Shaheed Syed Nazrul Islam Medical College Journal
Volume 9, Issue 1, January 2024
Original Contribution
DOI: https://doi.org/10.69699/ssnimcj.2024.v9.i1.02
Impairment of Renal Function and Dyselectrolytemia in Perinatal Asphyxia
1. Dr. Mst Hasina Begum, MBBS, Medical Officer, Sadar Hospital, Lalmonirhat, Bangladesh.
2. Dr. Md. Abdul Hye, FCPS (Physical Medicine), Assistant Professor (Physical Medicine), Rangpur Medical College, Rangpur, Bangladesh
3. Dr. Bedanta Majumder, MBBS Intern Doctor, BIRDEM Hospital, Dhaka, Bangladesh
4. *Dr. Shah Alam Albani, MD (Paediatrics), Senior Consultant (Paediatrics), 100 Bed Hospital, Saidpur, Nilphamari, Bangladesh. albanidr2016@gmail.com
5. Dr. Sabiha Nazneen, FCPS (Gynaecology & Obstetrics), Senior Consultant, (Gynaecology & Obstetrics), Feto-Maternal Medicine Department,Bangobandhu Sheikh Mujib Medical university(BSMMU) Dhaka, Bangladesh.
6. Dr. Prahlad Kumar Shil, MD (Paediatrics), Registrar (Paediatrics), Rangpur Medical College Hospital, Rangpur, Bangladesh.
7. Professor Dr. Bikash Kumar Majumder, FCPS(Pediatrics), Ex-Professor and Head of the Department of Pediatrics, Rangpur Medical College,Rangpur,Bangladesh
8. Dr. Monika Mazumder, FCPS (Paediatrics), Junior Consultant (Paediatrics), Pirgacha Health Complex, Rangpur, Bangladesh.
*For correspondence
Abstract
Background: Perinatal asphyxia is one of the major causes of neonatal death and disability worldwide. Asphyxiated newborns are vulnerable to develop impaired renal functions and derangement in electrolytes level.
Objective: To determine the effects of perinatal asphyxia on renal functions and serum electrolytes.
Methods: This cross sectional observational study was conducted at inpatient department of Paediatrics of Rangpur Medical College Hospital from May 2017to October 2017. After parental permission and clearance, total 200 eligible hospitalized term neonates fulfilling the inclusion and exclusion criteria were enrolled into the study. Estimation of serum creatinine, blood urea, serum sodium and potassium were done for every neonate after hospitalization. Data collection and processing were done for each patient. Data were analyzed through SPSS software (version 16.0). Level of significance was predetermined as p<0.05.
Results: Analysis revealed that out of 200 neonates 130(65%) patients were in Hypoxic Ishchemic Encephalopathy stage-ll followed by 50(25%) and 20(10%) patients in stage-lll and stage-l respectively. Of total subjects, 68(34%) neonates had raised serum creatinine (p<0.001) and majority (36 cases out of 50,18% of total) of them were in stage-lll. Blood urea was raised(p<0.001) in more than half (112 cases out of 200, 56% of total neonates) of the asphyxiated neonates, higher level was observed in stage-ll and stage-lll. Majority of asphyxiated neonates 139(69.5%) were hyponatremic which was significant in all stages of birth asphyxia (p=0.026). Hyperkalemia observed in 38(19%) asphyxiated neonates which was significant with increased severity of perinatal asphyxia (p=0.007).
Conclusion: Renal function impairment and electrolyte abnormalities are common in asphyxiated newborns. The degree of hyponatremia, hyperkalemia, raised serum creatinine and blood urea level were directly proportionate to severity of asphyxia. The early identification and time based intervention to assess renal function and electrolyte abnormality in the early post asphyxiated period will significantly reduce the morbidity and mortality.
[Shaheed Syed Nazrul Islam Med Col J 2024, Jan; 9 (1):3-11]
Keywords: Perinatal asphyxia, Serum creatinine, Blood urea, Hyponatremia, Hyperkalaemia.
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