Publication: pH Prodigy: Predicting early Neonatal Destiny in Perinatal Asphyxia through cord Blood’s Crystal ball
Date
2024
Journal Title
Journal ISSN
Volume Title
Publisher
Nepal Paediatric Society (JNPS)
Abstract
Abstract:
Introduction: Perinatal asphyxia, a condition affecting blood flow or gas exchange during birth, is a major contributor to neonatal morbidity and mortality. It adversely impacts various body systems, including renal, CNS, cardiac, and pulmonary functions. Common assessment methods, like Apgar scores, have limitations in subjectivity and sensitivity. Advanced technologies like aEEG and MRI, while more predictive, may lack universal accessibility. Studies exploring cord blood gas analysis as a link to short-term outcomes show promise in addressing perinatal asphyxia-related morbidity and mortality, particularly in resource-constrained settings such as ours.
Methods: This one-year prospective cohort study at B.P. Koirala Institute of Health Sciences, Dharan, Nepal included 150 inborn newborns of 37 weeks or more who exhibited either an Apgar score of less than 7 at 5 minutes of life. They were subjected for estimation of umbilical cord blood pH, APGAR score, and outcome looked were NICU admission, seizure incidence, hypoxic ischemic encephalopathy assessment by Sarnat and Sarnat score, neurological status, duration of hospital stay, and final outcome (Discharge, LAMA, death).
Results: Neonates with lower pH values have a higher likelihood of NICU admission, seizures, and hypoxic ischemic encephalopathy, extended hospital stays and increased mortality rates. A strong negative correlation between pH and hypoxic ischemic encephalopathy was observed, with a correlation coefficient of - 0.8112 (p < 0.001). Notably, pH emerged as the most significant independent predictor for hypoxic ischemic encephalopathy and abnormal neurologic examination (hypotonia).
Conclusion: Umbilical cord blood pH is valuable predictor of early neonatal outcome in perinatal asphyxia.
Description
Deepak Mishra
DM Resident, Neonatology Division, Department of Paediatrics, B.P.Koirala Institute of Health Sciences, Buddha Road, Dharan 56700, Nepal.
Nisha Keshary Bhatta
Professor and Head of Department, Neonatology Division, Department of Paediatrics, B.P.Koirala Institute of Health Sciences, Buddha Road, Dharan 56700, Nepal.
Arabindra Yadav
DM Resident, Neonatology Division, Department of Paediatrics, B.P.Koirala Institute of Health Sciences, Buddha Road, Dharan 56700, Nepal.
Lokraj Shah
Associate Professor, Neonatology Division, Department of Paediatrics, B.P.Koirala Institute of Health Sciences, Buddha Road, Dharan 56700, Nepal.
Shikhar Pradhan
DM Resident, Neonatology Division, Department of Paediatrics, B.P.Koirala Institute of Health Sciences, Buddha Road, Dharan 56700, Nepal.
Prakash Kumar Soni
DM Resident, Neonatology Division, Department of Paediatrics, B.P.Koirala Institute of Health Sciences, Buddha Road, Dharan 56700, Nepal.
Keywords
Cord blood pH, early neonatal outcome, hypoxic ischaemic injury, hypotonia, perinatal asphyxia