The aim of this study were, using only the score clinic of Sarnat and Sarnat, the blood markers of asphyxia that are routinely used in all hospitals of our country (Brazil) and the ultrasonography imaging method performed with 24 and 72 hours and 28 days of life, verify if these are sufficient to detect the neurological evolution of the patient. Methods The study was conducted with a prospective cohort of term newborns that suffering perinatal asphyxia by Buonocore criteria (2002). These criteria identify the level of the pH in cord blood that was collected of all newborns and also the blood markers: glutamic oxaloacetic transaminase, glutamic pyruvate transaminase, lactate dehydrogenase and creatine kinase (CKMB).These testes were collected at birth, with 24, 48 and 72 hours of life. The score clinical of Sarnat and Sarnat was performed with 24 hours, 48 hours and 72 hours of life and the ultrasound skull with 24, 48, 72 hours of life and in the end of neonatal period with 28 days of life. The period of study was one year. Results In the study´s period 2989 babies were born. The Buonocore criteria were found in 28 newborn showing a frequency of 1% of perinatal asphyxia. The marker of asphyxia were between the normal value of reference and only de iso-enzyme CKMB was a good marker, com value more than 5,10 ng/mL. The brain ultrasonography was altered with 72 hours of life, but one newborn presented alterations only with 28 days of life. The clinical examination using the clinical score of Sarnat and Sarnat demonstrated that 21,42% presented hypoxic-ischemic encephalopathy. In the ROC curve we observed sensitivity of 85,7%, specificity of 85,7% and accuracy of 85,7% correlated the value of CKMB and the brain ultrasonography of 72 hours of life. Conclusions Perinatal asphyxia may be diagnosed in any hospital if the neonatologist or the neurologist apply the easy score clinical of Sarnat and Sarnat, the iso-enzime CKMB and the serial ultrasonography. In this study the worse alteration was with 72 hours of life, however we must be careful because in one neonate the alteration was present only with 28 days of life.
DEDICATÓRIAA Deus, nosso amado Pai, que inspira meu viver e guia meu caminhar.A todos os recém-nascidos e a seus pais que, anonimamente, participaram desta pesquisa e compartilharam a experiência única de gerar uma nova vida.Aos meus tesouros e adoráveis filhos Dayanne e Johan, pela motivação em viver, crescer e persistir sem esmorecer.Ao meu esposo José Antônio, pela confiança, carinho e companheirismo dispensados nos momentos mais alegres e mais difíceis de nossas vidas.Aos meus amados pais Felix e Delia, in memorian, pelo amor incondicional que sempre me dispensaram, dos quais me orgulho e sempre me lembro com um sorriso no rosto.À minha amada mãe Maura pela vida, grande amor, dedicação e estímulo em todo momento, um presente de Deus na minha vida.Ao meu pai Ismael, pelo exemplo de perseverança e de vida.Às minhas amadas tias Eva e Betty, pelo amor e apoio através do tempo e da distância.Aos meus queridos primos Gustavo, Martin, Carito, Emanuel e Gary, que são minha inspiração.Ao anjo da minha vida, minha adorada Mel.Ao meu sogro Carlos, in memoriam, o homem mais digno e bondoso que já conheci.À minha sogra Hortência, cunhados e sobrinhos pela constante alegria e apoio.A toda minha família... vocês são os pilares de minha vitória, os meus ombros consoladores e por isso dedico esta vitória a vocês.
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