Abstract

CRUZ, Ana Cristina Silvestre da  and  CECCON, Maria Esther Jurfest. Prevalence of asphyxia and perinatal hypoxic-ischemic encephalopathy in term newborns, considering two diagnostic criteria. Rev. bras. crescimento desenvolv. hum. [online]. 2010, vol.20, n.2, pp.302-316. ISSN 0104-1282.

OBJECTIVES: to verify the prevalence of asphyxia and hypoxic-ischemic encephalopathy in term newborns according with two diagnostic criteria; To assess the neurological evolution according with each one of the criteria. METHOD: prospective cohort study with 30 newborns by means of two different diagnostic criteria at birth: criterion 1 preconized by the ACOG/APP, 1996 of (cord pH > 7,0, dysfunction of multiple organs, neurological manifestations in the first week of life beyond the Apgar between 0-3 in 5 minutes); the criterion 2 was defined by Buonocore et al., in 2002, as amended (> cord pH of 7,2, Apgar score of 4-6 at 5 minutes and need to maintain FIO₂ > 0.40 of saturation 86%); RESULTS: the prevalence of asphyxia with the criterion 1 was 0,64 per 1,000 termlin births and with the criteriom 2 1,1 per 1000 termlins birth. Among the 30 NB with asphyxia diagnoses, the hypoxic isquemic encephalopathy was 53%. More than a half has this serious complication. The newborns (NB) of the criterion 1, presented more fetal alterations and greator severity of asphyxia Both groups of newborns presented alterations of the heart, licor and idney functios and respiratory and metabolic acidosis. The newborns with metabolic acidosis had high levels of CKMB and a greator neurology impediment. In 85% of the NB with encephalopathy (1 and 2 stages of Sarnat), the Apgar of 5 minutes of life was 4 -6, and NB with encephalopathy (stages 3 of Sarnat) this value was 0-3. (p = 0,018). We found bigger more proportions of newborns of the criterion 2, with 1 and 2 stages of Sarnat. In the 3 stage, we found a bigger. proportions of NB of criterion 1 (p = 0,016). The mortality rate was 16.7% CONCLUSION: the criterion 1 was showord a better correlation with the severity and mortality of the patients but with it, we might exclude the patients that survire and had hypoxic-isquemic encephalopathy and that were included with the criterion 2.

Keywords : newborn; Perinatal; asphyxia; hypoxic-ischemic encephalopathy.

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