A review of neonatal outcomes to discharge, of perinatal asphyxia and the use of induced hypothermia as a treatment modality, at a tertiary centre in South Africa

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dc.contributor.authorSimpson, Rebecca
dc.date.accessioned2021-08-23T13:17:52Z
dc.date.available2021-08-23T13:17:52Z
dc.date.issued2020
dc.descriptionA research report submitted to the Faculty of Health Science, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Master of Medicine in Paediatrics, 2020en_ZA
dc.description.abstractBackground: Perinatal asphyxia (PA) is a significant cause of death and disability. Induced hypothermia (IH) has become crucial in it’s the management with improved mortality and morbidity, however is it a viable in low to middle income countries. Objectives: To review the neonatal clinical, demographic characteristics and outcomes of perinatal asphyxia with IH as a treatment modality in Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) Methods: A descriptive retrospective analysis of an established database. Neonates admitted between January 2013 and July 2017 with a birth weight >1800g and a 5-minute Apgar score ≤5, with features of perinatal asphyxia, were included. Results: N=639 neonates with 399 males (62.4%). The majority of the neonates were inborn (499/639, 84.5%).527 neonates (82.5%) diagnosed HIE, with majority grade two,43.3%. The overall survival rate was 87.1% to discharge. An increased incidence of HIE 7.7 /1000 live births since previous study. 33.3% neonates received IH.IH side effects and death were not significantly increased. Incidence of death was increased with the presence of seizures, MSL, MAS, PPHN, HIE, and grade 3 HIE classification (p <0.05). Conclusion: IH did not increase survival rates significantly but a study to assess the impact on the morbidity is warranted. IH for severe HIE and possible adjunct therapies should be considered. The crude use of an Apgar <7 at 10-minutes could be used as a poor prognostic factor. The high incidence rate echoes’ the need for a set criterion for PA in resource limited settings to record the incidence and set a benchmark for improvementen_ZA
dc.description.librarianCK2021en_ZA
dc.facultyFaculty of Health Scienceen_ZA
dc.identifier.urihttps://hdl.handle.net/10539/31526
dc.language.isoenen_ZA
dc.titleA review of neonatal outcomes to discharge, of perinatal asphyxia and the use of induced hypothermia as a treatment modality, at a tertiary centre in South Africaen_ZA
dc.typeThesisen_ZA
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