Electrolyte status in birth asphyxia.

OBJECTIVE: To study electrolyte status in asphyxiated newborns of different severity in early neonatal period and compare with controls. METHODS: Sodium, potassium and total calcium levels were estimated in the serum samples of asphyxiated newborns of different severity and control group immediately after birth. RESULTS: Mean serum sodium level was significantly lower (122.1 +/- 6.0 mEq/L vs 138.8 +/- 2.7 mEq/L; P < 0.001), mean serum potassium was higher (5.05 +/- 0.63 mEq/L vs 4.19 +/- 0.40 mEq/L; P < 0.001) and mean serum calcium level was found lower (6.85 +/- 0.95 mg/dl vs 9.50 +/- 0.51 mg/dl; P < 0.001) in cases than controls. Among cases, a strong positive linear correlation was found between the serum sodium, serum calcium levels and their Apgar scores, between sodium levels and total calcium levels and significant negative linear correlation between Apgar scores and serum potassium level. CONCLUSION: Among cases, hyponatremia and hypocalcemia developed early and simultaneously and the decrease in their serum levels was directly proportional to each other and to the degree of asphyxia. Though, mean potassium level was within the normal limit, the value was higher among cases than controls and directly proportional to asphyxia.

Urinary uric acid in preterm neonates.

OBJECTIVE: Study of uric acid level in spot urine of normal preterm AGA (appropriate for gestational age) babies in day one of their life. METHODS: Spot urine samples were collected from 45 normal preterm neonates within 24 hours of their birth for estimation of uric acid. RESULTS: The mean uric acid level was 36.50 +/- 5.99 mg/dl in normal preterm neonates as compared to 18.40 +/- 0.45 mg/dl in normal term babies (documented in another study) (p < 0.001). Also a significant negative linear correlation between body weight and urinary uric acid level was found {r (correlation coefficient) = - 0.970, P (probability) < 0.001 }. CONCLUSION: Higher mean uric acid level was found in spot urine samples of preterm normal neonates than that of normal term babies on day one. Further, urinary uric acid levels were found inversely proportional to the body weight or to the gestational age (as they are AGA) of the babies.

Correlation between Apgar score and urinary uric acid to creatinine ratio in perinatal asphyxia.

A randomized case control hospital based study was conducted over 12 months time on 31 asphyxiated and 31 normal newborn to see whether urinary uric acid can be used as a marker of perinatal asphyxia and can be correlated with the clinical diagnosis by Apgar score. Uric acid and creatinine were estimated in spot urine within 24 hours after birth in both cases and controls. A ratio between concentrations of uric acid to creatinine was estimated and compared between cases and controls. It was found that the ratios were significantly higher in cases than controls (3.1± 1.3 vs 0.96± 0.54; P < 0.001) and among asphyxia patients, a significant negative linear correlation was found between the uric acid to creatinine ratio and the Apgar score (r = -0.857, P < 0.001). So urinary uric acid to creatinine ratio can be used as an additional non-invasive dispace, easy and at the same time early biochemical marker of birth asphyxia which biochemically supports the clinical diagnosis and severity grading of asphyxia by Apgar score.