Vol. 5, Issue 2 (2019)
Clinical assessment of newborns with birth asphyxia with respect to renal parameters and serum electrolytes level
Author(s): Dr. Umesh Kumar, Dr. B. B Singh
Abstract: The duration of the delayed phase is not precisely known in the human fetus and new born but appears to increase over the first 24-48 hours and then start to resolve thereafter. In the human infant, the duration of this phase is correlated with adverse neurodevelopmental outcomes at 1 year and 4 years after insult. When a neonate suffers asphyxia, series of clinical and biochemical alterations occur which can adversely affect the outcome. While treating hyponatremic seizures, correction of the electrolyte disturbance is more effective than using anticonvulsants. Hyper kalemia is associated with cardiac dysfunction and death. Hypocalcaemia is associated with jitteriness, cardiac dysfunction and seizure. Further the degree of electrolyte imbalance may vary according to the severity of birth asphyxia. Hence present study was planned for clinical assessment of new borns with birth asphyxia with respect to renal parameters and serum electrolytes level. The study was conducted in Department of Paediatrics, ANMMCH, Gaya, bihar from Jan 2016 to Aug 2016. The 50 cases if the new born were enrolled in the present study. The 25 new borns were enrolled in Group A as cases of birth asphyxia and 25 new borns were enrolled in Group B as control patients. Detailed antenatal, natal and postnatal history and clinical examination was done and findings were recorded on predesigned pro forma. Serum electrolytes (sodium, potassium and calcium) were analysed using ion selective electrode by automated machine. Perinatal asphyxia is an important cause of neonatal renal failure. Monitoring of blood levels of urea, serum creatinine, serum calcium and urine output helps in the early diagnosis and management of renal failure in birth asphyxia. Hyponatremia, hyper kalemia and hypocalcaemia occur in neonates with birth asphyxia which may cause increased morbidity and mortality. More severe hyponatremia should be suspected if there is severe birth asphyxia and vice versa. Hence its level should be more regularly monitored to prevent the problems associated with it.