الفهرس 
Perinatal asphyxiaOnly 14 pages are availabe for public view
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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 .