Neonatal Unit, Department of Pediatrics, University Hospital of Kinshasa, Kinshasa, DR Congo.
J Trop Pediatr. 2013 Aug;59(4):274-9. doi: 10.1093/tropej/fmt011. Epub 2013 Mar 13.
Perinatal asphyxia is the third cause of neonatal death after prematurity and infection.
The purpose of this study was to determine the incidence, the etiology and the HIE score at the first day in term and near-term newborns with perinatal asphyxia at the University Hospital of Kinshasa.
50 term and near-term neonates with perinatal asphyxia were studied prospectively after they were admitted in neonatal intensive care from November 2009 to January 2011. For each patient admitted the perinatal data were collected. Clinical assessment was performed by the Sarnat grading and the Thompson score within twenty-four hours. Medcalc® was used for statistics.
50 babies were scored. The median maternal age was 31 years. In 22% of the mothers preeclampsia was diagnosed. Urogenital infection, IUGR were other prenatal diagnoses. Median Apgar score was 4 after 1 minute, 5 after 5 minutes and 6 after 10 minutes. Sarnat grade 1 was seen in 16 patients, Sarnat grade 2 in 20 patients and grade 3 in 8. Thompson score in the first 24 hours was more than 7 in 60% of the patients. A good correlation was found between the Thompson score and the Sarnat grade (r: 0,77; p < 0,0001). 14 of the 50 babies died. Both Sarnat and Thompson score correlated significantly with mortality.
The incidence of perinatal asphyxia at the University Hospital of Kinshasa remains high and the majority of patients had a severe HIE.
围产期窒息是仅次于早产和感染的导致新生儿死亡的第三大原因。
本研究旨在确定金沙萨大学医院足月和近足月新生儿围产期窒息的发生率、病因和第 1 天的 HIE 评分。
2009 年 11 月至 2011 年 1 月，我们前瞻性研究了 50 例入住新生儿重症监护病房的足月和近足月围产期窒息新生儿。对每位入院患者收集围产期数据。在 24 小时内通过 Sarnat 分级和 Thompson 评分进行临床评估。使用 Medcalc®进行统计分析。
对 50 例婴儿进行评分。母亲的中位年龄为 31 岁。22%的母亲被诊断为先兆子痫。泌尿生殖系统感染、宫内生长受限是其他产前诊断。1 分钟时 Apgar 评分为 4 分，5 分钟时为 5 分，10 分钟时为 6 分。16 例患者 Sarnat 分级 1 级，20 例患者 Sarnat 分级 2 级，8 例患者 Sarnat 分级 3 级。24 小时内 Thompson 评分>7 的患者占 60%。Thompson 评分与 Sarnat 分级之间存在良好的相关性（r：0.77；p <0.0001）。50 例婴儿中有 14 例死亡。Sarnat 分级和 Thompson 评分均与死亡率显著相关。
金沙萨大学医院围产期窒息的发生率仍然很高，大多数患者有严重的 HIE。
