You are here

Home » Content

PERİNATAL ASFİKSİ NEDENLERİ VE PROGNOZ

THE CAUSES OF PERINATAL ASPHYXIA AND PROGNOSIS

Journal Name:

  • Türkiye Aile Hekimliği Dergisi

Publication Year:

  • 2001

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Perinatal asphyxia remains a problem in the neonatal intensive care units in spite of an improvement in its diagnosis and treatment. Today, the main problem is to prevent the births resulting in asphy-xial newborns, rather than to treat the infants with perinatal asphy¬xia. The purpose of this study was to determine the causes of neonatal asphyxia and to analyse its prognosis. This prospective study consis¬ted of 31 fullterm (37-42 weeks of gestational age) neonates admitted to the Neonatal Unit of Dicle University Hospital for neonatal asphyxia between April and September 1998. All infants diagnosed as perinatal asphyxia were hospitalised and treated, and followed for a period between 8 and 12 months. While the causes of asphyxial damage were related to intrauterin and intrapartum factors with a ratio of %93.5, its causes were related to postpartum factors with a ratio of %6.5. Seven infants died in neonatal period (5 boys and 2 girls). Three infants had major sequelae and one infant had minor sequelae. Among 8 infants born in a home, 3 died, 1 had sequelae and 4 had a normal outcome. Of the 23 neonates born at hospital, 4 died, 3 had sequelae and 16 had a nor¬mal outcome. The mortality and morbidity of perinatal asphyxia were higher in infants born at home than those born at hospital. But, there wasn't a statistically significant difference (p>0.05). While the rate of poor prognosis in infants born at home was %50, it was %30.4 in those of born in a hospital. Therefore, it was considered that the unfavorable outcome rate of perinatal asphyxia could be decreased when perfect prenatal care is given to all high risk pregnancies and when they give birth to their children in hospital.
Bookmark/Search this post with
Abstract (Original Language): 
Perinatal asfiksi ; tanı ve tedavideki ilerlemelere rağmen, halen yeni-doğan yoğun bakım ünitelerinin önemli bir sorunu olmaya devam etmektedir. Bugün için asıl problem, asfiksik yaralanmaların tedavi edilmesinden ziyade, asfiksik doğumların önlenmesidir. Çalışmamız, perinatal asfiksiye neden olan durumların saptanması ve perinatal asfikside prognozu analiz etmek amacıyla, Nisan-Eylül 1998 arasında Dicle Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalı Yenidoğan Ünitesinde, perinatal asfiksi kesin tanısı ile tedavi edilen ve 8-12 ay süreyle izlenen 31 yenidoğan (37-42 gebelik haftası) bebek üzerinde prospektif olarak yapılmıştır. Çalışmamızda, asfiksiyal yaralanmaların nedeninin %93.5 oranında doğum öncesi ve doğum anındaki, %6.5 oranında da doğum sonrasındaki faktörlere bağlı olduğu saptandı. Toplam 7 infant (%22.5) eksitus oldu. Eksitus olanların 5'i erkek, 2'si kız bebekti. 3 hastada major, 1 hastada minor sekel gelişti. Doğumu evde gerçekleşen 8 olgunun 3'ü eksitus oldu, 1'inde sekel gelişti. Doğumu hastanede ge-çekleşen 23 olgunun 4'ü eksitus oldu, 3'ünde sekel gelişti. Doğumu evde gerçekleşenlerde, hem morbidite, hem de mortaliteyi, doğumu hastanede geçekleşenlere oranla daha yüksek bulduk; ancak istatistiksel olarak anlamlı farklılık saptanmadı (p>0.05). Evde doğan infantlarda kötü prognoz oranı %50 iken doğumu hastanede gerçekleşen infantlarda bu oranı %30.4 idi; bu nedenle tüm yüksek riskli gebeliklerde mükemmel bir prenatal bakım ve hastane şartlarında doğumun gerçekleştirilmesi sağlandığı zaman, perinatal asfikside istenmeyen sonuçların azaltılabileceği kanaatine varıldı.
FULL TEXT (PDF): 
PDF icon arastrmx_116859_5_pp_30-33.pdf
  • 1-4
30-33
  • Turkish

REFERENCES

References: 

1.
Küçüködü
k fi. Perinatal Asfiksi. Yenidoğan Hastalıkları. Ankara, Güneş Kitabevi, 1993; 363-5.
2. Menkes JH. Perinatal Central Nervous system asphyxia and travma. wdiseases of the Newborn'da. Ed. Schaffer and Avery's. 6. baskı, Philadelphia, W.B. Saunders Co, 1991; 406-21.
3. Yang LL. Perinatal asphyxia. Management, Procedures, On Call Problems, Diseases, Drugs'da. Ed. Gomelb TL, Cunningham MD, Eyal FG. 2. baskı, Norwalk, Appleton & Lange, 1992; 391-9.
4. Anr M, Vert P, Debruille C. Diagnostic et evolution de la souffrance ce-rebrale chez des nouveau-nes ayant peresente des signes d'hypoxie foeta-le. Etude prospective: Arch Fr Pediatr 1978; 35: 23-36.
5. Ashwal S, Cole D, Osborne S ve ark. L-NAME reduces infarct volume in a filament model of transient middle cerebral artery occlusion in the rat pup. Pediatr Res 1995; 38: 652-6.
6. Iadecola C. Bright and dark sides of nitric oxide in ischemic brain injury.
Trends Neurosci 1997; 20: 132-9.
7. Iadecola C, Zhang F, Xu X. Inhibition of inducible nitric oxide synthase ameliorates cerebral ischemic damage. Am J Physiol 1995; 268: 268¬92.
8. Matsui T, Nagafuji T, Auer R ve ark. Beneficial effect of nitric oxide synthase inhibitor on reversible and permanent focal ishemia in rats, using a newly devised microclip. J Cereb Blood Flow Metab 1993; 13:
150.
9. Grotta J. Safety and tolerability of the glutamate antagonist CGS 19755 in acute stroke patients. 19th International Joint Conference on Stroke and Cerebral Circulation. Stroke 1994; 25: 255.
10. Hagberg H, Thornberg E, Blennow M ve ark. Excitatory aminoacids in the cerebrospinal fluid of asphyxiated infants: relation to hypoxic-ische-mic encephalopathy. Acta Pediatr 1993; 82: 925-9.
11. Patel J, Edwards AD. Perinatal asfikside sonuçların tahmini. Pediyatri
gündemi
1997
; 1: 6-9.
12. Dubowitz D, Wertheim D, Mercuri E ve ark. Prognostic value of con¬tinuous EEG recording in full term infants with hypoxic ischaemic en-cephalopathy. Arch Dis Child 1994; 71: 97-102.
13. Martinez Bermejo A, Lopez Martin V, Roche C, Pascual Costroviejo
I. The role of neonatal electroencephalography in the prognosis of the hypoxic-ishemic syndrome. An Esp Pediatr 1990; 32: 7-10.
14. Tharnberg E, Thiringer K, Odeback A, Milsom I. Birth asphyxia: In¬cidence, clinical course and outcome in a Swedish population. Acta
Pediatr 1995; 84: 927-32.
15. Selton D, Andre M. Prognosis of hypoxic-ischaemic encephalopathy in full-term newborns-value of neonatal electroencephalography.
Neuropediatrics 1997; 28: 276-80.
16. Watanabe K, Miyazaki S, Hara K, Hakamada S. Behavioral state cycles, background EEGs and prognosis of newborns with perinatal hypoxia. Electroencephalogr Clin Neorophysiol 1980; 49: 618-25.
17. Dreyfus-Brisac C. Neonatal EEG. Reviews in Perinatal Medicine'da. Ed. Scarpelli EM, Cosmi EV. New York, Raven Press, 1979; 397-471.
18. Lupton BA, Hill A, Roland EH ve ark. Brain swelling in the asphy¬xiated term newborn: Pathogenesis and outcome. Pediatrics 1988; 82:
139-46.
19. Van Lieshout HBM, Jacobs FM, Roteveel JJ ve ark. The prognostic value of the EEG in asphyxiated newborns. Acta Neurol Scand 1995; 91:
203-7.
20. Gray PH, Tudehope DI, Masel JP ve ark. Perinatal hypoxic-ischaemic brain injury: Prediction of outcome. Dev Med Child Neurol 1993; 35:
965-73.

Thank you for copying data from http://www.arastirmax.com