Vol. 5, Issue 11 (2019)
Clinical evaluation of levels of urinary uric acid and creatinine ratio in neonatal asphyxia cases
Author(s): Dr. Anil Kumar, Dr. Lal Narayan Singh
Abstract: Perinatal asphyxia contributes significantly to neonatal morbidity and mortality. Factors like poverty, ignorance and lack of medical facilities and obstetric care (only a third of deliveries being institutional) contribute significantly to the magnitude of the problem of perinatal asphyxia in our country although a common condition, there is generally no accepted definition for birth asphyxia. It is a devastating clinical condition because of its potential for causing permanent damage, even death of the fetus or newborn baby. The signs of asphyxial injury are nonspecific and overlap with other illnesses. In the absence of perinatal records, it is difficult to retrospectively diagnose perinatal asphyxia The present study was planned to evaluate the urinary uric acid to creatinine ratio in perinatal asphyxia and showing increased uric acid and creatinine excretion in early spot urine for identification of perinatal asphyxia and to assess the severity of hypoxic ischaemic encephalopathy as a marker of severity of perinatal asphyxia in term babies and its correlation to APGAR score. The present study was planned in Department of Pediatrics, Government Medical College Bettiah, West Champaran, Bihar. Total 25 cases of the neonatal asphyxia were evaluated in the present study. For comparative evaluation 25 normal cases of the neonates were enrolled in the control group patients. The spot urine samples were collected within 6-24 h of life and analyzed in the hospital laboratory immediately. Urinary uric acid was estimated in auto-analyzer (Roch / Hitachi 917auto analyzer) by enzymatic colorimetric assay uricase method.10 Urinary creatinine was estimated in the same above instrument by using modified kinetic Jaffe’s method. The data generated from the present study concludes that urinary UA/Cr ratio increases considerably after birth asphyxia, and the increase is associated with severity of HIE with a poorer outcome. Hence, UA/Cr ratio might have an important role in diagnosing and predicting the outcome of perinatal asphyxia although there is a need for a large population based prospective study including preterm and term newborns to determine cut off values of urinary UA/Cr ratio for the severity of perinatal asphyxia.
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