Analysis of clinical and biochemical parameters to differentiate between antepartum and intrapartum asphyxia
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 6, Pages 1187-1193
Abstract
Background: Perinatal asphyxia is a clinical or biochemical evidence of lack of oxygen or excess of carbon dioxide in the body, due to failure of efficient respiration at birth with resultant hypoxia and acidemia. It is also of medicolegal importance to know the exact cause of fetal distress whether it is antepartum or intrapartum. This study was undertaken to evaluate the use of cord blood serum erythropoietin (S. Epo) and blood gas analysis as a predictor to differentiate between antepartum and intrapartum asphyxia.Material and Methods: A prospective cross- sectional study on 60 neonates born at term in the labor room of a tertiary hospital setting. Through clinical history and examination, cord blood serum erythropoietin and arterial blood gas analysis was performed in each case. Mild to moderate hypoxic-ischaemic encephalopathy (HIE) cases were treated with 500U/kg of recombinant human erythropoietin every alternate day for two weeks, with the first dose administered by 48 hours of life.
Results: Out of the 60 neonates, 68.3% required treatment with rHuEPO, Only those affordable of the treatment, (26.7%) were given rHuEPO. Amongst the 41 neonates with elevated S.Epo, 53.7% weighed<2.5 kg (mean weight- 2.52 kg). Low APGAR Score at 1 min (in 71.7% neonates) and 5 min (in 93.3% neonates) were strongly associated with increased levels of erythropoietin (p≤0.00). Cord blood pH showed acidosis in majority (71.7%) of the cases, while 28.3% had normal cord blood pH.
Conclusion: High levels of S.Epo is associated with antepartum asphyxia while normal S.Epo level with low pH is associated with an intrapartum cause of asphyxia
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