scholarly journals Effectiveness of Magnesium Sulphatein Term Neonate with Perinatal Asphyxia: A Study in Faridpurmedical College Hospital, Faridpur, Bangladesh

2021 ◽  
Vol 7 (1) ◽  
Keyword(s):  
Perinatal Asphyxia ◽  
Term Neonate ◽  
College Hospital

scholarly journals Randomized Controlled Trial between Levetiracetam and Phenobarbital in the Treatment of Neonatal Seizure due to Perinatal Asphyxia

2018 ◽  
Vol 42 (2) ◽  
pp. 67-72
Author(s):  
Abu Faisal Md Pervez ◽  
Md Fakhrul Amin Badal ◽  
SM Nurun Nabi ◽  
Mohammad Kamrul Hassan Shabuj ◽  
Sanjoy Kumer Dey ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Randomized Controlled Trial ◽  
Adverse Effects ◽  
Perinatal Asphyxia ◽  
Controlled Trial ◽  
Common Adverse Effect ◽  
Neonatal Seizure ◽  
College Hospital ◽  
Antiepileptic Agent ◽  
Randomized Controlled

Background: Seizure occurs more frequently in neonatal period and incidence of seizure is 50%-68% in perinatal asphyxia. At present phenobarbital is the drug of choice for treating neonatal seizure, which has some adverse effects on neurodevelopment status. Levetiracetam is a novel antiepileptic agent well-tolerated and effective in focal, generalized and neonatal seizure as well and lacks the adverse effects like phenobarbital. The present study was undertaken to compare the safety and efficacy of levetiracetam to phenobarbital in the treatment of neonatal seizure due to perinatal asphyxia.Methodology: This interventional study (Randomized Controlled Trial) was conducted in Department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka and Dhaka Medical College Hospital, Dhaka, Bangladesh from 1st January’ 2014 to 30th June’ 2015. Intravenous levetiracetam injection, 50 mg/kg loading followed by 10 mg/kg 8 hourly maintenance was used and phenobarbital intravenous 20-40 mg/kg loading and 2.5 mg/kg/dose 12 hourly maintenance was given as per institutional protocol.Results: Sixty-nine term asphyxiated neonates (intention to treat population) provided analyzable data. Seizure control was found significantly higher (p = 0.011) higher in levetiracetam group in comparison to phenobarbital group (71% vs 40%). Need for more than one drug was significantly lower in levetiracetan group (p=0.011). Adverse effects were found significantly (p=0.001) lower in levetiracetam group (9% vs 43%). No serious adverse effect was observed in any group and most common adverse effect was somnolence in both group followed by irritability. Restlessness, sedation and shallow breathing were found only in phenobarbital group.Conclusion: Levetiracetam is more effective and safe in comparison to phenobarbital in the treatment of neonatal seizure due to perinatal asphyxia.Bangladesh J Child Health 2018; VOL 42 (2) :67-72

scholarly journals Aetiology and Outcome of Acute Kidney Failure In Bangladeshi Children – Dhaka Medical College Hospital Experience

2016 ◽  
Vol 24 (2) ◽  
pp. 86-91
Author(s):  
Shireen Afroz ◽  
Maliha Alam Simi ◽  
Shanjida Sharmim ◽  
Rokeya Khanum ◽  
Laila Yeasmin ◽  
...  
Keyword(s):  
Kidney Failure ◽  
Perinatal Asphyxia ◽  
Diarrhoeal Disease ◽  
Posterior Urethral Valve ◽  
Medical College Hospital ◽  
Acute Kidney Failure ◽  
Acute Glomerulonephritis ◽  
College Hospital ◽  
Medical College ◽  
Severe Degree

Background: Acute Kidney Failure (AKF) is the acute loss of kidney function over hours or days, the aetiology of which varies in different countries.Objectives: The study was aimed to find out the aetiology and see the immediate outcome of AKF in children in a tertiary level teaching hospital in Bangladesh.Methods: This prospective observational study was conducted from June 2011 to December 2012 in the Paediatric Nephrology Department of Dhaka Medical College Hospital, Dhaka. AKF was evidenced by presence of any two: serum creatinine raised >3 fold from the baseline, urine output <0.3ml/kg/hr for 24 hours or anuria for 12 hours. A total of 50 children with AKF were evaluated regarding their socio-demographic and clinical data. All underwent intermittent peritoneal dialysis and other necessary supportive care as needed. They were followed up for 3 months after enrolment.Results: Age of the children ranged from 5 days to 12 years. Among them, 33 were male and 17 female. Majority of the patient were from rural area and from a poor socioeconomic status. Out of 50 children majority (76%) were under 5 year age. The aetiology of AKF was mainly prerenal 66%, followed by renal 32 %, post renal 2%children. Among the pre-renal AKF 68% were due to diarrheal complications,12% neonatal AKF were due to severe perinatal asphyxia (PNA). Haemolytic uraemic syndrome, wasp envenomation and acute glomerulonephritis were the common renal causes of AKF. Post-renal cause of AKF was due to posterior urethral valve. The overall 38(76%) survived with normal renal functions, 10(20%) died and 2(4%) developed chronic kidney disease. The higher mortality rate was due to late referral, multi organ failure and severe degree of renal failure.Conclusion: This study suggests that diarrhoeal disease was the major cause of paediatric AKF. AKF is more common in infancy and associated with increased mortality. Common cause of neonatal AKF is severe perinatal asphyxia.J Dhaka Medical College, Vol. 24, No.2, October, 2015, Page 86-91

scholarly journals Ultrasonographic Findings of Brain in Perinatal Asphyxiated Babies

2018 ◽  
Vol 29 (2) ◽  
pp. 21-25
Author(s):  
M Luthfor Rahman ◽  
Kabiruzzaman Shah ◽  
Parimal K Paul ◽  
Sanaul Haq ◽  
M Belal Uddin ◽  
...  
Keyword(s):  
Perinatal Asphyxia ◽  
Cost Effective ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Paediatric Department ◽  
Preterm Babies ◽  
Stage 1 ◽  
Cns Lesions

Perinatal asphyxia is a major cause of morbidity and mortality among the newborns in developing countries like Bangladesh. The CNS lesions following perinatal asphyxia can be detected by ultrasonography before closure of fontanels which is easier, cost-effective, and convenient than other methods like CT scan and MRI. This cross-sectional type of descriptive study was conducted on 99 perinatal asphyxiated babies in the Paediatric department of Rajshahi Medical College Hospital during the period of July 2008 to June 2010 to assess CNS lesions in different grades of HIE in term and preterm babies. A non-random purposive sampling method was adopted to select the sample unit. Ultrasonography of the brain of each patient was done at the Centre for Nuclear Medicine & Ultrasound, Rajshahi only once within first 28 days of life when the baby became clinically stable. Ultrasonographic findings showed that 13.1% term babies had abnormal findings of which cerebral edema occupied the major portions (54.54 %). About 20.0% preterm babies had abnormal ultrasonographic findings of which ventriculomegaly without IVH (66.6%).The study also showed that the prevalence of intracranial abnormality was higher (78.6%) among the perinatal asphyxiated babies with HIE stage-2 in comparison to that of the HIE stage-3 (14.3%) and HIE stage-1(7.1%).So, this study provided evidences in favour of role of ultrasonography of brain in the evaluation of perinatal asphyxiated babies and designing appropriate management.TAJ 2016; 29(2): 21-25

scholarly journals Clinical Profile and Ultrasonographic Evaluation of Brain in Perinatal Asphyxia

2014 ◽  
Vol 41 (3) ◽  
pp. 33-37
Author(s):  
F Noman ◽  
MI Islam ◽  
HA Khan
Keyword(s):  
Gestational Age ◽  
Cerebral Oedema ◽  
Perinatal Asphyxia ◽  
Periventricular Leukomalacia ◽  
Full Term ◽  
Ventricular Dilatation ◽  
Age Group ◽  
College Hospital ◽  
Medical College ◽  
Preterm Babies

This descriptive cross sectional study was carried out in the department of paediatrics, Mymensingh Medical College Hospital from March 2006 to December 2006. This study was performed on 100 consecutive asphyxiated newborns who were admitted in Mymensingh Medical College Hospital during the study period. Among them, 50 babies were preterm and 50 babies were full term with moderate to severe perinatal asphyxia. Full term (>37 weeks of gestation) and preterm (<37 weeks of gestation) newborn babies with perinatal asphyxia was taken as case in inclusion criteria. Among the preterm babies, highest number 23(46%) were in the age group o/ 34-36 weeks of gestational age and among the term babies, highest number 24(48%) were in the age group of 39-40 weeks of gestational age. This study shows that 39% mothers had prolong obstructed labour, 21% had premature rupture membrane and 17% had pre-eclamptic toxaemia during pregnancy,. Convulsion 66%, poor primitive reflexes 52%, cyanosis 49% pallor 32%, respiratory distress 32% and apnoic spells 26% were the common presentations of asphyxiated babies. Out of 50 preterm asphyxiated newborn, one showed periventricular leukomalacia, two IVH and two ventricular dilatation. In the present study abnormal sonogram were detected in ten term babies. Two cases showed features of cerebral oedema and eight cases showed mild to moderate ventriculomegaly together with several subcortical cystic lesions of varying size. In case of comparison, eight cases had ventricular dilatation in term babies while 2 cases had in preterm babies. None of the term babies had ventricular haemorrhage but 2 had in preterm babies. Only, one preterm baby had periventricular leukomalacia but none among the term babies. There were 2 cases of cerebral oedema in term babies but none in preterm babies. Thus ultrasonography helps early recognition of intracranial abnormalities in asphyxiated newborns. So prognosis may be assessed, complication may be anticipated and appropriate management plan can be designed. DOI: http://dx.doi.org/10.3329/bmj.v41i3.18956 Bangladesh Medical Journal 2012 Vol.41(3): 33-37

scholarly journals Cardiac changes in asphyxiated neonates-need for early detection to improve long-term outcome

2017 ◽  
Vol 4 (5) ◽  
pp. 1844
Author(s):  
Raja Lakshmanan ◽  
Yogendra Singh Verma
Keyword(s):  
Perinatal Asphyxia ◽  
Myocardial Dysfunction ◽  
Pulmonary Artery Hypertension ◽  
Cardiac Monitoring ◽  
College Hospital ◽  
Term Outcome ◽  
Long Term Outcome ◽  
T Wave ◽  
Echocardiographic Examination

Background: Cardiac changes are common in Perinatal asphyxia. Detecting them early will help in specific management and good long-term outcome. Cardiac monitoring is recommended in every resuscitation as per NRP 7. Objective of present study was to evaluate myocardial dysfunction in neonates having Hypoxic Ischemic Encephalopathy by clinical, electrocardiographic and echocardiographic examination. Methods: Observational analytical study of 79 neonates who suffered from asphyxia as per selection criteria were done at medical college hospital. Myocardial dysfunction was evaluated by clinical features assessed on first 2 days and electrocardiographic and echocardiographic examination was done after 24 hours. Data were collected and analysed by SPSS 21 software.Results: Respiratory distress was found in 67.08% of the subjects. Prolonged capillary refill time was found in 39.24% of the subjects. Mean QTc (ms) interval was prolonged in non-survivors (496.6±20.8) when compared with survivors (418.2±33.7) (p - 0.000). T wave changes were present in non-survivors (94.7%) when compared to survivors (41.7%) (LR- 19.558). ST wave changes were present in non-survivors (73.7 %) compared with survivors (10%) (LR- 28.483). Mean Ejection Fraction (%) was shortened in non-survivors (53.79±7.53) compared with survivors (71.48±10.28) (p-0.000). Significant tricuspid regurgitation (78.94%) was present among non-survivors compared to survivors (10%) (LR- 17.859). Evidences of significant pulmonary artery hypertension were found in most of the (78.94%) non-survivors compared to survivors (10%) (LR-22.4). Similarly, severe grades of asphyxia had significantly high findings of increased CRT, reduced EF, LVES, ST and T wave changes etc.Conclusions: Cardiac changes in severe asphyxia are high and can be identified early by clinical, electroctrocardiographic and echocardiographic examination. 

Intraventricular Hemorrhage in the Full-Term Neonate Associated With Abdominal Compression

PEDIATRICS ◽  
1992 ◽  
Vol 89 (2) ◽  
pp. 327-329
Author(s):  
KURT WEHBERG ◽  
MARTIN VINCENT ◽  
BOBBY GARRISON ◽  
JOSEPH F. DILUSTRO ◽  
L. MATTHEW FRANK
Keyword(s):  
Intraventricular Hemorrhage ◽  
Perinatal Asphyxia ◽  
Birth Trauma ◽  
Full Term ◽  
Term Neonate ◽  
Neurologic Examination ◽  
Abdominal Compression ◽  
Third Trimester ◽  
Apgar Scores ◽  
Spontaneous Vaginal Delivery

Intraventricular hemorrhage (IVH) in the full-term neonate usually is associated with birth trauma and/or perinatal asphyxia. A cause can be found in approximately 75% of cases; however, the remainder have no identifiable risk factors.1 This report describes a 13-day-old full-term neonate who sustained an IVH following moderate abdominal trauma. CASE REPORT History A full-term male newborn was delivered via an uncomplicated spontaneous vaginal delivery to a 35-year-old biparous mother with third trimester diet-controlled gestational diabetes mellitus. Apgar scores were 8 at 1 minute and 9 at 5 minutes. Birth weight was 3660 g, and the results of the neurologic examination were normal with a fronto-occipital head circumference of 35.0 cm.

Neonatal Mortality: Effects of Selective Pediatric Interventions

PEDIATRICS ◽  
1985 ◽  
Vol 75 (1) ◽  
pp. 51-57
Author(s):  
Adekunle H. Dawodu ◽  
Charles E. Effiong
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Mortality ◽  
Current Knowledge ◽  
Perinatal Asphyxia ◽  
Birth Asphyxia ◽  
Case Fatality ◽  
Therapeutic Interventions ◽  
Low Birth Weight Infants ◽  
College Hospital

A previous prospective study of neonatal mortality in babies receiving special care at the University College Hospital, Ibadan, revealed that respiratory failure associated with prematurity, perinatal asphyxia, sepsis, and congenital malformations were the major causes of high neonatal mortality. To improve survival, selective measures were taken to improve care of low-birth-weight infants and prevent or treat intrapartum and postnatal hypoxia, metabolic acidosis, hypoglycemia, and hypothermia. A change in the initial antibiotic management of suspected septicemia to the use of cloxacillin and an aminoglycoside was also introduced, based on the current knowledge of etiologic agents and their antimicrobial sensitivities. In the 5-year period (1976 to 1980), the neonatal mortality in babies weighing 2,500 g and more at birth dropped significantly from 1.2% to 0.7% (P &lt; .02). The case fatality rates from birth asphyxia and neonatal sepsis dropped by 48% and 32%, respectively. Despite therapeutic interventions, however, the neonatal mortality in babies with birth weight of 1,000 g or less, 1,001 to 1,500 g, 1,501 to 2,000 g, and 2,001 to 2,499 g remained unchanged at about 82%, 25%, 9%, and 3%, respectively. These results suggest that early identification of infants at risk of developing birth asphyxia or neonatal septicemia and institution of prompt and appropriate management could produce a significant reduction in mortality in infants of normal birth weight. Survival of low-birth-weight infants requires additional high technical, financial, and manpower resources, which most centers in developing countries cannot afford at the present time. Therefore, efforts are probably better concentrated on decreasing the incidence of low birth weight.

scholarly journals Impact of Antenatal Care (ANC) on Perinatal Asphyxia.

2020 ◽  
Vol 14 (1) ◽  
pp. 34-36
Author(s):  
Anita Sarker ◽  
Iffat Ara Shamsad ◽  
Najnin Umme Zakia ◽  
Khyrun Nahar ◽  
Sabiha Shimul
Keyword(s):  
Birth Weight ◽  
Antenatal Care ◽  
Perinatal Asphyxia ◽  
College Hospital ◽  
Face To Face ◽  
Medical College ◽  
Group I ◽  
Group Ii ◽  
The Impact ◽  
Control Study

Antenatal care (ANC) is very important for all women for their own health and their neonates. This study was done to observe the impact of antenatal care on perinatal asphyxia. This case-control study was conducted at Neonatology Department of Dhaka Medical College Hospital, Dhaka from July 2014 to December 2014. Fifty neonates with perinatal asphyxia (Group I) and fifty neonates without perinatal asphyxia (Group II) were selected as study subjects. After selection, informed written consent was taken. Then data were collected by face to face interview of the mother. The mean age of neonates was 49.0±72.1 hours in group I and 55.8±63.9 hours in group II. Majority (80.0%) of the neonates had birth weight 2.5- 4.0 kg in group I and only 22(44.0%) neonates had birth weight 2.5-4.0 kg in group II. Almost half (48.7%) of the mothers received antenatal check-up at UHC/FWC/MCWC in group I and 20(41.7%) in group II. It was observed that 19(38.0%) mothers received antenatal care from untrained Dai in group I and 42(84.0%) in group II. Only 30.0% of the mothers received adequate antenatal check-up in group I and 68.0% in group II. Mothers having baby with perinatal asphyxia received significantly less number of ANC. Faridpur Med. Coll. J. Jan 2019;14(1): 34-36

scholarly journals A comparative study on the use of mannitol and dexamethasone in severe perinatal asphyxia among newborn babies conducted in Ad-din Sakina Medical College, Jessore

Mediscope ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. 16-20
Author(s):  
KZ Hossain ◽  
MA Islam ◽  
PK Das
Keyword(s):  
Intracranial Pressure ◽  
Comparative Study ◽  
Cerebral Edema ◽  
Clinical Condition ◽  
Perinatal Asphyxia ◽  
Raised Intracranial Pressure ◽  
Anterior Fontanelle ◽  
College Hospital ◽  
Term Newborn ◽  
Medical College

We conducted a comparative study on sixty full-term newborn babies with cerebral edema and severe perinatal asphyxia treating with mannitol or dexamethasone in Ad-din Sakina Medical College Hospital, Jessore. The age (in hours) of the children in both groups was similar. The score for clinical condition of the children with perinatal asphyxia at 24 hours, 48 hours and 72 hours after using mannitol were significantly lower than the respective score at 24 hours, 48 hours and 72 hours after using dexamethasone (p < 0.01, p < 0.05 and p < 0.001, respectively). The score for bulging condition of anterior fontanelle of the children with perinatal asphyxia at 24 hours, 48 hours and 72 hours after using mannitol were significantly lower than the respective score at 24 hours, 48 hours and 72 hours after using dexamethasone (p < 0.05, p < 0.05 and p < 0.001, respectively). The score for clinical condition of the children with perinatal asphyxia at 24 hours, 48 hours and 72 hours after using mannitol were significantly lower than the respective score before the treatment (p < 0.05, p < 0.001 and p < 0.001, respectively). The scores at 48 hours and 72 hours after using dexamethasone were significantly lower than the respective score before the treatment (p < 0.001 and p < 0.001, respectively). The score for bulging condition of anterior fontanelle of the children with perinatal asphyxia at 24 hours, 48 hours and 72 hours after using mannitol were significantly lower than the respective score before the treatment (p < 0.001, p < 0.001 and p < 0.001, respectively). The score at 48 hours and 72 hours after using dexamethasone were significantly lower than the respective score before the treatment (p < 0.001 and p < 0.001, respectively). Mannitol seems to be more beneficial than dexamethasone in the management of severe perinatal asphyxia due to raised intracranial pressure associated with cerebral edema.Mediscope Vol. 5, No. 2: Jul 2018, Page 16-20

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