Jampala Virinchi, Kompally Vasudev, Bukkapatnam Subhan B, Gudi Pratap
Department of Pediatrics, Government Medical College, Jayashankar Bhupalpally, Bhupalpally, IND.
Department of Pediatrics, Gandhi Medical College, Secunderabad, IND.
Cureus. 2024 Nov 9;16(11):e73321. doi: 10.7759/cureus.73321. eCollection 2024 Nov.
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.
背景与目的 缺氧缺血性脑病（HIE）仍是新生儿领域的一个关键问题，治疗性低温（TH）是一项关键治疗策略。然而，评估长期预后需要采用综合方法，因为即使儿童没有明显的运动障碍，也可能出现神经心理和学习方面的挑战。本研究旨在探讨脑电图（EEG）和神经影像学检查结果与HIE临床严重程度之间的相关性。材料与方法 这项前瞻性观察性研究纳入了印度特伦甘纳邦一所医学院附属医院收治的110例足月新生儿窒息病例。数据由一名调查员通过直接与父母、护理人员及其他相关人员访谈，收集于预先设计的病例记录表中。结果 在分析的110例新生儿中，大多数属于HIE II级（49.1%），主要通过正常阴道分娩（61.8%）。常见危险因素包括产程延长（57.3%）和羊水粪染（42.7%）。血清参数存在差异，钠、钾、血尿素、血培养、EEG及磁共振成像（MRI）检查结果与HIE分期之间存在显著关联。EEG异常（36.4%）和MRI异常（63.6%）结果与HIE严重程度显著相关。结论 本研究为足月窒息新生儿的临床 - 放射学相关性提供了有价值的见解，突出了EEG和神经影像学检查方法的诊断价值。血清参数和影像学检查结果与HIE严重程度显著相关，强调了综合评估在预测新生儿预后中的重要性。EEG和MRI在预测出院时异常神经状况方面显示出高敏感性，表明它们在预后评估中的实用性。
