TITLE:
Pilot Study: Magnesium Sulphate Administration and Early Resolution of Hypoxic Ischemic Encephalopathy in Severe Perinatal Asphyxia
AUTHORS:
Simon Pius, Mustapha Bello, Jose Pwavimbo Ambe, Yenti Machoko, Adama Yusuf Clement, Rhoda Genesis, Mark Inusa Kamas
KEYWORDS:
Severe Perinatal Asphyxia, HIE, Magnesium Sulphate, Neuroprotection, Early Breastfeeding
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.9 No.1,
March
22,
2019
ABSTRACT: Introduction: Perinatal asphyxia is one of the leading causes of
perinatal death and a recognized cause of neuromotor disability among
survivors. About 20% - 30% of
asphyxiated newborns who develop hypoxic ischemic encephalopathy (HIE) die
during the neonatal period, and one third to one half of survivors are left
with cerebral palsy and mental retardation. Objective of the Study: Was to
determine the effect of magnesium sulphate as neuroprotective drug in hypoxic ischemic
encephalopathy resulting from severe perinatal asphyxia. Materials and
Methods: A prospective administration of magnesium sulphate to 52 severely
asphyxiated newborns with hypoxic ischemic encephalopathy was conducted over one year
period from 1st August 2017 to 31st July 2018. Results: Most (96.2%) of patients were
term baby (GA ≥ 37 weeks). Most (90.4%) were in-hospital born, vaginal delivery
accounted for 55.8% and 44.2% assisted delivery respectively. About one half
(55.8%) of the patients commenced MgSO4 therapy at 4 therapy at 6 - and >24 hours after birth
respectively. Time of commencement of first enteral feeding (p = 0.018) and
time to full enteral feeding (p = 0.015) showed significant correlation with
the survival without neurological deficit. The earlier the commencement of MgSO4 therapy, the better the proportion with strong palmar grasp, sucking
reflex, tone and early resolution of encephalopathy. Conclusion: All the
study subjects treated with magnesium sulphate had impressive improvement; however there is a need to conduct randomized
placebo-controlled trial treatment of severe perinatal asphyxia so as to determine
its effects on early resolution of hypoxic ischemic encephalopathy/neuroprotective
activity.