Cardiovascular involvement in birth asphyxia

Background: Asphyxia before, during, or after birth is an important cause of perinatal mortality and morbidity. The newborn infant who does not breathe at birth suffers from oxygen lack, carbon dioxide excess, and fall in blood pH. Although the fetal and neonatal myocardium seems to be resistant to hypoxia, heart failure is commonly seen after perinatal asphyxia. We performed this study to determine the incidence of cardiovascular insult in birth asphyxia. Materials and Methods: This is a prospective, observational, hospital-based study carried out on 152 asphyxiated neonates admitted in Neonatal Intensive Care Unit (NICU) of Rural Medical College of Pravara Institute of Medical Sciences, Loni, Ahmednagar, Maharashtra, from September 2013 to August 2015. Results: Cardiovascular involvement was seen in 48 (32%) of the infants who had birth asphyxia. Cardiovascular dysfunction most commonly manifested by the use of inotropes (32%) followed by abnormal echocardiography (27%), electrocardiography (ECG) changes (13%), and elevated creatinine kinase-MB (14.5%). Out of the 48 neonates who had cardiovascular system (CVS) dysfunction, 28 children survived till hospital discharge. Conclusions: CVS dysfunction is present in significant proportion of neonates following asphyxia injury and neonates with cardiovascular dysfunction have a poor outcome.