Asphyxia could increase infant morbidity and mortality. Ante- and intrapartum cardiotocography (CTG) examination could lead to a false positive diagnosis of asphyxia (fetal distress). Troponin I (TnI) is an important ...Asphyxia could increase infant morbidity and mortality. Ante- and intrapartum cardiotocography (CTG) examination could lead to a false positive diagnosis of asphyxia (fetal distress). Troponin I (TnI) is an important factor to the pathogenesis of asphyxia. Cord blood TnI level is increased in infants with fetal cardiac dysfunction, causing pathological CTG and low APGAR score (<7). In the future, TnI is expected to reduce false positive diagnosis of asphyxia caused by CTG. This research was conducted to examine and analyze the differences of cord blood TnI level between normal and asphyxiated infants and to determine the correlation between TnI level and APGAR score. An observational analytical cross sectional study was conducted to a total of 36 patients with asphyxiated infants (18 patients) and normal infants (18 patients). Subjects were selected according to the inclusion and exclusion criteria. Cardiotocography, TnI level, and APGAR score were examined. Umbilical cord blood samples were taken from each subject for the measurement of TnIlevel using a highly sensitive indirect sandwich Enzyme Linked Immunosorbent Assay (ELISA). Statistical analysis was performed by Mann-Whitney and Rank Spearman correlation coefficient test. Cord blood TnI level of asphyxia andnormal groups were 1615.77 ± 1199.98 pg/mL and 819.88 ± 145.82 pg/mLrespectively (p ≤ 0.05). Rank Spearman correlation coefficient between cord blood TnI level and 1’ and 5’ APGAR score was -0.523 (p = 0.026;p ≤ 0.05)and -0.502 respectively (p = 0.034;p ≤ 0.05). There was a statistically significant difference between cord blood TnI level of asphyxia and normal groups;cord blood TnI level of asphyxia group was higher than normal group. Furthermore, negative correlation was observed between cord blood TnI level and APGAR score.展开更多
Introduction: Our aim was to identify the risk factors of clinical birth asphyxia and subsequent newborn death in the presence of nuchal cord in a sub-Saharan Africa setting. Methodology: It was a six-months’ case-co...Introduction: Our aim was to identify the risk factors of clinical birth asphyxia and subsequent newborn death in the presence of nuchal cord in a sub-Saharan Africa setting. Methodology: It was a six-months’ case-control study involving 117 parturients whose babies presented with a nuchal cord at delivery. The study was carried out at the Yaoundé Gyneco-Obstetric and Pediatric Hospital, Cameroon, from January 1st to June 30th 2013. Results: The risk factors of clinical birth asphyxia identified were: first delivery, absence of obstetrical ultrasound during pregnancy, nuchal cord with more than one loop, duration of second stage of labor more than 30 minutes during vaginal delivery. The risk factors for newborn death from clinical birth asphyxia in the presence of nuchal cord were: maternal age Conclusion: We recommend a systematic obstetrical ultrasound before labor, so as to detect the presence of a nuchal cord, its tightness and the number of loops. Also, cesarean section should be considered when a nuchal cord is associated with first delivery, tightness or multiple looping.展开更多
A study was conducted to determine midwives adherence to guidelines on management of birth asphyxia at Queen Elizabeth Central Hospital in Blantyre district, Malawi. The study design was descriptive cross sectional us...A study was conducted to determine midwives adherence to guidelines on management of birth asphyxia at Queen Elizabeth Central Hospital in Blantyre district, Malawi. The study design was descriptive cross sectional using quantitative data analysis method on 75 midwives that were working in the maternity unit of the hospital. A structured questionnaire was used to collect data on participant’s demographic characteristics and midwives’ comprehension of birth asphyxia and an observational check list was used to observe midwives’ adherence to WHO resuscitation guidelines. In addition midwives were observed on their adherence to the Integrated Maternal and Neonatal Health guidelines that were developed by the Malawi Ministry of Health. The findings indicate that the midwives had knowledge of birth asphyxia in general. However, there were gaps in their ability to identify warning signs of birth asphyxia through partograph use. In addition the midwives did not adhere to 9 out of the 21 steps of the resuscitation guideline. Generally there was substandard adherence to guidelines on identification of warning signs of birth asphyxia and neonatal resuscitation. On the other hand, the facility did not have adequate resuscitation equipment and supplies. The results are discussed in relation to the importance of adhering to resuscitation guidelines in the management of birth asphyxia for babies that do not breathe at birth. Training of the midwives on partograph use and resuscitation to improve neonatal outcomes is recommended. It is recommended further that the health facility should have adequate resuscitation equipment and supplies.展开更多
目的研究联合应用Apgar评分、脐动脉血pH值与乳酸诊断新生儿窒息的效果.方法选取2020年4月至2022年3月广州市番禺区妇幼保健院收治的100例新生儿窒息患儿为研究组,同期在本院分娩的200例正常新生儿为对照组,比较2组1 min Apgar评分、脐...目的研究联合应用Apgar评分、脐动脉血pH值与乳酸诊断新生儿窒息的效果.方法选取2020年4月至2022年3月广州市番禺区妇幼保健院收治的100例新生儿窒息患儿为研究组,同期在本院分娩的200例正常新生儿为对照组,比较2组1 min Apgar评分、脐动脉血pH值及乳酸水平,并分析各单项指标及不同指标联合诊断新生儿窒息的准确率、灵敏度和特异度.结果研究组1 min Apgar评分、脐动脉血pH值和乳酸水平均高于对照组(均P<0.001).各单项指标中,1 min Apgar评分诊断准确率高于脐动脉血pH值和乳酸(均P<0.01)、灵敏度高于脐动脉血pH值(P<0.05)、特异度高于乳酸(P<0.01);联合指标中,1 min Apgar评分+脐动脉血pH值诊断准确率、灵敏度和特异度分别为80.67%、81.00%和80.50%,1 min Apgar评分+乳酸诊断准确率、灵敏度和特异度分别为80.00%、84.00%和78.00%,1 min Apgar评分+脐动脉血pH值+乳酸诊断准确率、灵敏度和特异度分别为95.00%、100.00%和92.50%,1 min Apgar评分+脐动脉血pH值+乳酸的诊断准确率、灵敏度和特异度高于1 min Apgar评分+脐动脉血pH值和1 min Apgar评分+乳酸(均P<0.001).结论在应用1 min Apgar评分与脐动脉血pH值的基础上联合乳酸检测能够提高新生儿窒息的诊断效果.展开更多
目的应用畸变产物耳声发射(DPOAE)对窒息新生儿与正常新生儿进行听力筛查,比较其听力损失的发生率。方法使用MAICO ERO SCAN新生儿筛查型耳声发射仪对195例窒息新生儿和3002例正常新生儿进行DPOAE听力筛查。根据1分钟Apgar评分,将195例...目的应用畸变产物耳声发射(DPOAE)对窒息新生儿与正常新生儿进行听力筛查,比较其听力损失的发生率。方法使用MAICO ERO SCAN新生儿筛查型耳声发射仪对195例窒息新生儿和3002例正常新生儿进行DPOAE听力筛查。根据1分钟Apgar评分,将195例窒息新生儿分为轻度(177例)和重度(18例)窒息。窒息新生儿初筛在病情稳定后进行,正常新生儿在出生后1～5天进行,窒息新生儿通过及未通过者均于出生后1、3、6、12个月分别再测试,监测有无迟发性耳聋的发生;正常新生儿未通过者在出生后42天进行复筛,两组两次检测仍未通过者在出生后3个月时用听性脑干反应(ABR)、40Hz-AERP和声导抗进行诊断性听力评估。采用SPSS10.0软件进行统计学分析。结果 195例窒息新生儿,初筛通过148例,初筛通过率为75.90%(148/195),未通过47例,未通过率为24.10%(47/195);3002例正常新生儿,初筛通过2504例,初筛通过率为86.41%(2504/3002),正常新生儿初筛通过率显著高于窒息新生儿(P<0.01)。轻度窒息新生儿177例,初筛通过138例,初筛通过率77.97%(138/177),重度窒息新生儿18例,初筛通过10例,初筛通过率55.56%(10/18),轻度窒息新生儿初筛通过率高于重度窒息新生儿(P<0.05)。窒息新生儿复筛通过率为92.59%(25/27),正常新生儿复筛通过率为97.49%,两者差异无统计学意义(χ2=0.916,P>0.05)。确诊窒息新生儿听力损伤1例,听力损失检出率5.13‰(1/195);正常新生儿听力损失6例,听力损伤检出率为2.00‰(6/3002),两者差异无统计学意义(χ2=0.574,P>0.05)。结论正常新生儿听力初筛通过率显著高于窒息新生儿,复筛通过率两组无差异,窒息新生儿与正常新生儿听力损失检出率无显著性差异,DPOAE可作为窒息新生儿与正常新生儿听力筛查的一种有效方法。展开更多
目的探讨脐动脉血pH值评价新生儿窒息及预测窒息并发症的临床意义。方法抽取2006年1月—2008年4月在我院分娩的健康产妇552例。监测其新生儿脐动脉血pH值,分析脐动脉血pH值与生后1 min Apgar评分的关系,分别对脐动脉血pH值及1 min Apga...目的探讨脐动脉血pH值评价新生儿窒息及预测窒息并发症的临床意义。方法抽取2006年1月—2008年4月在我院分娩的健康产妇552例。监测其新生儿脐动脉血pH值,分析脐动脉血pH值与生后1 min Apgar评分的关系,分别对脐动脉血pH值及1 min Apgar评分对于预测新生儿窒息并发症进行真实性的评价。结果1 min Apgar评分与脐动脉血pH值相关(χ2=278.13,P<0.05)。脐动脉血pH值对于预测窒息并发症较Apgar评分有更高的敏感度及特异度。pH值异常发生比例与HIE程度有关,随HIE程度的提高而增加(χ2=4.437,P<0.05)。结论脐动脉血pH值能客观评价新生儿出生时的状况,对监测新生儿预后、早期采取有效措施防治窒息并发症有指导意义。展开更多
文摘Asphyxia could increase infant morbidity and mortality. Ante- and intrapartum cardiotocography (CTG) examination could lead to a false positive diagnosis of asphyxia (fetal distress). Troponin I (TnI) is an important factor to the pathogenesis of asphyxia. Cord blood TnI level is increased in infants with fetal cardiac dysfunction, causing pathological CTG and low APGAR score (<7). In the future, TnI is expected to reduce false positive diagnosis of asphyxia caused by CTG. This research was conducted to examine and analyze the differences of cord blood TnI level between normal and asphyxiated infants and to determine the correlation between TnI level and APGAR score. An observational analytical cross sectional study was conducted to a total of 36 patients with asphyxiated infants (18 patients) and normal infants (18 patients). Subjects were selected according to the inclusion and exclusion criteria. Cardiotocography, TnI level, and APGAR score were examined. Umbilical cord blood samples were taken from each subject for the measurement of TnIlevel using a highly sensitive indirect sandwich Enzyme Linked Immunosorbent Assay (ELISA). Statistical analysis was performed by Mann-Whitney and Rank Spearman correlation coefficient test. Cord blood TnI level of asphyxia andnormal groups were 1615.77 ± 1199.98 pg/mL and 819.88 ± 145.82 pg/mLrespectively (p ≤ 0.05). Rank Spearman correlation coefficient between cord blood TnI level and 1’ and 5’ APGAR score was -0.523 (p = 0.026;p ≤ 0.05)and -0.502 respectively (p = 0.034;p ≤ 0.05). There was a statistically significant difference between cord blood TnI level of asphyxia and normal groups;cord blood TnI level of asphyxia group was higher than normal group. Furthermore, negative correlation was observed between cord blood TnI level and APGAR score.
文摘Introduction: Our aim was to identify the risk factors of clinical birth asphyxia and subsequent newborn death in the presence of nuchal cord in a sub-Saharan Africa setting. Methodology: It was a six-months’ case-control study involving 117 parturients whose babies presented with a nuchal cord at delivery. The study was carried out at the Yaoundé Gyneco-Obstetric and Pediatric Hospital, Cameroon, from January 1st to June 30th 2013. Results: The risk factors of clinical birth asphyxia identified were: first delivery, absence of obstetrical ultrasound during pregnancy, nuchal cord with more than one loop, duration of second stage of labor more than 30 minutes during vaginal delivery. The risk factors for newborn death from clinical birth asphyxia in the presence of nuchal cord were: maternal age Conclusion: We recommend a systematic obstetrical ultrasound before labor, so as to detect the presence of a nuchal cord, its tightness and the number of loops. Also, cesarean section should be considered when a nuchal cord is associated with first delivery, tightness or multiple looping.
文摘A study was conducted to determine midwives adherence to guidelines on management of birth asphyxia at Queen Elizabeth Central Hospital in Blantyre district, Malawi. The study design was descriptive cross sectional using quantitative data analysis method on 75 midwives that were working in the maternity unit of the hospital. A structured questionnaire was used to collect data on participant’s demographic characteristics and midwives’ comprehension of birth asphyxia and an observational check list was used to observe midwives’ adherence to WHO resuscitation guidelines. In addition midwives were observed on their adherence to the Integrated Maternal and Neonatal Health guidelines that were developed by the Malawi Ministry of Health. The findings indicate that the midwives had knowledge of birth asphyxia in general. However, there were gaps in their ability to identify warning signs of birth asphyxia through partograph use. In addition the midwives did not adhere to 9 out of the 21 steps of the resuscitation guideline. Generally there was substandard adherence to guidelines on identification of warning signs of birth asphyxia and neonatal resuscitation. On the other hand, the facility did not have adequate resuscitation equipment and supplies. The results are discussed in relation to the importance of adhering to resuscitation guidelines in the management of birth asphyxia for babies that do not breathe at birth. Training of the midwives on partograph use and resuscitation to improve neonatal outcomes is recommended. It is recommended further that the health facility should have adequate resuscitation equipment and supplies.
文摘目的研究联合应用Apgar评分、脐动脉血pH值与乳酸诊断新生儿窒息的效果.方法选取2020年4月至2022年3月广州市番禺区妇幼保健院收治的100例新生儿窒息患儿为研究组,同期在本院分娩的200例正常新生儿为对照组,比较2组1 min Apgar评分、脐动脉血pH值及乳酸水平,并分析各单项指标及不同指标联合诊断新生儿窒息的准确率、灵敏度和特异度.结果研究组1 min Apgar评分、脐动脉血pH值和乳酸水平均高于对照组(均P<0.001).各单项指标中,1 min Apgar评分诊断准确率高于脐动脉血pH值和乳酸(均P<0.01)、灵敏度高于脐动脉血pH值(P<0.05)、特异度高于乳酸(P<0.01);联合指标中,1 min Apgar评分+脐动脉血pH值诊断准确率、灵敏度和特异度分别为80.67%、81.00%和80.50%,1 min Apgar评分+乳酸诊断准确率、灵敏度和特异度分别为80.00%、84.00%和78.00%,1 min Apgar评分+脐动脉血pH值+乳酸诊断准确率、灵敏度和特异度分别为95.00%、100.00%和92.50%,1 min Apgar评分+脐动脉血pH值+乳酸的诊断准确率、灵敏度和特异度高于1 min Apgar评分+脐动脉血pH值和1 min Apgar评分+乳酸(均P<0.001).结论在应用1 min Apgar评分与脐动脉血pH值的基础上联合乳酸检测能够提高新生儿窒息的诊断效果.
文摘目的应用畸变产物耳声发射(DPOAE)对窒息新生儿与正常新生儿进行听力筛查,比较其听力损失的发生率。方法使用MAICO ERO SCAN新生儿筛查型耳声发射仪对195例窒息新生儿和3002例正常新生儿进行DPOAE听力筛查。根据1分钟Apgar评分,将195例窒息新生儿分为轻度(177例)和重度(18例)窒息。窒息新生儿初筛在病情稳定后进行,正常新生儿在出生后1～5天进行,窒息新生儿通过及未通过者均于出生后1、3、6、12个月分别再测试,监测有无迟发性耳聋的发生;正常新生儿未通过者在出生后42天进行复筛,两组两次检测仍未通过者在出生后3个月时用听性脑干反应(ABR)、40Hz-AERP和声导抗进行诊断性听力评估。采用SPSS10.0软件进行统计学分析。结果 195例窒息新生儿,初筛通过148例,初筛通过率为75.90%(148/195),未通过47例,未通过率为24.10%(47/195);3002例正常新生儿,初筛通过2504例,初筛通过率为86.41%(2504/3002),正常新生儿初筛通过率显著高于窒息新生儿(P<0.01)。轻度窒息新生儿177例,初筛通过138例,初筛通过率77.97%(138/177),重度窒息新生儿18例,初筛通过10例,初筛通过率55.56%(10/18),轻度窒息新生儿初筛通过率高于重度窒息新生儿(P<0.05)。窒息新生儿复筛通过率为92.59%(25/27),正常新生儿复筛通过率为97.49%,两者差异无统计学意义(χ2=0.916,P>0.05)。确诊窒息新生儿听力损伤1例,听力损失检出率5.13‰(1/195);正常新生儿听力损失6例,听力损伤检出率为2.00‰(6/3002),两者差异无统计学意义(χ2=0.574,P>0.05)。结论正常新生儿听力初筛通过率显著高于窒息新生儿,复筛通过率两组无差异,窒息新生儿与正常新生儿听力损失检出率无显著性差异,DPOAE可作为窒息新生儿与正常新生儿听力筛查的一种有效方法。
文摘目的探讨脐动脉血pH值评价新生儿窒息及预测窒息并发症的临床意义。方法抽取2006年1月—2008年4月在我院分娩的健康产妇552例。监测其新生儿脐动脉血pH值,分析脐动脉血pH值与生后1 min Apgar评分的关系,分别对脐动脉血pH值及1 min Apgar评分对于预测新生儿窒息并发症进行真实性的评价。结果1 min Apgar评分与脐动脉血pH值相关(χ2=278.13,P<0.05)。脐动脉血pH值对于预测窒息并发症较Apgar评分有更高的敏感度及特异度。pH值异常发生比例与HIE程度有关,随HIE程度的提高而增加(χ2=4.437,P<0.05)。结论脐动脉血pH值能客观评价新生儿出生时的状况,对监测新生儿预后、早期采取有效措施防治窒息并发症有指导意义。
