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.

Delayed development in newborns with hypoxic ischemic encephalopathy stage-2.

2021 ◽  
Vol 28 (03) ◽  
pp. 333-337
Author(s):  
Amna Wajdan ◽  
Maria Saleem ◽  
Asim Khurshid
Keyword(s):  
Normal Development ◽  
Case Series ◽  
Birth Asphyxia ◽  
Hypoxic Ischemic Encephalopathy ◽  
Demographic Information ◽  
Telephone Number ◽  
Female Ratio ◽  
Delayed Development ◽  
Male To Female ◽  
Ischemic Encephalopathy

Objective: To determine the frequency of delayed development in newborns with hypoxic ischemic encephalopathy (HIE) stage 2 presenting to Nishtar Hospital Multan. Study Design: Descriptive Case Series. Setting: Department of Pediatrics, The Children’s Hospital and The Institute of Child Health, Multan. Period: August 2019 to February 2020. Material & Methods: Children with birth asphyxia (HIE stage 2) admitted in NICU were registered. The basic demographic information including name, age, sex, address and telephone number was recorded in a specifically designed proforma. Children were followed up at 3 months and developmental milestones were recorded in the proforma. Results: Mean age of newborns was 17.15±15.95 hours and mean weight was 2.88±0.28 kg. There were 55 male newborns (67.9%) and 26 female newborn babies (32.1%). Male to female ratio was 2.1:1. Frequency of delayed development of the beabies in our study was 34.6% while 53 babies (65.4%) had normal development assessed through milestones achieved at 3 months. Milestones achieved at 3 months were; head control in 54 newborns (66.7%), lifts head and chest above couch in prone position in 50 newborns (61.7%), head above line of body on ventral suspension in 55 newborns (67.9%), follows light through an arc of 180 degrees/defensive blink in 21 newborns (25.9%), turns to nearby voice in 38 newborns (46.9%), happy response to mother’s face when feeding in 63 newborns (77.8%). Conclusion: Frequency of delayed development of the newborns with stage-2 HIE in our study was high.

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.

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.

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

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 Low Cost Level II Newborn Care Service: Experience Of Kathmandu Medical College Teaching Hospital

2004 ◽  
Vol 43 (152) ◽  
pp. 62-66
Author(s):  
D S Manandhar ◽  
K Manandhar
Keyword(s):  
Mortality Rate ◽  
Teaching Hospital ◽  
Low Cost ◽  
Birth Asphyxia ◽  
College Teaching ◽  
Special Care ◽  
Live Births ◽  
Medical College ◽  
Special Care Baby Unit ◽  
Level Ii

Newborn infants require special care when they become sick. Majority of the newborn require only feeding,warmth and loving care by the mothers. Nearly 15-20% of newborns become sick requiring care in hospital.Most of these babies can be managed using low cost locally made equipment which makes newborn careaffordable. This is a prospective study of 201 sick newborns looked after in the Special Care Baby Unit(SCBU) of Kathmandu Medical College Teaching Hospital (KMCTH) using locally made low cost equipment.In the period of 28 months from 2nd July, 2001 to 17th Oct. 2003, 882 babies were delivered at KathmanduMedical College Teaching Hospital (KMCTH). 859 were live births. Out of 859 live births, 173 (20.1%)were admitted in the special care baby unit (SCBU). SCBU of this hospital also admitted 28 babies bornoutside the hospital. The main causes of admission in SCBU were low birth weight (37.3%), neonataljaundice (18.9%), birth asphyxia (6.9%), septicaemia (2.4%) and out of 201 babies admitted in SCBU,89% were discharged in good condition, 3.9% of the babies left against medical advice, 2 babies (one withcongenital hydronephrosis and another with congenital hypertrophic pyloric stenosis) were transferred toKanti Children Hospital for surgery and 11 babies (5.4%) expired. The main causes of neonatal deathswere extreme prematurity (70%), septicaemia (23%), birth asphyxia (15.3%) and congenital anomalies(7.6%). The perinatal mortality rate (PMR) and neonatal mortality rate (NMR) during this period were26.4/1000 births and 15.1/1000 live births respectively. In SCBU, locally made low cost equipment(Resuscitaire, Warm cot, Phototherapy and Oxygen hood designed by Prof D.S. Manandhar) are beingused in the manangement of sick babies, since the unit was started on 2nd July, 2001. Babies with birthweight as low as 1020 gms and gestation as low as 28 weeks have survived in this unit. This unit has shownthat Level II care could be provided with simple and low cost equipment and results are quite satisfactory.Good antenatal care, good care during delivery including use of partogram and care during postnatalperiod have helped to make this result good. Expansion of such facilities in district and bigger hospitals inthe country are not only affordable but also will have great impact in saving many lives. This will have amajor impact in reducing the present high IMR and NMR of the country.Key Words: Care of sick neonates, low cost locally made equipment, common neonatal problems,special care baby unit, and level II care.

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.

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