Hospital Based Prospective Observational Study Evaluating Electrolyte Abnormalities in Patients with Perinatal Asphyxia
Authors/Creators
- 1. Senior Resident, Department of Paediatrics, BMIMS, Pawapuri, Nalanda, Bihar, India
- 2. Assistant Professor, Department of Paediatrics, BMIMS, Pawapuri, Nalanda, Bihar, India
- 3. Assistant Professor, HOD, Department of Paediatrics, BMIMS, Pawapuri, Nalanda, Bihar, India
Description
Aim: The aim of the study was to assess the electrolyte abnormalities among asphyxiated neonates. Background: In basic term birth asphyxia is delay in establishing spontaneous respiration upon delivery of a new-born. More precisely, birth asphyxia is defined as the presence of hypoxia, hypercapnia, and acidosis leading to systemic disturbances in the new-born probably electrolyte disturbance also. Knowledge of these electrolyte disturbances is very valuable as it can be an important parameter affecting perinatal morbidity, mortality and ongoing management. Material & Methods: This prospective observational study was conducted in NICU, BMIMS, Pawapuri, Nalanda, Bihar, during a study period of one year from May 2022 to April 2023 among asphyxiated neonates admitted at this institute and a total of 100 cases were enrolled in the study. Serum Sodium level has been estimated. Informed consent was obtained from the legal guardians of each participant. Results: The baseline characteristics of the participants in the study revealed that in 72% of instances, the mothers were primipara. Within the neonatal population, a majority of 60% consisted of males, while the remaining 40% were females. A mere 32% of the neonates under study had undergone consistent prenatal check-ups, while 58% had undergone sporadic check-ups, and 10% had not had any antenatal check-ups. Within the cohort of neonates under consideration, it was observed that 68% were delivered via the vaginal canal, while the remaining 32% were born by lower uterine segment cesarean section (LSCS). In 40% of instances, the domicile served as the location of delivery, while 24% of cases occurred at a clinic, and 36% took place at a hospital. Based on the classification of asphyxia, it was shown that 52% of infants exhibited moderate asphyxia, 20% had mild asphyxia, and 28% presented with severe asphyxia. Based on the analysis of blood sodium levels in newborns, it was observed that among the 20 mild instances, 15% exhibited hyponatremia, characterized by serum sodium levels below 130 mmol/l. Similarly, among the moderate asphyxia cases, 73.08% had hyponatremia, while 71.42% of the severe asphyxia cases exhibited the same condition. The sodium levels of the other subjects were within the usual range. Based on the assessment of blood potassium levels in newborns, it was shown that 15% of the 20 mild cases, 3.84% of the 52 intermediate cases, and 7.14% of the 28 severe cases had hypokalemia, characterized by a serum potassium level below 3.5 mmol/l. In contrast, it was observed that none of the 20 cases classified as mild, 9.62% of the 52 cases classified as moderate, and 28.58% of the 28 cases classified as severe had hyperkalemia or a blood potassium level over 6 mmol/l. Conclusion: The research findings indicate that perinatal asphyxia patients frequently experience electrolyte abnormalities. Specifically, infants with perinatal asphyxia exhibit a higher incidence of hyponatremia and hyperkalemia. Additionally, there is a significant correlation between the severity of asphyxia and the observed increases in serum creatinine and blood urea levels.
Abstract (English)
Aim: The aim of the study was to assess the electrolyte abnormalities among asphyxiated neonates. Background: In basic term birth asphyxia is delay in establishing spontaneous respiration upon delivery of a new-born. More precisely, birth asphyxia is defined as the presence of hypoxia, hypercapnia, and acidosis leading to systemic disturbances in the new-born probably electrolyte disturbance also. Knowledge of these electrolyte disturbances is very valuable as it can be an important parameter affecting perinatal morbidity, mortality and ongoing management. Material & Methods: This prospective observational study was conducted in NICU, BMIMS, Pawapuri, Nalanda, Bihar, during a study period of one year from May 2022 to April 2023 among asphyxiated neonates admitted at this institute and a total of 100 cases were enrolled in the study. Serum Sodium level has been estimated. Informed consent was obtained from the legal guardians of each participant. Results: The baseline characteristics of the participants in the study revealed that in 72% of instances, the mothers were primipara. Within the neonatal population, a majority of 60% consisted of males, while the remaining 40% were females. A mere 32% of the neonates under study had undergone consistent prenatal check-ups, while 58% had undergone sporadic check-ups, and 10% had not had any antenatal check-ups. Within the cohort of neonates under consideration, it was observed that 68% were delivered via the vaginal canal, while the remaining 32% were born by lower uterine segment cesarean section (LSCS). In 40% of instances, the domicile served as the location of delivery, while 24% of cases occurred at a clinic, and 36% took place at a hospital. Based on the classification of asphyxia, it was shown that 52% of infants exhibited moderate asphyxia, 20% had mild asphyxia, and 28% presented with severe asphyxia. Based on the analysis of blood sodium levels in newborns, it was observed that among the 20 mild instances, 15% exhibited hyponatremia, characterized by serum sodium levels below 130 mmol/l. Similarly, among the moderate asphyxia cases, 73.08% had hyponatremia, while 71.42% of the severe asphyxia cases exhibited the same condition. The sodium levels of the other subjects were within the usual range. Based on the assessment of blood potassium levels in newborns, it was shown that 15% of the 20 mild cases, 3.84% of the 52 intermediate cases, and 7.14% of the 28 severe cases had hypokalemia, characterized by a serum potassium level below 3.5 mmol/l. In contrast, it was observed that none of the 20 cases classified as mild, 9.62% of the 52 cases classified as moderate, and 28.58% of the 28 cases classified as severe had hyperkalemia or a blood potassium level over 6 mmol/l. Conclusion: The research findings indicate that perinatal asphyxia patients frequently experience electrolyte abnormalities. Specifically, infants with perinatal asphyxia exhibit a higher incidence of hyponatremia and hyperkalemia. Additionally, there is a significant correlation between the severity of asphyxia and the observed increases in serum creatinine and blood urea levels.
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Additional details
Dates
- Accepted
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2023-12-10
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References
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