الفهرس | Only 14 pages are availabe for public view |
Abstract Perinatal asphyxia is a major cause of neonatal mortality and irreversible damage to the brain. Severe asphyxia may induce major deficit shortly after birth, while mild to moderate asphyxia episodes may result in cognitive and attentive disorders later on in development. There is an urgent need to better understand its pathophysiology and to identify as early as possible reliable indices of brain injury in the asphyxic newborns to apply potential therapeutic interventions at the optimal time and to identify those infants at high risk for developmental delays and disabilities. Oxygen free radicals are involved in the pathogenesis of perinatal asphyxia and subsequent hypoxic ischemic encephalopathy. Catalase enzyme is one of the antioxidant enzymes, increased in hypoxic ischemic encephalopathy but unable to scavenge the free radicals. The aim of the study was to evaluate serum catalase level as adiagnostic marker of hypoxic ischemic encephalopathy in neonates with perinatal asphyxia . The current study was conducted on 45 full term neonates; all were subjected to full clinical examination, and laboratory investigations: - Blood gas. - CBC & CRP. - Serum catalase levels. Summary 96 The neonates in the present study were classified into two groups: Group I (patients group): This group included thirty term babies with perinatal asphyxia and hypoxic- ischemic encephalopathy (19males and 11 females) with mean gestional age (39.00 ± 1.02) wks classified as grade I, grade II, and grade III according to sarnat and sarnat’s classification. Group II (control group): This group included fifteen apparently healthy term babies (9males and 6 females) with mean gestational age (39.33 ± 1.18) wks . Among both groups there was no statistically significant difference between control and studied cases as regard mode of delivery (p value > 0.05) Concerning the maternal problems PROM was 26.7% of cases, (MAS) meconium aspiration syndrom was 16.7%, APH was 16.7%, obstructed labour and breech delivery were 10% of cases respectively. Mothers without any maternal problems were 20% of cases. Concerning the seizures it was present in 60% of the cases. Concerning, CBC and blood gases parameters, studied cases had highly significant lower PH, Po2, Hco3 and plat. Count as compared to control group ( p value <0.001) while they had significantly higher pco2 ( p value <0.001). There was a highly significant difference in Apgar1,5 and 10 min between cases and control. Mean serum catalase level was significantly higher among patients group compared to control group. Summary 97 There was also statistically significant correlation between serum catalase level and grade of hypoxia . There was a highly significant difference in the mean ± SD of serum catalase levels among cases with seizures when compared to the cases without seizures. There was no significant difference in the mean of catalase among cases as regard mode of delivery. There was no significant correlation between serum catalase level and gestational age, PCO2,Hb, TLC, CRP and platelets count. There was highly significant negative correlation between s.catalase level and Apgar 1, 5 and 10 min & PH& PO2& HCO3 ( p value < 0.001). from this study, it is concluded that catalase levels are significantly higher in newborns with perinatal asphyxia compared to healthy neonates. Measurement of catalase levels may thus have an important role in predicting high risk newborns with asphyxial insult. And from this study, it is recommended that : 1. The level of catalase used as predictive and diagnostic marker at birth but more researches is necessary and normative age dependent data, along with definite cutoff values, must first be established. 2. The use of antioxidants is also theoretically appealing in the management of perinatal asphyxia . |