are reviewed.

scholarly journals Correlation of Thompson Score in Predicting Early Outcome of Newborn with Birth Asphyxia

2020 ◽  
Vol 18 (3) ◽  
pp. 406-410
Author(s):  
Sabina Shrestha ◽  
Sangita Puree Dhungana ◽  
Sujit Shrestha ◽  
Gentle Sunder Shrestha
Keyword(s):  
Neurodevelopmental Outcome ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
Clinical Score ◽  
Hypoxic Ischemic Encephalopathy ◽  
Early Outcome ◽  
Medical College ◽  
A Prospective Study ◽  
Ischemic Encephalopathy

Background: Birth asphyxia is one of the important causes of neonatal morbidity and mortality, accounting up to 30% of neonatal death in Nepal. It is also an important cause of long term neurological disability and impairment. Thompson encephalopathy score is a clinical score which can be used to assess the newborn with hypoxic ischemic encephalopathy for the prognosis and their neurodevelopmental outcome. The aim of the study was to assess the role of Thompson score in predicting the early outcome of neonates with birth asphyxia. Methods: A prospective study was conducted from May 2019 to April 2020 in Nepal Medical College. All the term babies during the period with Apgar score of less than seven at five minutes were considered to have birth asphyxia and included in the study. Neurological examination was done on first, second and third day using HIE score proposed by Thompson and severity of hypoxic ischemic encephalopathy was classified accordingly. Outcome was measured as normal, morbidity with encephalopathy, seizure, organ dysfunction and death. Results: Out of 391 newborn admitted to neonatal unit, 84 (21.4%) had birth asphyxia. Mild Thompson score on day 1,2,3 were 49(58.3%), 49 (58.3%), 51(60.7%); moderate Thompson score on day 1,2,3 were 21 (25%), 21 (25%), 18(21.4%) and severe Thompson score on day 1, 2, 3 were 14 (16.7%), 14 (16.7%), 15(17.9%) respectively. Out of 14 babies who had severe Thompson score on day 1, 11(91.7%) expired and 3 (16.7%) developed encephalopathy. Conclusions: There was strong correlation of severity of Thompson score with the outcome. Keywords: Birth asphyxia; hypoxic ischemic encephalopathy; thompson score

scholarly journals Electrolyte imbalance in neonates with hypoxic ischemic encephalopathy: A single center study.

2020 ◽  
Vol 27 (10) ◽  
pp. 2159-2164
Author(s):  
Muhammad Shamaoon ◽  
Nadia Razzaq ◽  
Muhammad Ahsan ◽  
Arslan Ahmad ◽  
Tehmina Maqbool ◽  
...  
Keyword(s):  
Birth Asphyxia ◽  
Fetal Distress ◽  
Cross Sectional Study ◽  
Hypoxic Ischemic Encephalopathy ◽  
Electrolyte Imbalance ◽  
Control Group ◽  
Serum Electrolyte ◽  
Cross Sectional ◽  
Electrolyte Level ◽  
Ischemic Encephalopathy

Objectives: To determine the mean serum electrolyte level in neonates with perinatal birth asphyxia with moderate hypoxic ischemic encephalopathy. Study Design: Descriptive Cross Sectional study. Setting: Pediatric Ward, Emergency and OPD, Allied Hospital, Faisalabad. Period: December 2017 to May 2018. Material & Methods: In our study, out of 190 cases were included, Results: mean g. age was calculated as 39.44+1.51 weeks, 49.47% (n=94) were male and 50.53% (n=96) were females. Mean APGAR score at 1 minute was calculated as 4.59+0.49 whereas 5.41+0.67 at 5 minutes. Mean weight of the neonates was calculated as 2771.58+256.83 grams. Frequency of delivered through history of fetal distress was recorded in 43.68% (n=83), mean serum electrolytes shows that serum sodium 137.71+1.69 mg/dl, serum potassium 3.92+0.18 mg/dl and serum calcium 8.45+0.51 mg/dl. Conclusion: We concluded that mean serum electrolyte level in neonates with perinatal birth asphyxia with moderate hypoxic ischemic encephalopathy were in normal range, however, in absence of control group and data analysis in qualitative way, we are unable to record the frequency of hypocalcemia, hyponatremia and hyperkalemia, which may be done in coming trials.

scholarly journals CLINICAL PROFILE AND SHORT TERM OUTCOME OF HYPOXIC ISCHEMIC ENCEPHALOPATHY AMONG BIRTH ASPHXIATED BABIES IN A TERTIARY CARE HOSPITAL

2021 ◽  
Vol 71 (1) ◽  
pp. 24-28
Author(s):  
Hafsa Niaz ◽  
Jawad Jalil ◽  
Qamar Zaman Khan ◽  
Faisal Basheer ◽  
Shahzad Akhtar ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Birth Asphyxia ◽  
Clinical Profile ◽  
Hypoxic Ischemic Encephalopathy ◽  
Care Hospital ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome ◽  
Ischemic Encephalopathy ◽  
Grade Iii

Objective: To determine the clinical profile, selected antepartum and intrapartum risk factor for adverse shortterm outcomes of hypoxic ischemic encephalopathy in babies with birth asphyxia. Study Design: Cross sectional study. Place and Duration of Study: Neonatal Intensive Care Unit of Pak Emirates Military Hospital, Rawalpindi, fromJan to Dec 2018. Methodology: This study including all birth asphyxiated babies born who fulfilled the inclusion criteria.Following data was collected prospectively regarding gender, gestational age, birth weight and mode of delivery, maternal age, antenatal follow up, history of premature rupture of membranes and meconium stained liquor. Babies were categorized into different stages of hypoxic ischemic encephalopathy according to Sarnat and Sarnat staging. Selected antepartum and intrapartum risk factors leading to hypoxic insult at birth were studied and short-term outcome was recorded in the form of need of mechanical ventilation, mortality and discharge from the hospital.Results: The frequency of birth asphyxia turned out to be 122/5986 (2.03%) at our center. Thirty four (27.87%)required mechanical ventilation, mortality was recorded at 20/122 (16.39%). While 61 (50%) babies suffered from stage I hypoxic ischemic encephalopathy, 13/20 (65%) of newborn who expired were suffering from grade III hypoxic ischemic encephalopathy. Conclusion: The severity of hypoxic ischemic encephalopathy affects the outcome of newborns having birthasphyxia with hypoxic ischemic encephalopathy grade III associated with maximum mortality. Early identifycation of pregnancies at risk for asphyxia, with appropriate intervention in selected cases is the key to prevent birth asphyxia and its ensuing neonatal complications.

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