Organ dysfunction other than central nervous system in perinatal asphyxia

Significant asphyxial insult to the fetus is likely to compromise a number of different organ systems of which the brain, kidneys and myocardium are particularly vulnerable, though bowel, endocrine and pulmonary complications may also occur. However much emphasis is given to central nervous system (CNS) dysfunction while other organs take a backseat.  Objectives: To evaluate the frequency of organ dysfunction other than CNS in perinatal asphyxia and to correlate the organ dysfunction with immediate mortality. Method: A prospective observational study was done in all asphyxiated newborns, delivered at Pravara Institute of Medical Sciences, Loni, from September 2013 to August 2015. Neonates born before 37 weeks of gestation, or born outside the hospital or with congenital anomalies or with early onset sepsis were excluded from the study. Prior approval was obtained from the institutional ethics committee. A detailed history was taken and examination performed on admission to the neonatal intensive care unit (NICU). The clinical course was followed up to 14 days of birth. Data obtained was recorded. Data analysis was done by descriptive statistics as mean, SD, median, range and percentage. Comparison was done by applying Chi-square test. Significance was assessed at 5% (p Results: During the study period 152 asphyxiated babies, fulfilling the preformed inclusion criteria were admitted in the NICU. The common modes of delivery were normal vaginal (55.2%) and caesarean section (38%). Meconium stained amniotic fluid (35.5%) was the most common perinatal risk factor followed by prolonged second stage of labour (23.7%). The renal system was involved in 64% cases, respiratory system in 45%, cardiovascular system in 32%, gastrointestinal system in 16%, hepatic system in 05% and the haematological system in 03%. There was an overall mortality rate of 37.5%. Conclusions: In the present study common organs of involvement other than the CNS were renal (64%), respiratory (45%), cardiovascular (32%) and gastrointestinal (16%). The overall mortality rate was 37.5%. Deaths were higher when 3 or more organs were involved. Sri Lanka Journal of Child Health , 2018; 47 (2): 141-145