Outcome of Newborns with Birth Asphyxia

Abstract

Birth asphyxia is one of the common causes of mortality and morbidity in neonates and the incidence is 2–9
per 1000 live borns. The present work is a retrospective hospital based observational study. Babies born at
B.P. Koirala Institute of Health Sciences, Dharan, Nepal during the period from April 2002 to April 2003
with gestational age 37 weeks with Apgar score 6 at 5 minutes were included in the study. The aim was
to study the clinical profile, the acid base parameters and the outcome of asphyxiated newborns. Babies with
congenital defects, evidence of infection and maternal drug addiction were excluded from the study. All
babies were resuscitated according to the guidelines of American Heart Association. Data on 50 birth asphyxia cases were tabulated and analysed. There were 10 (20%) cases of severe birth asphyxia (Apgar score:
1-3 ) and 40 (80%) cases of moderate birth asphyxia (Apgar score: 4-6). Staging of hypoxic ischaemic encephalopathy (HIE) was performed according to Sarnat’s staging. Thirty percent of these cases presented
with various stages of HIE and the incidence was higher in low Apgar score group. The common presentations of HIE cases had depressed neonatal reflexes, seizures, lethargy, and pupillary abnormalities. The
common acid base disturbance was metabolic acidosis which was observed only in babies with HIE-3. Two
neonates (4%) died during the hospital stay due to multiorgan failure and severe metabolic acidosis.

Key Words: Birth asphyxia, Hypoxic ischaemic encephalopathy, Apgar score