HYPOXIC ISCHEMIC ENCEPHALOPATHY IN NEONATES

Abstract

Background: Birth anoxia remains an important cause of mortality and morbidity in neonates.Hypoxia/ischemia can lead to permanent brain damage and also affects other tissues of the body. Itresults from lack of oxygen before, during or after birth. The study was designed to assess the riskfactors of birth asphyxia, common presentations and association of Apgar score with grades ofhypoxic-ischemic encephalopathy. Methods: the study is descriptive, prospective and carried out inthe Paediatric Department of Ayub Teaching Hospital, Abbottabad from September 2007 tillSeptember 2008. A total number of 181 neonates (144 males and 37 females) who showed theneurological signs of hypoxic-ischemic encephalopathy were included in the study. Maternal historywas taken, Apgar scoring was done and neurological grading was done for the assessment of braindamage. Results: out of 181 neonates 77.9% were full term, 8.8% were premature, 5.2% were havingintra uterine growth retardation and 6.1% were post mature. 38.7% were diagnosed as having grade-3,38.7% as grade-2 and 22.6% as grade-1 encephalopathy. Mortality due to hypoxic ischemicencephalopathy in our unit was 16%. 52.5% of the mothers were primigravida, 50% of the multigravidmothers had history of perinatal deaths, and 6.1% had ante-natal examination. Antenatal factors likelack of antenatal examinations, toxaemia of pregnancy and prolonged labour were major contributorsto the mortality of neonates. Conclusion: Primigravid mothers, maternal anaemia, lack of antenatalexamination, toxaemia of pregnancy and prolonged labour were the major contributors to the hypoxicischemic encephalopathy. Early recognition of the risk factors and public health awareness needs to beaddressed. Improvements in maternal health and regular antenatal checkups should be emphasised.Key words: Hypoxic ischemic encephalopathy, risk factors, birth asphyxia.