Research Information System
Thesis Type: Expertise In Medicine
Institution Of The Thesis: Gazi Üniversitesi, Tıp Fakültesi, Turkey
Approval Date: 2020
Thesis Language: Turkish
Student: ELİF ÇİVİT
Supervisor: NURİYE EBRU ERGENEKON
Abstract:Perinatal asphyxia is still one of the global health problems in spite of the advances in diagnosis and treatment methods. Patients with perinatal asphyxia are evaluated according to the stages and recommended supportive therapy if it is mild-stage. If it is moderate/severe stage then neuroprotective treatments such as active hypothermia along with supportive therapy are recommended. Therefore, there is a need for specifiers to differentiate between mild and moderate/severe stage patients and studies on whether mild stage patients should be treated. This study was conducted to research data that distinguish patients with mild-stage and moderate/severe stage HIE and to determine the need for neuroprotective therapy by evaluating the prognosis of mild-stage patients. In our study, 33 patients who were monitored upon the diagnosis of perinatal asphyxia at GÜTF NICU between 2015-2019 were included; and the results of these patients were analyzed retrospectively. To the involving patients, supportive therapy and passive hypothermia were applied at mild-stage, and active hypothermia therapy along with supportive therapy were applied at moderate/severe stage. Based on the literature, APGAR scores, cord lactate; before treatment glucose level, uric acid, AST values were thought to be beneficial in differentiating the mild and moderate/heavy stages and the sensitivity and specificity of the determined values were examined. In addition, a correlation was found between lactate and CK levels and HIE stages. When the 18th month PMD scores of the patients were examined, mild stage patients were expected to be better, but no difference was observed between the stages. Low number of cases that can be monitored in the long term and the effectiveness of the hypothermia treatment applied to the group with moderate/severe HIE may have played a role in this. The results of our study were not sufficient to distinguish patients with moderate/severe stage HIE from mild stage patients. Like recent studies, our study also contradicts old studies reporting that morbidity was not observed in mild stage patients. If it is supported by large sampled randomly controlled studies that the prognosis of mild stage patients may not be as good as expected, whether neuroprotective therapy should be given to them can be reassessed. Keywords: Perinatal asphyxia, Hypoxic ischemic encephalopathy, Neonatal encephalopathy