Outcome of different grades of perinatal asphyxia in a tertiary care hospital

Mohammad Abdul Hai Mia1, Md. Mahbubul Hoque2, Ishrat Jahan3, Mohammad Faizul Hoque
Khan3, Khandaker Rokshana Akhter4, MAK Azad Chowdhury5
Abstract
Introduction: Perinatal asphyxia is a major cause of morbidity and mortality among
the newborns in the developing countries. It is one of the leading cause of neonatal
mortality that is about 21% in our country and also a major cause of cerebral palsy.
The frequency of neurodevelopmental sequelae in surviving infants is approximately
15% to 45%. The risk of cerebral palsy in survivors of perinatal asphyxia is 5% to 10%
compared to 0.2% in the general population in developed country. Severe HIE (Sarnat
& Sarnat stage-III) carries a mortality rate of 80% and survivors often have multiple
disabilities including spastic cerebral palsy, severe or profound mental retardation,
cortical blindness and seizure disorder.
Objective: To find out the immediate and early outcome of different grades of
perinatal asphyxia classified according to clinical parameter of Sarnat & Sarnat
staging.
Methodology: This cross sectional study was conducted in Neonatal Unit of Dhaka
Shishu Hospital. Consecutive 135 cases of asphyxiated term newborn, aged between
0-48 hours were enrolled and classified by Sarnat & Sarnat staging and followed up
during hospital stay and at 3 months of age.
Results: Among 135 cases, 26.7%, 36.3% and 37.0% were stage-I (mild), stage-II (moderate)
and stage-III (severe). Overall mortality of asphyxiated cases was 27.4%. Whereas that of
stage-I cases 85.7% and 40% of stage-II and stage-III cases survived. Overall incidence of
neurological deficit among survived neonates was 29.6%. All cases (100%) of stage-I
(mild) recovered completely, 35.7% of stage-II (moderate) and 70% of stage-III (severe)
asphyxiated patients had neurological deficit as assessed at 3 months of age.
Conclusion: Grading of perinatal asphyxia is important to asses the outcome and to
counsel the parents as mortality and morbidity is high in severe (stage-III) asphyxiated
babies.

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