Perinatal asphyxia in a specialist hospital in Port Harcourt, Nigeria

Abstract

Objectives : To find the prevalence, and identify risk factors and outcome in neonates who were admitted into the Braithewaite Memorial Specialist Hospital (BMSH) for perinatal asphyxia. Method : This was a descriptive cross sectional observational study of neonates with low Apgar scores admitted over a period of ten months into the Special Care Baby Unit of the BMSH. All babies with Apgar scores less than six at one minute and for whom consent was obtained were recruited consecutively. For outborn babies with no Apgar score recording, a history of poor cry from birth with either poor colour, respiratory distress, floppiness or loss of primitive reflexes were used. Results : One hundred and fifty seven of 630 babies admitted had perinatal asphyxia giving a prevalence of 29.4%. Mean gestational age of affected babies was 36.84±3.67 weeks, and mean birth weight was 3.0±0.9kg. Sixty two (39.5%) of their mothers had no antenatal care (ANC). Mode of delivery in 98 (62.4%) was caesarian section, of which 80 (81.6%) were emergencies, many of whom had complications before presentation. One hundred and seven (68.2%) and 38(24.2%) babies, had Apgar Score of 4-5 and 0-3 in one minute respectively. The commonest risk factors were cephalopelvic disproportion (CPD) in the mothers and abnormal presentation, predominantly breech in the fetus. 31.6% of those with severe perinatal asphyxia died. Conclusion : Prevalence of perinatal asphyxia is high. Lack of ANC, CPD and breech presentation were contributory factors. There is urgent need for maternal education on need for ANC, early intervention and skilled care of babies at birth. Key words : perinatal asphyxia, newborns, specialist hospital