[Early assessment in perinatal hypoxia. Prognostic markers].
BACKGROUND
Perinatal asphyxia and its neurological signs are the most important cause of brain damage and neurological sequelae in full term newborn babies. Neuroprotection treatments currently being investigated promise to reduce such sequelae, but these treatments are not without risk and the patients involved should be selected.


OBJECTIVE
To analyze a scale composed of variables recorded from the start of delivery until the fourth hour of life, comparing the neurological evolution of the patients. By means of this scale we aim to establish a criterion for the selection of neonates with acute perinatal asphyxia, who would benefit from neuroprotector treatment.


METHODS
A retrospective study was made of 50 patients with the diagnosis of perinatal asphyxia. Our scale was formed of the following variables: intrauterine meconiorrhexis, pathological cardiotocographic recordings, resuscitation at birth, Apgar score at five minutes, pH of the umbilical artery blood, neurological examination, multisystemic involvement, seizures, persistent metabolic acidosis and need for mechanical ventilation during the first hours of life. The patients were followed up for at least one year by means of periodical studies (neurological examination and evaluation of psychomotor development according to the Brunnet Lezinne test). For statistical analysis we used the chi squared test, Fisher's exact test, Kruskal-Wallis test and the area beneath the ROC curve.


CONCLUSIONS
The scale presented constitutes a rapid, easy method which is statistically significant for the selection of perinatal asphyxia of high neurological risk which would benefit from neuroprotector treatment after the event.
López-Gómez
L
L
Servicio de Neonatología, Sección de Neuropediatría, Hospital General Universitario Gregorio Marañón, Madrid, España.
Castro
P
P
Bernardo
A B
AB
Megías
A
A
Blanco
D
D
D000138:Acidosis / Q000209:etiology; D001034:Apgar Score; D001238:Asphyxia Neonatorum / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D001925:Brain Damage, Chronic / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D005316:Fetal Distress / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D006863:Hydrogen-Ion Concentration; D002534:Hypoxia, Brain / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D007231:Infant, Newborn; D008297:Male; D008470:Meconium; D018696:Neuroprotective Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D011379:Prognosis; D011596:Psychomotor Disorders / Q000453:epidemiology / Q000209:etiology; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012151:Resuscitation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013036:Spasms, Infantile / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D013997:Time Factors
D018696:Neuroprotective Agents
Evaluación precoz en la hipoxia perinatal. Marcadores pronósticos.