A COMPARATIVE STUDY ON PREDICTORS OF ADVERSE OUTCOME IN PERINATAL ASPHYXIA

Abstract

Perinatal asphyxia is a leading cause of mortality and significant morbidity. Mild cases does not have a significant problem but moderate to severe cases can lead to many short and long term complications Objectives: The present study was done to evaluate various markers of perinatal asphyxia and their role in predicting adverse outcome. Methods: 108 neonates suspected to have experienced perinatal asphyxia were included in the study and followed up until discharge/ death. Role of cord blood pH, APGAR at 5 min and 10 min were compared with outcome. Results: Out of 108 studied neonates, 78(72.2%) needed resuscitation whereas 30(27.78%) didn’t need any form of resuscitation, 20(18.52%) were in HIE stage 1, 11(10.19%) were in stage 2 & 25(23.15%) were in stage 3 of hypoxic ischemic encephalopathy according to sarnat & sarnat staging. Correlation coefficient and P value was calculated for cord blood pH and APGAR as a predictor of ischemic brain injury among the newborns with hypoxic ischemic encephalopathy & it was observed that both are statistically significant (p value<0.001) & significant negative correlation with severity of birth asphyxia. The mean APGAR score at  5 min,10min and mean cord blood pH in the babies without HIE were 7.9±0.6,8.9±0.3 and 7.28±0.08, respectively. Whereas the mean APGAR at 5 min, 10min and mean cord blood pH in the babies with HIE-I were 6.3±1.3,8.35±0.58 and 7.04±0.04; HIE-II  4.54±0.52,6.09±0.30 and 6.99±0.01; HIE-III 3.6±1.1,5.44±0.96 and 6.84±0.04. Conclusion: Umbilical cord blood pH is with cut off <7.10 remains the best predictor for perinatal asphyxia & poor early neonatal outcome followed by 5 min APGAR score. Following APGAR to 10 min has no significant advantage over 5 min APGAR.

Keywords: Perinatal asphyxia, APGAR, Cord blood pH, HIE