Treatment and outcome of neonates with hypoxic ischaemic encephalopathy at B.P. Koirala Institute of Health Sciences

Introduction: Perinatal asphyxia is an important cause of neonatal deaths and neonatal intensive care unit (NICU) admission.

Objectives: This study was done to evaluate treatment pattern in neonates having hypoxic ischaemic encephalopathy (HIE) and its relationship with their outcome. 

Method: A hospital based prospective study of one year duration was carried out in term neonates with perinatal asphyxia and HIE, enrolled from the paediatric wards and NICU.

Results: Of the 60 term neonates included in the study, 49 (81.7%) were males. The mean birth weight was 2971± 421g. HIE was mild in 13 (21.7%) cases, moderate in 27 (45%) cases and severe in 20 (33.3%) cases. Seventeen neonates were admitted to the NICU. Oxygen was required in 45 neonates (mean duration 60.3 hours). Mechanical ventilation and vasopressors were given in 13 and 29 neonates respectively. Most of the neonates received antibiotics for 5 days. Mean duration of hospital stay was 146.2 hours. Thirteen neonates (21.7%) were neurologically abnormal at discharge. Forty one (68%) neonates were discharged from hospital, 6 (10%) expired during the hospital stay and 7 left against medical advice.

Conclusions: In this study at the B. P. Koirala Institute of Health Sciences, 22% neonates with perinatal asphyxia and HIE were neurologically abnormal at the time of discharge and there was a 10% mortality.

(Key words: Perinatal asphyxia, hypoxaemic ischaemic encephalopathy)

Sri Lanka Journal of Child Health, 2017; 46(2): 128-132