The Hypoxic Ischaemic Encephalopathy Score in Predicting Neurodevelopmental Outcomes Among Infants with Birth Asphyxia at the Muhimbili National Hospital, Dar … (original) (raw)
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2016
Perinatal asphyxia remain a major cause of neonatal morbidity and mortality , and hypoxic-ischemic encephalopathy is considered a serious clinical condition worldwide, it is an important cause of permanent damage to the central nervous system , it may result in death or manifested later on with cerebral palsy or developmental delay. Aim of the study To search for the determinants of outcome (fate) in those newborns with hypoxic-ischemic encephalopathy. Patient and methods Total number of patients enrolled in our study were one-hundred twenty one(eighty-five male and thirty-six females). The study was conducted from the first of October 2013 to the thirty of September 2014. All the involved cases were diagnosed with Hypoxic-ischemic encephalopathy by clinical Sarnat classification. Result Perinatal asphyxia was more reported among male gender (70.2%) and there is higher association with induced vaginal delivery (38%) , primipara mothers (61.1%) , irregular antenatal care (55.3%) and ...
BMC Pediatrics, 2017
Background: Hypoxic Ischemic Encephalopathy (HIE) remains a problem of great concern worldwide especially in developing countries. The occurrence of a neurological syndrome can be an indicator of insult to the brain. We aimed to determine the prevalence, HIE proportions, neurological signs and early outcomes of newborns that developed birth asphyxia at KCMC Tanzania. Methods: A prospective study was conducted at KCMC from November 2014 to April 2015 among newborns with birth asphyxia. Sarnat and Sarnat score was used to assess newborns immediately after birth to classify HIE and were later followed daily for 7 days or until discharge. Results: Of the 1752 deliveries during the study period, 11.5% (n = 201) had birth asphyxia. Of the 201 newborns, 187 had HIE. Of these 187 with HIE; 39.0% had moderate HIE and 10.2% had severe HIE according to the Sarnat and Sarnat classification. Neurological signs that were observed during the study period were; weak/absent reflexes (46.0%), hypotonia (43.3%) and lethargy (42.2%). Mortality was 9.1% among the 187 newborns with HIE. Mortality was higher among newborns with severe HIE 84.2% (16/19) compared to those with moderate HIE 1.4% (1/73). On the 7th day after delivery, 17.1% (32/187) of the newborns did not show any change from the initial score at delivery. Conclusion: Prevalence of birth asphyxia is high in our setting and most of the newborns (49%) end up with moderate/severe HIE. Good obstetric care and immediate resuscitation of newborns are vital in reducing the occurrence of HIE and improving the general outcome of newborns.
PAFMJ
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 disc...
Open Journal of Pediatrics, 2017
Introduction: Neonatal asphyxia is a major cause of infant morbidity in Cameroon. The aim of this study was to describe the short-term neurological outcome of children following neonatal Hypoxic-ischemic encephalopathy (HIE). Methodology: We conducted a retrospective cohort study from May 2010 to September 2013. We included 39 exposed cases against 78 non-exposed cases followed-up for at least 9 months. The variables studied were: age, sex, head circumference, neurological sequelae, postural anomalies and motor skills and developmental age/quotient. The data collected were analyzed using Epi info software version 3.5.3. The Fisher Exact Test was used to compare the variables with a significance threshold defined for p < 0.05. Results: We recruited 39 cases for 78 controls. The majority (74.40%) of cases were classified as HIE Sarnat 3 and 25.60% Sarnat 2. Most of the children were aged 12-36 months with a mean age of 18 months. The male sex was predominant with a sex ratio of 1.2; and 61.50% of children with HIE had head circumference < −2 Zscore. Thirtyone (79.50%) of the exposed cases developed a handicap against 2 (2.60%) in the control group. The handicaps were 61.54% severe, 10.26% moderate and 7.70% mild. The main sequelae were mental retardation (66.70%), cerebral palsy (46.20%) and epilepsy (30.80%). The associated anomalies were microcephaly and bucco facial dyspraxia. The neurosensory disorders consisted of blindness (41%), oculomotor disorders (18%) and deafness (7.70%). The mean developmental quotient in the cases was 49.59%. Conclusion: The frequency of neurological sequelae following HIE was high in our series. Efforts should be made to prevent perinatal asphyxia and to ensure the availability of material and staff trained to help babies' breath in all the delivery rooms in our maternities.
Sri Lanka Journal of Child Health, 2017
Introduction: Perinatal asphyxia is an important cause of neonatal deaths and neonatal intensive care unit (NICU) admission. Objectives: To assess the treatment pattern in neonates having hypoxic ischaemic encephalopathy (HIE) and its relationship with their outcome. Method: A hospital based prospective study of one year duration was carried out at B.P. Koirala Institute of Health Sciences, Nepal in term neonates with perinatal asphyxia and HIE, enrolled from the paediatric wards and NICU. Results: Of the 60 term neonates included in the study, 49 (81.7%) were males. The mean birth weight was 2971±421g. HIE was mild in 13 (21.7%) cases, moderate in 27 (45%) cases and severe in 20 (33.3%) cases. Seventeen neonates were admitted to the NICU. Oxygen was required in 45 neonates (mean duration 60.3 hours). Mechanical ventilation and vasopressors were given in 13 and 29 neonates respectively. Most of the neonates received antibiotics for 5 days. Mean duration of hospital stay was 146.2 hours. Thirteen (21.7%) neonates were neurologically abnormal at discharge. Forty one (68%) neonates were discharged from hospital, 06 (10%) expired during the hospital stay and 7 left against medical advice. Conclusions: In this study at the B. P. Koirala Institute of Health Sciences, 22% neonates with perinatal asphyxia and HIE were neurologically abnormal at the time of discharge and there was a 10% mortality.
Bangladesh Critical Care Journal, 2021
Background: Neonatal hypoxic ischemic encephalopathy (HIE) is a major cause of mortality, morbidity and long-term neurological deficits. Objective: The aim of the study was to determine the severity of encephalopathy and immediate neurodevelopmental outcomes in term neonates with HIE admitted in NICU at a tertiary care hospital. Materials and Methods: This was a Prospective Cohort study conducted between July 2016 and June 2017 at Dhaka Medical college Hospital, Dhaka. Asphyxiated term newborns who came within 12 hours of birth were enrolled in this study. Sarnat and Sarnat score was used to assess newborns immediately after birth to classify HIE. Neurodevelopmental assessment was performed using age specific rapid neurodevelopmental assessment tool (RNDA) at and 3 months after discharge to identify impairment in specific developmental domains. We determined the relation between severity of HIE and clinical outcome. Results: 60 patients were included in this study and their mean dur...
Revista da Associacao Medica Brasileira (1992), 2017
Hypoxic ischemic encephalopathy is a major complication of perinatal asphyxia, with high morbidity, mortality and neurologic sequelae as cerebral palsy, mostly in poor or developing countries. The difficulty in the diagnosis and management of newborns in these countries is astonishing, thus resulting in unreliable data on this pathology and bad outcomes regarding mortality and incidence of neurologic sequelae. The objective of this article is to present a new clinical diagnostic score to be started in the delivery room and to guide the therapeutic approach, in order to improve these results.