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Synergistic Clinico-Radiological Assessment of Term Newborns Afflicted by Birth Asphyxia in a Tertiary Medical
Virinchi Jampala1, Vasudev Kompally2, Subhan B Bukkapatnam3
1Department of Pediatrics, Government Medical College, Jayashankar Bhupalpally, Bhupalpally, IND.
Insights
Hypoxic-ischemic encephalopathy (HIE) in newborns is concerning. This study found that electroencephalography (EEG) and magnetic resonance imaging (MRI) significantly correlate with HIE severity, aiding in predicting outcomes.
Area of Science:
- Neonatal Neurology
- Pediatric Neuroimaging
- Clinical Outcomes Research
Background:
- Hypoxic-ischemic encephalopathy (HIE) is a major cause of newborn mortality and morbidity.
- Therapeutic hypothermia (TH) is a standard treatment, but long-term neurodevelopmental outcomes require careful assessment.
- Neuropsychological deficits can occur even without overt motor impairments in HIE survivors.
Purpose of the Study:
- To investigate the correlation between electroencephalography (EEG) and neuroimaging findings with the clinical severity of HIE in term neonates.
- To assess the prognostic value of EEG and MRI in predicting neurological outcomes in infants with birth asphyxia.
Main Methods:
- A prospective observational study involving 110 term neonates diagnosed with birth asphyxia.
- Data collected using a Case Record Form, including clinical history, serum parameters, EEG, and MRI findings.
- Correlation analysis performed between HIE severity staging and various diagnostic parameters.
Main Results:
- HIE Grade II was most common (49.1%).
- Abnormal EEG findings were observed in 36.4% and abnormal MRI in 63.6% of neonates.
- Significant associations were found between HIE severity and serum electrolytes, blood urea, blood culture, EEG, and MRI results.
Conclusions:
- EEG and MRI findings are significantly associated with HIE severity in term newborns.
- These neuroimaging modalities are valuable tools for assessing clinical severity and predicting neurological outcomes in HIE.
- Comprehensive assessment including serum parameters and imaging is crucial for prognostication in neonates with birth asphyxia.
Abstract:
Background and objectives Hypoxic-ischemic encephalopathy (HIE) remains a critical concern in newborns, with therapeutic hypothermia (TH) serving as a key treatment strategy. However, assessing long-term outcomes requires a comprehensive approach, as children may develop neuropsychological and learning challenges even in the absence of noticeable motor impairments. This study aims to explore the correlation between electroencephalography (EEG) and neuroimaging findings with the clinical severity of HIE. Materials and methods This prospective observational study included a sample of 110 term neonates with birth asphyxia admitted to a medical college-affiliated hospital in Telangana, India. Data were collected on a predesigned Case Record Form by a single investigator through direct interviews with parents, caregivers, and other relevant individuals. Results Among the 110 neonates analyzed, most fell into HIE Grade II (49.1%), delivered predominantly via normal vaginal delivery (61.8%). Common risk factors included prolonged labor (57.3%) and meconium-stained amniotic fluid (42.7%). Serum parameters revealed variations, with significant associations between sodium, potassium, blood urea, blood culture, EEG, and magnetic resonance imaging (MRI) findings and HIE staging. Abnormal EEG (36.4%) and MRI (63.6%) findings correlated significantly with HIE severity. Conclusions The study provides valuable insights into clinico-radiological correlations in term newborns with birth asphyxia, highlighting the diagnostic value of EEG and neuroimaging modalities. Serum parameters and imaging findings showed significant associations with HIE severity, emphasizing the importance of comprehensive assessment in predicting neonatal outcomes. EEG and MRI demonstrated high sensitivity in predicting abnormal neurological conditions at discharge, suggesting their utility in prognostication.
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