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Birth asphyxia in fullterm neonates in basra maternity and children hospital

Author: 
Ala’a Hashim Tawfeeq, Aida Abdul Kareem and Assim Khalid Assim
Subject Area: 
Health Sciences
Abstract: 

Objectives: a case-control study has carried out on term neonates with birth asphyxia, whom were admitted to 1st neonatal care unit at Basra Maternity and Children Hospital, to assess the frequency of birth asphyxia, its clinical features and some related neonatal, maternal (labour and delivery) variable as well as its outcome. Method: a total of (85) full term neonates, 50(58.82%) males and 35(41.17%) females, were recruited in the study from the first of December 2011 to 1st of December 2012. A total of (11486) full term neonates were delivered during the study period; (125) normal neonates delivered in the same period were regarded as control group. Detailed neonatal, maternal, perinatal, labor and delivery history were taken and compared in cases and control. Results: frequency of birth asphyxia was (0.74%) of total births and represented (4.9%) of total admission to the 1st neonatal unit. All patients need resuscitation with suction and oxygen and 24.7% need intubation, while most control cried immediately after birth and only 16% of them needed simple resuscitation and responded to direct oxygen. No significant difference regarding neonatal history (gestational age, sex, weight) in cases and control (p- value >0.05). The main clinical features were related to the central nervous system and respiratory system. The neurological symptoms include irritability, convulsion, increase tone, lethargy, poor feeding, and decrease tone with the following percentages respectively (55.3%), (47.1%), (32.9%), (31.8%), (25.9%), (14.1%). Respiratory distress and cyanosis was reported in (50.5%) and (45.9%) of patients respectively. Maternal risk factors for asphyxia were; young mothers (˂ 18 years), primiparous mothers, mothers with no antenatal care, and history of maternal medical problems (P-value <0.05). Assisted vaginal deliveries, complications of labour (like prolonged rupture of membrane, prolonged labour, cord prolapse, and meconium) and breech presentation were found as risk factors of asphyxia (P-value <0.05). Regarding the mortality of asphyxiated neonate (22.3%) of cases died, mainly in stage(3) then stage(2), and more in males. Recommendations: So regular antenatal care, close monitoring of fetus during labour, adequate resuscitation at birth can prevent asphyxia, and sharing in decreasing its frequency and morbidity.

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