Asian Journal of Pediatric Research

Introduction: Perinatal asphyxia is a common neonatal problem and contributes significantly to neonatal morbidity and mortality. Encephalopathy occurs in 50% to 60% of patients with severe perinatal asphyxia. Moderate hypoxic ischaemic encephalopathy (HIE), 10% to 20% die and 30% to 40% develop neurodeficits, whereas 50% of those with severe HIE die and almost all survivors develop neurodeficits. The systematic administration of magnesium sulphate (MgSO₄) after perinatal asphyxia has shown effective resolution of neuronal injury.  We have conducted this study to validate the effect of MgSO₄ in severely asphyxiated neonates, so as to utilize its benefits on ameliorating the outcome associated with severe perinatal asphyxia/HIE.

Objective of the Study: To determine the characteristics and outcome of magnesium sulphate on neurological outcome in severe perinatal asphyxia

Materials and Methods: A prospective interventional study of magnesium sulphate treatment of neonates with severe perinatal asphyxia conducted over one year period from 1^st August 2017 to 31^st July 2018.

Results: Of the 52 neonates, male 34 while there 18 female giving a ratio of (M: F is 1:1.8).  There were 30 (57.7%) in-born and 22 (42.3%) out-born, the total asphyxia cases (30/144) giving the incidence of 20.8% among in born. About one half (55.8%) of the patients commenced MgSO₄ therapy at < 6 hours after birth, while 30.6% and 16.6% commenced MgSO₄ therapy at 6 - < 24 hours and > 24 hours after birth respectively. About one half (49.0%) commenced enteral feeding within 5 – 7 days while 36.7% and 14.3% commenced enteral feeding at 4 < days and at > 7 days respectively. Majority of the patients commenced full enteral feeding at either between 5 – 7 days or > 7 days while only 36.7% of the neonates commenced full enteral feeding before 5 days. Equally, primary outcome, fully recovered and initiation breast feeding.

Conclusion: Of the fifty two patients managed, 5 (9.6%) died during the treatment period after 8^th day of admission and at follow up, while 47 (90.4%) survived. Also greater 50% of the survivors commenced breast feeding within five days of admission and were clinical normal at follow up clinic. Whether this coincidental or a true effect of MgSo₄, a future prospective randomized controlled trial may make the picture clearer