Spectrum of multi-organ system involvement in perinatal asphyxia in neonatal intensive care unit department of Pediatrics, King George hospital, Visakhapatnam, Andhra Pradesh, India

Abstract

Background: The objective of the current study to find out the maternal risk factors associated and spectrum of involvement of multiorgan dysfunction in perinatal asphyxia.Methods: This is a prospective study comprises of 102 asphyxiated neonates. At the time of admission blood samples were taken for complete blood picture, random blood sugar, serum electrolytes, septic screen & blood culture. For the assessment of the central nervous system a neurosonogram would be carried out in all asphyxiated new-borns. Computed tomography scan was done who had abnormal neurosonogram. Chest x ray was done for all respiratory cases. Echocardiogram was done for cardiac assessment. Renal system evaluated by serum creatinine and urine output.Results: Of these 102 babies, 59 were males and 43 were females. Major risk factors in the study were meconium stained amniotic fluid cases, eclampsia, pregnancy induced hypertension, premature rupture of membranes and prolonged second stage of labour. central nervous system (CNS) involvement occurred in all 102 (100%) neonates. Hypoxic ischemic encephalopathy was the most common presentation of CNS involvement. Respiratory involvement was noted in 42 (41.5%). Renal involvement was seen in 27 (26.5%). Cardiovascular system involvement was observed in 26 (25.5%). Gastrointestinal involvement was observed in 16 (15.68%). Hematological abnormalities were seen in 14.7%.Conclusions: Multiorgan dysfunction is common in neonates with perinatal asphyxia. Overall mortality was 24.5%, which clearly indicates the need for early detection of maternal risk factors, better obstetric management and the prompt resuscitator measures.