| Autor: |
Mghirbi, Oussama, Barka, Myriam, Aziza, Rim Ben, Chourou, Hajeur, Kacem, Samia, Bouraoui, Amira, Hentati, Nadia Nadia, Hannechi, Sadok, Blibech, Sonia, Youssef, Mariem, Saidene, Maher, Hammouda, Hachmi Ben, Hamida, Hayet Ben, Elouaer, Maroua, Monastiri, Kamel, Merchaoui, Sonia, Mahdhaoui, Nabiha |
| Předmět: |
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| Zdroj: |
Perinatal Journal; 2024 Supplement, Vol. 32, p33-34, 2p |
| Abstrakt: |
Objective: Regardless of the progress made in perinatal medicine, perinatal asphyxia (PNA) remains a major concern in developing countries. A multicenter study conducted in 2014 showed that the overall incidence was about 4‰ live births in Tunisia. The purpose of our research was to establish the occurrence of PNA, identify its causes and evaluate its outcomes based on hypoxic-ischaemic encephalopathy stage, and primary complications resulting from PNA. Methods: A descriptive and analytical multicenter study was carried out from January to December 2020. It enrolled all full-term neonates admitted to six university hospital neonatology departments for management of PNA in Tunisia. Inclusion criteria were sentinel event during antenatal period or abnormalities on fetal heart rate monitoring, APGAR score<7 at fifth minutes or evidence of neurologic signs with or without multi-visceral involvement. Results: Our study enrolled 183 patients, with an incidence of PNA of 5.6‰ live births at term. The mean age of the mothers was 30.6 ± 5 years, and 48.6% were primiparous. Pregnancies were monitored by a private practitioner in 59% of cases and were uneventful in 61.2% of cases. The mean term of delivery was 39 weeks’ amenorrhea, with the majority being inborn (88%). Forceps was recured in 39% of cases, and one in 10 newborns suffered obstetrical trauma. The etiologies of ANP were mainly funicular causes and remained undetermined in 26% of cases. Anoxic-ischemic encephalopathy was classified as stages I, II and III in 60%, 26% and 14% of cases, respectively. Multivisceral failure was observed in 11.5% of cases. Neurological investigations were inadequately performed, with no imaging in 38.3% of cases and no electroencephalogram in 59%. The mortality rate was 14.8% and was correlated with the sarnat and sartnat severity score, the apgar score and the place of delivery . Fifty-five percent of survivors were lost to follow-up. for those followed up, 13.6% had neulogic anomalies at one year of age and 7.6% at two years. Conclusion: PNA remains frequent in our country with limited management. The optimisation of obstetrical management is imperative. The prevention of neurological sequelae by cerebral hypothermia must be established in our country. A follow-up network must also be established to avoid lost to follow-up and to support children with neurological sequelae disorders as well as their parents. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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