Abstract

Aim: Hypoxic ischemic encephalopathy (HIE) is one of the most important reason of morbidity and mortality in neonates. This study was aimed to review the etiology, clinical-laboratory features and mortality rate of neonates with HIE.Material and

Method: Sixty-three full-term babies with HIE admitted to the Erzurum Nenehatun Obstetric and Maternity Hospital Neonatal Intensive Care Unit between March 2007 and March 2008 were evaluated retrospectively.

Results: HIE was diagnosed in 6.1% of all patients observed in our unit in this period. There were 20 females (31.7%) and 43 males (68.3%). The mean gestational age was 38.8±1.4 weeks and the mean birth weight was 3265±561 gram. The ratio of neonates delivered by cesarean section was 23.8%, and by spontaneous vaginal delivery was 76.2%. The etiologic factors for hypoxic ischemic encephalopathy were intrapartum 58.8% and antepartum 12.8%. The most frequently affected organs were liver (58.7%), lung (54%) and kidney (42.9%), except central nervous system. The ratio of neonates who developed seizures within the first week of life was 61.9%. According to modified Sarnat and Sarnat staging, 17 (27%) patients were in Stage I, 27 (42.8%) in Stage II and 19 (30.2%) in Stage III. The mean hospitalization time was 11.9±12.9 days. The mortality rate was 27% (17), while 63% of neonates has been discharged.

Conclusion: HIE still continues to be an important health issue in Neonatal Intensive Care Units, especially in the eastern Turkey, despite advances in diagnosis and treatment

Keywords: Hypoxic - ischemic encephalopathy, newborn, term

References

  1. Carter BS, Haverkamp AD, Merenstein GB. The definition of acute perinatal asphyxia. Clin Perinatol 1993;20(2):287-304.
  2. Volpe JJ. Hypoxic-ischemic encephalopathy: clinical aspects. In: Volpe JJ (ed). Neurology of the Newborn. Philadelphia: WB Saun- ders, 2001:331-94.
  3. Costello AM, Manandar DS. Perinatal asphyxia in less developed countries. Arch Dis Child Fetal Neonatal Ed 1994;71(1):F1-3.
  4. Brann AW. Hypoxic Ischemic Encephalopathy (asphyxia). Pediatr Clin North Am 1986;33(3):451-64.
  5. Badr Zahr LK, Purdy I. Brain injury in the infant: the old, the new, and the uncertain. J Perinat Neonatal Nurs 2006;20(2):163-75.
  6. Erdem G. Perinatal mortality in Turkey. Peadiatr Perinat Epidemiol 2003;17(1):17-21.
  7. Klinger G, Beyene J, Shah P, Perlman M. Do hyperoxemia and hy- pocapnia add to the risk of brain injury after intrapartum asphyxia? Arch Dis Child Fetal Neonatal Ed 2005;90(1):F49-52.
  8. Shah P, Riphagen S, Beyene J, Perlman M. Multiorgan dysfunction in infants with post-asphyxial hypoxic-ischemic encephalopathy. Arch Dis Child Fetal Neonatal Ed 2004;89(2):F152-5.
  9. Stoll BJ, Kliegman RM. The newborn infant. In: Behrman RE, Kliegman RM, Jenson HB (eds). Nelson Textbook of Pediatrics (17th ed). Philadelphia: WB Saunders, 2004:566-568.
  10. Sarnat HB, Sarnat MS. Neonatal encephalopathy following fetal distress. Arch Neurol 1976; 33(10):696-705.
  11. Satar M, Narlı N, Kırımi E, Atıcı A, Türkmen M, Yapıcıoğlu H. Hipoksik iskemik ensefalopatili 205 olgunun değerlendirilmesi. T Klin Pediatri 2001;10(1):36-41.
  12. Katar S, Devecioğlu C, Sucaklı İ, Taşkesen M. Hipoksik iskemik ensefalopatili 80 Term yenidoğan hastanın değerlendirilmesi. Di- cle Tıp Dergisi 2007;34(1):38-41.
  13. Türk Neonatoloji Derneği Hipoksik İskemik Ensefalopati Çalışma Grubu. Türkiye’de yenidoğan yoğun bakım ünitelerinde izlenen hipoksik iskemik ensefalopatili olgular, risk faktörleri, insidans ve kısa dönem prognozları. Çocuk Sağlığı ve Hastalıkları Dergisi 2008;51(3):123-29.
  14. Duran R, Aladağ N, Vatansever U, Süt N, Acunaş B. The impact of Neonatal Resuscitation Program courses on mortality and morbidity of newborn infants with perinatal asphyxia. Brain Dev 2008;30(1):43-6.
  15. Gurbuz A, Karateke A, Yilmaz U, Kabaca C. The role of perina- tal and intrapartum risk factors in the etiology of cerebral palsy in term deliveries in a Turkish population. J Matern Fetal Neonatal Med 2006;19(3):147-55.
  16. Acunaş B, Çeltik C, Garipardıç M, Karasalihoğlu S. Perinatal asfiksili yenidoğanların etyoloji, klinik ve prognoz açısından değerlendirilmesi. T Klinik Pediatri 1999;8(1):21-6.
  17. Peliowski A, Finer NN. Birth asphyxia in the Term infant. In: Sin- clair JC, Bracken MB (eds). Effective Care of the Newborn Infant. Oxford: Oxford University Press, 1992:249-279.
  18. Patel J, Edwards AD. Prediction of outcome after perinatal asphyx- ia. Curr Opin Pediatr 1997;9(2):128-32.

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How to cite

1.
Bilgin LK, Aladağ N, Aygün C, Altay D. HYPOXIC ISCHEMIC ENCEPHALOPATHY: EVALUATION OF 63 TERM NEONATES. Turk J Pediatr Dis [Internet]. 2011 Aug. 1 [cited 2025 May 25];5(2):89-94. Available from: https://turkjpediatrdis.org/article/view/138