Volume : VIII, Issue : III, March - 2019
Electroencephalographic And Cranial USG Studies In Full Term Newborn With Birth Asphyxia And Their Relation With Immediate Outcome
Dr. Pramod Patil, Dr. Vyankatesh Tarkasband, Dr. Rohit Agarwal, Dr. Amol Thorat
Abstract :
Background: Neonatal asphyxia is single most important cause of neurological morbidity and mortality in the first week of life in the full–term infants. It occurs in 0.5% of full term newborns. Amongst which incidence of early death was 7% and neurological handicap was 28%. The exact prognosis of infants who survive severe asphyxia is difficult to judge. A combination of abnormal neurological signs with investigations including cranial USG, CT, EEG studies for determining neurological damage is more helpful in predicting the outcome. Aims: To study the EEG patterns and cranial USG in asphyxiated full term new born babies within first seven days. To determine the prognostic importance for immediate outcome of SARNAT and SARNAT scores, EEG and Cranial USG, abnormalities seen during the first seven days in full term newborns with birth asphyxia. Methodology: Prospective study conducted in Apple Saraswati Multispeciality Hospital from Dec. 2016 to Nov. 2018. Study includes 55 neonates admitted during this period; out of which 40 were cases and 15 were controls. They were categorised according to SARNAT and SARNAT scoring as HIE grade I, II and III. In all neonates, EEG was recorded within 7 days and cranial USG was done on 4th day of life. Repeat neurological examination was done on 7th day of life, and correlated with SARNAT and SARNAT score, cranial USG and EEG. Statistical analysis in relation to asphyxiated status, immediate outcome and EEG record was done using chi–square evaluation with ‘P’ value of less than 0.05 considered as significant. Result: In our study, out of 40 cases, it was observed that, according SARNAT and SARNAT scores, 7 babies were with HIE grade I, 28 with HIE grade II and 5 with HIE grade III. Amongst which survival rate was 100%, 78% and 0% respectively at the end of 7th day. Out of 22 babies of HIE grade II, 10 babies (46%) have abnormal neurological examination and out of HIE grade I all are normal. Abnormal EEG pattern was seen in 3 babies (43%) with HIE grade I, 25 babies (89%) with HIE grade II all 5 babies (100%) with HIE grade III. Out of 33 babies with abnormal EEG, 11 expired (33%) at 7th day of life. Therefore, EEG is good predictor of immediate outcome. Cranial USG finding revealed, 12 babies (92%) with grade II ICH amongst which survival rate was 58%, and 1 baby (8%) with grade III ICH with 0% survival. Out of 13 babies with abnormal USG, only 7 (54%) survived till 7th DOL and of which 4 (57%) were found with abnormal neurological examinations on 7th day of life. Out of 27 babies with normal cranial USG only 22 (81%) survived till 7th DOL, of which 6 (27%) babies show some neurological abnormality at 7th day of life. Conclusion: EEG and cranial USG, appears to be non–invasive diagnostic and prognostic tools in investigations of babies with birth asphyxia. Normal EEG patterns, normal cranial USG findings with normal neurological examinations on 7th day life was 100% associated with good immediate outcome. Abnormal EEG patterns showed neurological deficits in 45% of babies, and mortality is 33% babies in immediate neonatal period. The severity of ICH is also directly proportional to mortality and morbidity. EEG, cranial USG and SARNAT and SARNAT scoring taken together gives most accurate prediction on neurological development of babies with birth asphyxia and its immediate outcome.
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DOI : 10.36106/ijsr
Cite This Article:
ELECTROENCEPHALOGRAPHIC AND CRANIAL USG STUDIES IN FULL TERM NEWBORN WITH BIRTH ASPHYXIA AND THEIR RELATION WITH IMMEDIATE OUTCOME, Dr. Pramod Patil, Dr. Vyankatesh Tarkasband, Dr. Rohit Agarwal, Dr. Amol Thorat INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH : Volume-8 | Issue-3 | March-2019
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ELECTROENCEPHALOGRAPHIC AND CRANIAL USG STUDIES IN FULL TERM NEWBORN WITH BIRTH ASPHYXIA AND THEIR RELATION WITH IMMEDIATE OUTCOME, Dr. Pramod Patil, Dr. Vyankatesh Tarkasband, Dr. Rohit Agarwal, Dr. Amol Thorat INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH : Volume-8 | Issue-3 | March-2019
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