ABSTRACT
Objective: To compare the Conventional and Combined Apgar scoring systems in predicting adverse early neurologic outcomes in term and near term babies with birth asphyxia. Methods: A retrospective cross sectional study was conducted over a period of 2 years. All the neonates with gestational age more than 35 weeks delivered in this hospital with birth asphyxia requiring admission in NICU were included in the study. Neonates with gestational age less than 35 weeks, those with major congenital anomalies and death in delivery room were excluded from the study. The APGAR and COMBINED APGAR scores were noted. Convulsion, use of anticonvulsant drugs, requirement of mechanical ventilation, and duration of hospital stay were also noted. The data was analysed using fisher exact test. Results: Statistically significant associations were observed between Apgar score less than 3 at 1 minute and occurrence of convulsion (p=0.003) and requirement of ventilation (p<0.001), Apgar score less that 6 at 5 minutes” occurrence of convulsion (p=0.001) and requirement of ventilation (p<0.001), Combined Apgar score less that 7 at 1 minute and occurrence of convulsion (p=0.003) and requirement of ventilation (p=0.002), Combined Apgar score less that 10 at 5 minutes and occurrence of convulsion (p<0.001) and requirement of ventilation (p<0.001), and early neonatal death (within 7 days)” and Combined Apgar score less than 7 at 1 minute (p=0.09) and Combined Apgar score less than 10 at 5 minutes (p=0.09). Conclusion: Though a low combined apgar score was superior to the traditional apgar score in predicting early neonatal mortality, no difference was seen in prognostication of convulsion and mechanical ventilation.
ABSTRACT
Background: Children with Congenital Heart Disease have associated structural neurological abnormalities and those surviving infancy are even subjected to various environmental factors which might contribute to neurological abnormalities. Hence the objective is to study the neurological abnormalities of children with Congenital Heart Disease.Methods: A retrospective cross-sectional observation study was conducted over the period of 3 years (June 2016-May 2019). Data were collected from medical records department of 121 children of 2-12 years of age diagnosed with congenital heart disease. Neurological examination findings and neuro imaging and EEG findings where relevant were noted. To assess the association of adverse neurological outcome and congenital heart disease, data analysis was performed using Fisher's exact test.Results: 38% children of 2-12 years of age with congenital heart disease had adverse neurological profile. Neurological abnormalities were significantly associated with cyanotic heart disease (p value 0.0001). Statistically significant association were found between congenital cyanotic heart disease and seizure (p value=0.04), hemi paresis (p value=0.039), brain abscess (p value=0.012) and coma (p=0.01).Conclusions: Congenital cyanotic heart disease has significant associations with neurological abnormalities in children. These results demand attention for the neurological health of the largely uncorrected cardiac disease in Indian children