Title: Effect of Perinatal Asphyxia on Myocardial Function in Term Neonate

Authors: Dr S.K. Valinjkar, Dr Shruti Dhale, Dr Pallavi Samariya, Dr Tejasi Sawant, Dr Bushra Ansari

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i8.184

Abstract

Perinatal Asphyxia is a common problem with incidence varying from 0.5- 2% of live births. It is a third most common cause of neonatal death (23%) after preterm birth (28%) and sepsis (26%).The asphyxia injury involve virtually every organ system of body. In this study clinical parameters, Electrocardiographic changes and Cardiac enzymes studied to evaluate the myocardial function in newborns with perinatal asphyxia. In general myocardial function is often under diagnosed and requires high index of suspicion. Neonates with severe hypoxic damage reflected significant changes in ECG and enzymes levels.

References

  1. Adcock LM, Papile LA: Perinatal asphyxia. In Manual of neonatal care 6th Edited by Cloherty JP, Eichenwald EC, Stark AR. New Delhi: Wolters Kluwer; 2008:518–523.
  2. Flores-Nava G, Echevarría-Ybarguengoitia JL, Navarro-Barrón JL, García-Alonso A: Isquemiamiocárdicatransitoriaen el reciénnacido con asfixiaperinatal (miocardiopatíahipóxica). Biol Med Hosp Infant Mex 1990,47:809–13.
  3. Shah P, Riphagen S, Beyene J, Perlman M: Multiorgan dysfunction in infants with post-asphyxial hypoxic-ischaemic encephalopathy. Arch Dis Child Fetal Neonatal Ed 2004, 89:F152–F155.
  4. Sarnat HB, Sarnat MS. Neonatal encephalopathy following fetal distress. A clinical and electroencephalographic study. Arch Neurol1976;33:696-705.
  5. Van de Riet JE, Vandenbussche FP, Le Cessie S, Keirse MJ. Newborn assessment and long-term adverse outcome: A systematic review. Am J Obstet Gynecol 1999;180:1024-9.
  6. Committee on Obstetric Practice, American College of Obstetricians and Gynecologists. ACOG Committee Opinion. Number 326, December 2005. Inappropriate use of the terms fetal distress and birth asphyxia. Obstet Gynecol 2005;106:1469-70
  7. Ferriero DM. Neonatal brain injury. N Engl J Med 2004;351:1985-95.
  8. Rennie JM, Hagmann CF, Robertson NJ. Outcome after intrapartumhypoxic ischaemia at term. Semin Fetal Neonatal Med 2007;12:398-407.
  9. Massaro AN, Chang T, Kadom N, Tsuchida T, Scafi di J, Glass P, et al.Biomarkers of brain injury in neonatal encephalopathy treated with hypothermia. J Pediatr2012;161:434-40.
  10. Sarnat HB, Sarnat MS. Neonatal encephalopathy following fetal distress. A clinical and electroencephalographic study. Arch Neurol1976;33:696-705.
  11. Wiberg N, Källén K, Herbst A, Olofsson P. Relation between umbilicalcord blood pH, base deficit, lactate, 5-minute Apgar score and developmentof hypoxic ischemic encephalopathy. Acta Obstet Gynecol Scand 2010;89:1263-9.
  12. Lawn JE, Cousens S, Zupan J. Lancet Neonatal Survival Steering Team. 4 million neonatal deaths: When? Where? Why? Lancet 2005; 365(9462): 891-900.
  13. Caliskan E, Doger E, Cakiroglu Y, Duman C, Turker G, Yucesoy I. Cord blood cardiac troponin I andcreatine kinase MB levels in poor neonatal outcomes. J Turkish-German Gynecol Assoc 2006; 7: 98-102.
  14. Araujo K, Da Silva J, Sanudo A, Kopelman B. Plasmaconcentrations of cardiac troponin I in newborn infants. Clin Chem 2004; 50: 1717-1718.
  15. Groenendaal F, Vries LS. Selection of babies for intervention after birth asphyxia. Semin Neonatol2000; 5: 17-32.
  16. Baum H, Hinze A, Bartels P, Neumeier D. Reference values for cardiac troponins T and I in healthy neonates. Clin Biochem 2004; 37: 1079-1082.
  17. Pasternak JF: Hypoxic-ischemic brain damage in the term infant. Pediatr Clin North Am 1993, 40:1061–1071.
  18. Saili A, Sarna MS, Gathwala G, Kumari S, Dutta AK: Liver dysfunction insevere birth asphyxia. Indian Pediatr 1990, 27:1291–4.
  19. Tapia-Rombo CA, Carpio-Hernandez JC, Salazar-Acuna AH, Alvarez Vazquez E, Mendoza-Zanella RM, Perez-Olea V, et al: Detection of transitory myocardial ischemia secondary to perinatal asphyxia. Arch Med Res 2000,31:377–383.
  20. Barberi I, Calabro MP, Cordaro S, Gitto E, Sottile A, Prudente D, et al:Myocardial ischaemia in neonates with perinatal asphyxiaelectrocardiographic, echocard-iographic and enzymatic correlations. Eur J Pediatr 1999, 158:742–747.
  21. Costa S, Zecca E, De Rosa G, De Luca D, Barbato G, Pardeo M, Romagnoli C: Is serum troponin T a useful marker of myocardial damage in newborninfants with perinatal asphyxia? ActaPaediatrica 2007, 96:181–184.
  22. Rajakumar PS, Bhat BV, Sridhar MG, Balachander J, Konar BC, Narayanan P et al: Cardiac Enzyme Levels in Myocardial Dysfunction in Newbornswith Perinatal Asphyxia. Indian J Pediatr 2008, 75:1223–1225.
  23. Kanik E, Ozer EA, Bakilar AR, Aydinlioglu H, Dorak C, Dogrusoz B, et al: Assessment of myocardial dysfunction in neonates with HIE: is it asignificant predictor of mortality? The Journal of maternal-fetalandneonatal medicine 2009, 22:239–242.
  24. Hansen AR, Soul JS. Perinatal Asphyxia and Hypoxic-Ischaemic Encephalopathy. In: Cloherty JP, Eichenwald EC, Hansen AR, Stark AR, editors. Manual of neonatal care. 7th edition. Philadelphia: Lippincott Williams and Wilkins, a Wolters Kluwar business; 2012: 711-728.
  25. Sachan R, Agrawal A. Myocardial ischemia in neonate with perinatalas-phyxia. Indian J Child Health. 2017; 4(1):1.
  26. Agrwal J, Shah GS, Poudel P, Baral N, Agrwal A, Mishra OP. Electrocardio-graphic and enzymatic correlations with outcome in neonates with hypoxic –ischemic encephalopathy. Italian J Pediatr. 2012;38:33.

Corresponding Author

Dr Tejasi Sawant

Resident