Abstract:
Background and aim: Perinatal asphyxia is the inability of newborns to initiate and maintain effective breathing at birth. It is a common neonatal problem globally that contributes significantly to newborn morbidity and mortality, especially in developing countries, with different risk factors predominant in different settings.
Our aim is to study and evaluate the prevalence of the various factors associated with perinatal asphyxia in term newborns.
Methods: This was a retrospective study conducted over two years. The analysis concerned the characteristics of pregnant women and fetuses during pregnancy and childbirth in 75 newborns with perinatal asphyxia defined by the combination of two of the following criteria: an Apgar score < 5 to five minutes, fetal metabolic acidosis, early multi-organ alterations before 72 hours of life, signs of anoxischemic encephalopathy, early neonatal brain imaging showing non-focal abnormalities.
Results: Among the 75 newborns, hypoxic ischemic encephalopathy (HIE) stage 1,2,3 was represented respectively 36%, 44%, 20%. The maternal age was in 90% between 20 and 40 years, in 63% were first-time mothers
Post-maturity was present in 9% of neonates with perinatal asphyxia, preeclampsia and eclampsia was present in 20.8% of cases, intrauterine growth restriction 6.6%, fetal macrosomia 4%, breech presentation 8%, and twin gestation 5.3%. Other pregnancy complications (retroplacental hematoma, gestational diabetes, oblique position, transverse position, placenta previa) accounted for 20%.
Labor-related complications were observed in 71% of cases, the majority of women had spontaneous labor (86%), instrument-assisted delivery was more likely to develop perinatal asphyxia in 52%, the presence of tinted or meconium fluid was present in 13% of cases. Other complications such as induction failure, abnormal presentation, and uterine rupture were observed in 8%. Fetal distress was found in 89.8% diagnosed by ACRE abnormalities that were significantly associated with perinatal asphyxia. The mortality rate in asphyxiated newborns was 11.3% and stage III of Sarnat was a significant risk factor for mortality.
Conclusion: Perinatal asphyxia is a common problem, with a high mortality rate. The most important risk factor was fetal distress during labour and the 24-hour Sarnat stage was an important determinant of mortality. The risk can be greatly reduced by good obstetric intervention in terms of adequate fetal monitoring during pregnancy and labour, and good resuscitation in the delivery room.
