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Online ISSN
1305-3124

Established
1993

Editors-in-Chief
​Cihat Şen, ​Nicola Volpe

Editors
Cecilia Villalain, Daniel Rolnik, M. Mar Gil

Managing Editors
Murat Yayla

Statistics Editor
Resul Arısoy

PP-041 Hypoxic and ischemic encephalopathy: current situation in Tunisia, a descriptive and analytical multicenter study

Oussama Mghirbi, Myriam Barka, Rim Ben Aziza, Hajeur Chourou, Samia Kacem, Amira Bouraoui, Nadia Nadia Hentati, Sadok Hannechi, Sonia Blibech, Mariem Youssef, Maher Saidene, Hachmi Ben Hammouda, Hayet Ben Hamida, Maroua Elouaer, Kamel Monastiri, Sonia Merchaoui, Nabiha Mahdhaoui

Article info

PP-041 Hypoxic and ischemic encephalopathy: current situation in Tunisia, a descriptive and analytical multicenter study. Perinatal Journal 2024;32(2024):33-34 DOI: 10.59215/prn.24.032supp041

Author(s) Information

Oussama Mghirbi1(Manuscript Writer)
Myriam Barka1(Manuscript Writer)
Rim Ben Aziza2(Manuscript Writer)
Hajeur Chourou2(Manuscript Writer)
Samia Kacem2(Manuscript Writer)
Amira Bouraoui3(Manuscript Writer)
Nadia Nadia Hentati3(Manuscript Writer)
Sadok Hannechi4(Data Collector)
Sonia Blibech4(Data Collector, Results Interpreter)
Mariem Youssef5(Data Collector)
Maher Saidene5(Data Collector)
Hachmi Ben Hammouda5(Data Collector)
Hayet Ben Hamida6(Data Collector)
Maroua Elouaer6(Data Collector)
Kamel Monastiri6(Data Collector)
Sonia Merchaoui1(Data Collector, Data Analyst, Manuscript Writer, Final Reviewer)
Nabiha Mahdhaoui1(Data Collector, Data Analyst, Manuscript Writer, Final Reviewer)

  1. Sousse University, Ibn El Jazzar Medical Faculty of Sousse, Department of Resuscitation and neonatal Medicine, University Hospital Center Farhat Hached, Sousse, Tunisia
  2. Tunis Maternity and Neonatology Center, Department of Resuscitation and Neonatal Medicine, Tunis, Tunisia
  3. Hedi Chaker Hospital, Department of Resuscitation and Neonatal Medicine, Sfax, Tunisia
  4. Tunis Military Hospital, Department of Resuscitation and Neonatal Medicine, Tunis, Tunisia
  5. Tahar Sfar Hospital, Department of Resuscitation and Neonatal Medicine, Mahdia, Tunisia
  6. Fattouma Bourguiba Hospital, Department of Resuscitation and Neonatal medicine, Monastir, Tunisia
Correspondence

Oussama Mghirbi, Sousse University, Ibn El Jazzar Medical Faculty of Sousse, Department of Resuscitation and neonatal Medicine, University Hospital Center Farhat Hached, Sousse, Tunisia, [email protected]

Publication History

Manuscript Received: May 02, 2024

Manuscript Accepted: May 03, 2024

Publication date: May 18, 2024

Conflicts of Interest

No conflicts declared.

Objective
Regardless of the progress made in perinatal medicine, perinatal asphyxia (PNA) remains a major concern in developing countries. A multicenter study conducted in 2014 showed that the overall incidence was about 4‰ live births in Tunisia. The purpose of our research was to establish the occurrence of PNA, identify its causes and evaluate its outcomes based on hypoxic-ischaemic encephalopathy stage, and primary complications resulting from PNA.
Methods
A descriptive and analytical multicenter study was carried out from January to December 2020. It enrolled all full-term neonates admitted to six university hospital neonatology departments for management of PNA in Tunisia. Inclusion criteria were sentinel event during antenatal period or abnormalities on fetal heart rate monitoring, APGAR score<7 at fifth minutes or evidence of neurologic signs with or without multi-visceral involvement.
Results
Our study enrolled 183 patients, with an incidence of PNA of 5.6‰ live births at term. The mean age of the mothers was 30.6 ± 5 years, and 48.6% were primiparous. Pregnancies were monitored by a private practitioner in 59% of cases and were uneventful in 61.2% of cases. The mean term of delivery was 39 weeks' amenorrhea, with the majority being inborn (88%). Forceps was recured in 39% of cases, and one in 10 newborns suffered obstetrical trauma. The etiologies of ANP were mainly funicular causes and remained undetermined in 26% of cases. Anoxic-ischemic encephalopathy was classified as stages I, II and III in 60%, 26% and 14% of cases, respectively. Multivisceral failure was observed in 11.5% of cases. Neurological investigations were inadequately performed, with no imaging in 38.3% of cases and no electroencephalogram in 59%. The mortality rate was 14.8% and was correlated with the sarnat and sartnat severity score, the apgar score and the place of delivery . Fifty-five percent of survivors were lost to follow-up. for those followed up, 13.6% had neulogic anomalies at one year of age and 7.6% at two years.
Conclusion
PNA remains frequent in our country with limited management. The optimisation of obstetrical management is imperative. The prevention of neurological sequelae by cerebral hypothermia must be established in our country. A follow-up network must also be established to avoid lost to follow-up and to support children with neurological sequelae disorders as well as their parents.
Keywords

Perinatal asphyxia, newborn, hypoxic-ischaemic encephalopathy, incidence, labor complications

Article's type
Abstract (Formatted)
Pages
33-34
Article info
Online publication date: May 18, 2024
Perinatal Journal 2024; 32 (2024)
DOI
10.59215/prn.24.032supp041
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