Original researchNeonatal organ system injury in acute birth asphyxia sufficient to result in neonatal encephalopathy
Section snippets
Materials and methods
A prospectively maintained neonatal database was queried to identify all diagnoses of acute intrapartum asphyxia, acute birth asphyxia, or neonatal encephalopathy from January 1, 1994, to January 1, 2000, at the University of Texas Medical Branch at Galveston. The study was approved by the University of Texas Medical Branch institutional review board. This data set was cross-referenced using diagnostic coding in medical records. Maternal and neonatal records were then hand extracted for
Results
A total of 129 newborns were identified with the diagnosis of either acute intrapartum asphyxia, acute birth asphyxia, or neonatal encephalopathy. Five cases were excluded for insufficient data. Seventy cases were excluded as they failed to meet one of the four essential criteria. Of the remaining 54 cases that sustained an acute intrapartum asphyxial episode, eight were excluded because of gestational ages of less than 32 weeks. The remaining 46 patients are the subjects of this report.
Of the
Discussion
Evidence of multiple organ system damage was the overwhelming rule, and not the exception, in this cohort of 46 cases of clearly demonstrated acute intrapartum asphyxia with resultant neonatal encephalopathy. Combinations of laboratory and imaging studies demonstrated involvement of the renal, hepatic, central nervous, and cardiac systems in over 70% of cases. The least likely organ system to show injury was the hematologic system, and even here, 54% of neonates showed evidence of injury.
We
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