Efficacy of Umbilical Cord Lactate Level in Predicting the Hypoxic Ischemic Encephalopathy (HIE) in Neonates After Perinatal Asphyxia

Muhammad Bilal Arshad; Iqra  Ayub; Bakhtawar  Arshad; Shabbir  Hussain; Muhammad Tariq  Nadeem; Samina  Tabbusum

doi:10.51253/pafmj.v75i1.9204

Authors

Muhammad Bilal Arshad Department of Pediatrics, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Iqra Ayub Department of Physiology, Rawalpindi Medical University, Rawalpindi Pakistan
Bakhtawar Arshad Department of Anesthesia, AHF
Shabbir Hussain Department of Pediatrics, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Muhammad Tariq Nadeem Department of Pediatrics, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Samina Tabbusum Department of Pediatrics, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75i1.9204

Keywords:

Hypoxic Ischemic Encephalopathy, Lactate Level, Perinatal Asphyxia, Umbilical Artery

Abstract

Objective: To compare the umbilical artery lactate level in different grades of Hypoxic Ischemic Encephalopathy in neonates with perinatal asphyxia.

Study Design: Cross-sectional study.

Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan, from Dec 2021 to Feb 2022.

Methodology: A group of 70 neonates with gestational age of 36 weeks (252 days) and above, who were reported to have any late deceleration, meconium staining of liquor, low 5 minute APGAR score and need for neonatal resuscitation for more than 1 minute, were selected and their umbilical artery lactate levels were measured. Neonates were classified into two groups by using Sarnet and Sarnet classification with Group-A having neonates with No or Mild Hypoxic Ischemic Encephalopathy and Group-B with Moderate to Severe Hypoxic Ischemic Encephalopathy.

Results: A total of 70 patients were enrolled in the study with median gestational age of 267 days and mean weight of 2.70±0.60 kg. A total of 45 neonates were found to have No or mild Hypoxic Ischemic Encephalopathy (Group-A) with mean lactate level of 3.64±1.49 mmol/L and 25 diagnosed with moderate to severe Hypoxic Ischemic Encephalopathy (Group-B) had mean lactate level of 9.40±2.26 mmol/L. Mean lactate levels were significantly raised for Moderate to Severe Hypoxic Ischemic Encephalopathy (p≤0.005).

Conclusions: The umbilical artery lactate level can be used as a predictor of moderate-to-severe Hypoxic Ischemic Encephalopathy in neonates suffering from perinatal asphyxia.

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