title: Grading of perinatal asphyxia by clinical parameters and agreement between this grading and Sarnat & Sarnat stages without measures.
abstract: A cross sectional study was done in Neonatal unit of Dhaka Shishu Hospital (DSH) to develop a grading system of perinatal asphyxia by clinical parameters, to show an agreement between this grading and Sarnat & Sarnat stages and to assess the outcome. Consecutive 60 cases of asphyxiated term newborn, aged between 0-48 hours were enrolled in this study who were classified according to new proposed scoring and Sarnat & Sarnat staging system simultaneously on same set up. All asphyxiated cases were managed as per protocol of neonatal unit of this hospital and followed up accordingly till 3 months of age. Out of 60 cases, sarnat stage-I cases were 16 of which all were mild according to proposed scoring system. Sarnat stage-II cases were 20 and among them 2 were mild, 16 were moderate and 2 were severe according to proposed scoring system. Sarnat stage-III cases were 24, among them 24 were severe according to proposed scoring system. The level of agreement between proposed scoring & Sarnat staging was 93.3% where kappa value was 0.899. Overall mortality of asphyxiated cases was 33.3%. About 42.9% of Sarnat stage-II and 80%(8) of Sarnat stage-III cases had neurological deficit whereas 50%(3) of moderate and 80%(4) of severely asphyxiated cases had neurological deficit on follow up at 3 months of age. Brief clinical grading system is more convenient & easier than that of Sarnat & Sarnat staging. But it is also equally as effective as Sarnat staging in classifying asphyxiated babies into different grades & to assess the outcome of perinatal asphyxia.
authors.affiliation: Dr Mohammad Abdul Hai Mia, Assistant Professor, Department of Neonatology, Sylhet MAG Osmani Medical College, Sylhet, Bangladesh.
authors.forename: A H
authors.initials: AH
authors.lastname: Mia
authors.forename: K R
authors.initials: KR
authors.lastname: Akter
authors.forename: M A
authors.initials: MA
authors.lastname: Rouf
authors.forename: M N
authors.initials: MN
authors.lastname: Islam
authors.forename: M M
authors.initials: MM
authors.lastname: Hoque
authors.forename: M A
authors.initials: MA
authors.lastname: Hossain
authors.forename: A K
authors.initials: AK
authors.lastname: Chowdhury
mesh_terms: D001238:Asphyxia Neonatorum / Q000145:classification*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D012720:Severity of Illness Index