Akmal Laeeq Chishty, Azhar Iqbal, Abid Anjum, Sajid Maqbool.
Spectrum of multiorgan systemic involvement in birth asphyxia.
Pak J Pathol Jan ;12(3):81-7.

A prospective study was carried out on cases of birth asphyxia in the neonatal unit of the Children`s Hospital, Lahore to find out the clinical spectrum and extent of multiorgan systemic involvement. Two hundred consecutive cases fulfilling the inclusion criteria were included from 1st Jan 2001. Male female ratio was 2.6:1, with mean admission weight 2.89 kg and mean gestation 39.5 weeks. They were born vaginally (83%) and through C-section (17%) and were all born elsewhere, (home = 38% maternities - 6%, hospitals = 26%). 75% cases cable within 24 hours of birth. Multiorgan systemic involvement was bond in majority of cases like encephalopathy in all cases, hypothermia (39.7%)), hypoglycemia (27%), metabolic acidosis (77%), hyperbilirubinemia (24%). hypocalcelmia (12%), aspiration pneunomia (24%), apnea requiring ventilatory support (40%), hypotension (29.5%), hematemesis (21.5%), persistent feeding intolerance (8%) and early onset sepsis (30%). More extensive involvement (>3 body systems) was shown to be associated with higher mortality (OR=11, p-value <0.05). Regarding outcome, 116 eases (58%) were discharged home in satisfactory condition and 80 eases (40%) died. At discharge. 43% surviving neonates showed persisting abnormal neurologic findings. Antenatal monitoring of high risk pregnancies. Timely refrral and resuscitation at the time of birth at all levels is mandatory to reduce high case fatality and morbidity related to birth asphyxia.

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