Echocardiographic patterns in asphyxiated neonates
Keywords:
neonatal asphyxia, heart disease, echocardiography
Abstract
Background Neonatal asphyxia is a disorder in neonates dueto decreased oxygenation (hypoxia) and decreased perfusion to
organs (ischemia). Duration of asphyxia and early management
influence the severity of organ dysfunction, including the heart.
Objectives To obtain patterns of cardiac abnormality in
neonatal asphyxia in Cipto Mangunkusumo Hospital with
echocardiography. Design A cross-sectional study was performed on 22 asphyxiated neonates and 22 other non-asphyxiated neonates from March to October 2008. Inclusion criteria were term neonates, Apgar score :S 6 in the first minute for asphyxiated neonates and ?. 7 for normal/non-asphyxiated neonate. Echocardiographic examination was performed before the age of 48 hours.
Results There were 7/22 asphyxiated neonates and 1/22 nonaxphyxiated neonate with heart disease (P <0.05). The most
common cardiac abnormality found in asphyxiated neonates was
patent ductus arteriosus, followed by atrial septal defect, tricuspid regurgitation, and pulmonary hypertension.
Conclusion Cardiac abnormality is significantly found more often
in asphyxiated than in non-asphyxiated neonates.
References
1. Aminullah A. Konsekuensi kelainan sistemik berbagai organ
tubuh akibat hipoksia dan iskemia neonatus. In: Suradi
R, Monintja HE, Amelia P, Kusumowardhani D, editors.
Penanganan mutakhir bayi prematur: Memenuhi kebutuhan
bayi prematur untuk menunjang peningkatan kwalitas
sumber daya manusia. Jakarta: Balai penerbit FKUI, 1997;
p.165-84.
2. Alisjahbana A, Hidayat S, Mintardaningsih, Primardi A,
Harliany E, Sofia tinY, et al. Management of birth asphyxia at
home and health center. Pediatr Indones. 1999;39:88-101.
3. Christopher P, Barnett, Max P, Paul GE. Clinicopathological
correlations in postasphyxial organ damage: A donor organ
perspective. Pediatrics. 1997 ;99: 797-9.
4. Manoe VM, Amir I. Gangguan fungsi multi organ pada
asfiksia berat. Sari Pediatri. 2003;5:72-8.
5. Gomella TL. Perinatal asphyxia. In: Gomella TL, Cunningham
MD, Eyal FG, Zenk KE, editors. Neonatology management,
procedures, on-call problems, diseases and drugs. 5th ed.
United States: McGraw-Hill Companies, 2004; p.512-23.
6. Report of the National Neonatal Perinatal Database (National
Neonatology Forum, India). 2000 [cited 2007 Dec 11th ].
Available from: URL: http://www.asphyxia.htm.2000.
7. Wood D, Malan A. Asphyxia neonatal. Department of
Pediatric and Child Health of Cape Town. [cited 2005 Jun
18th]. Available from: URL: http://web.urc.ac.za/depts/ich/
teaching/undergrad/6thyear/nnh/nnhcpo3.htm1996.
8. Roberton NRC. Asphyxia. In: Roberton NRC, editor. A
manual of neonatal intensive care. 3th ed. Cambridge:
Edward Arnold, 1993; p.72-6.
9. Snyder EY, Cloherty JP. Perinatal asphyxia. In: Cloherty JP,
Stark AR, penyunting. Manual of neonatal care. 4th ed.
Philadelphia: Williams & Wilkins, 1998; p.515-33.
10. Shah P, Riphagen S, Beyene J, Perlman M. Multiorgan
dysfunction in infants with post asphyxial hypoxicischaemic
encephalopathy. Arch Dis Child Fetal Neonatal.
2004;89: 152-5.
11. Arthur G, J Timothy B, David JF, Steven RN. Neonatology.
In: The science and practice of pediatric cardiology. 2nd ed.
Baltimore: Williams & Wilkins, 1997; p. 2833-46.
12. Ranjit MS. Cardiac abnormalities in birth asphyxia. Indian
J Pediatr. 2000;67: 529-32.
13. Herdy GV, Lopez VG, Aragao ML, Pinto CA, Tavares JPA,
Azeredo FB, et a!. Perinatal asphyxia and heart problems.
Arq Bras Cardia!. 1998;71:121-6.
14. Madiyono B, Rahayuningsih SE, Sukardi R. Penyakit jantung
bawaan. In: Penanganan penyakit jantung pada bayi dan
anak. 1st ed. Jakarta: Balai penerbit FKUI, 2005; p. 1-36.
15. Karimi E, Tuncer 0, Atas B, Sakarya ME, Ceylan A. Clinical
value of color Doppler ultrasonography measurements of
full-term newborns with perinatal asphyxia and hypoxic
ischemic encephalopathy in first 12 hours of life and long
term prognosis. Tohoku J Exp Med. 2002; 197:27-33.
16. Ancel AM, Alix AG, Gaya F, Cabanas F, Burgueros M, Quero
J. Multiple organ involvement in perinatal asphyxia. J Pediatr.
1995; 127:786-93.
17. Low JA, Killen H, Derrick EJ. The prediction and prevention
of intrapartum fetal asphyxia in pre term pregnancies. Am J
Obstet Gynecol. 2002; 187:279-82.
18. Gordon B, Avery. Pathophysiology of intrapartum asphyxia
and resuscitation. In: Neonatology. Pathophysiology and
Management of the Newborn. 2nd ed. Philadelphia: JB
Lippincott Company, 1981; p. 183-9.
19. Skinner J. Diagnosis of patent ductus arteriosus. Semin
Neonatal. 2001;6:49-61.
20. Barberi I, Calabro M.P, Cordaro S, Gitto E, Sottile A,
Prudente D, et al. Myocardial ischaemia in neonates with
perinatal asphyxia, electrocardiographic, echocardiographic
and enzymatic correlations. Eur J Pediatr. 1999;158:742-7.
21. Hankins GDV, KoenS, Gei AF, Lopez SM, Van Hook J'W,
Anderson GD. Neonatal organ system injury in acute birth
asphyxia sufficient to result in neonatal encephalopathy. Am
Col Obst Gyn. 2002;99:688-91.
22. Deselina B, Putra ST, Suradi R. Prevalence of patent
ductus arteriosus in premature infants at neonatal ward,
Cipto Mangunkusumo Hospital, Jakarta. Paediatr lndones.
2004;44: 11-2.
23. Nakanishi T. Interventional catheterization. Curr Opin
Cardiol. 2000;15:211-5.
24. Reller MD, Rice GM, Me Donald RW. Review of studies
evaluating ductal patency in premature infant. J Pediatr.
1993;122:559-62.
25. Evans NJ, Arcel NJ. Postnatal circulatory adaptation in
healthy term and preterm neonates. Arch Dis Child.
1990;65:24-6.
26. Tricuspid regurgitation. The encyclopedia of medical
imaging volume V2. [cited 2005 Jul15th]. Available from:
URL: http://www.amershamhealth.com/medcylopaedia/
medical/article.asp ?vol:volume + V + 2&article = tricusp
id regurgitation.htm.
27. Myung KP. Transient myocardial ischemia. In: Pediatric
cardiology for practitioners. 3th ed. United States: Mosbyyears,
1996; p. 390-2.
28. Mancini MC. Tricuspid regurgitation. [cited 2005 Jul15th].
Available from: URL: http://www.emedicine.com/med/
topic2314.htm
tubuh akibat hipoksia dan iskemia neonatus. In: Suradi
R, Monintja HE, Amelia P, Kusumowardhani D, editors.
Penanganan mutakhir bayi prematur: Memenuhi kebutuhan
bayi prematur untuk menunjang peningkatan kwalitas
sumber daya manusia. Jakarta: Balai penerbit FKUI, 1997;
p.165-84.
2. Alisjahbana A, Hidayat S, Mintardaningsih, Primardi A,
Harliany E, Sofia tinY, et al. Management of birth asphyxia at
home and health center. Pediatr Indones. 1999;39:88-101.
3. Christopher P, Barnett, Max P, Paul GE. Clinicopathological
correlations in postasphyxial organ damage: A donor organ
perspective. Pediatrics. 1997 ;99: 797-9.
4. Manoe VM, Amir I. Gangguan fungsi multi organ pada
asfiksia berat. Sari Pediatri. 2003;5:72-8.
5. Gomella TL. Perinatal asphyxia. In: Gomella TL, Cunningham
MD, Eyal FG, Zenk KE, editors. Neonatology management,
procedures, on-call problems, diseases and drugs. 5th ed.
United States: McGraw-Hill Companies, 2004; p.512-23.
6. Report of the National Neonatal Perinatal Database (National
Neonatology Forum, India). 2000 [cited 2007 Dec 11th ].
Available from: URL: http://www.asphyxia.htm.2000.
7. Wood D, Malan A. Asphyxia neonatal. Department of
Pediatric and Child Health of Cape Town. [cited 2005 Jun
18th]. Available from: URL: http://web.urc.ac.za/depts/ich/
teaching/undergrad/6thyear/nnh/nnhcpo3.htm1996.
8. Roberton NRC. Asphyxia. In: Roberton NRC, editor. A
manual of neonatal intensive care. 3th ed. Cambridge:
Edward Arnold, 1993; p.72-6.
9. Snyder EY, Cloherty JP. Perinatal asphyxia. In: Cloherty JP,
Stark AR, penyunting. Manual of neonatal care. 4th ed.
Philadelphia: Williams & Wilkins, 1998; p.515-33.
10. Shah P, Riphagen S, Beyene J, Perlman M. Multiorgan
dysfunction in infants with post asphyxial hypoxicischaemic
encephalopathy. Arch Dis Child Fetal Neonatal.
2004;89: 152-5.
11. Arthur G, J Timothy B, David JF, Steven RN. Neonatology.
In: The science and practice of pediatric cardiology. 2nd ed.
Baltimore: Williams & Wilkins, 1997; p. 2833-46.
12. Ranjit MS. Cardiac abnormalities in birth asphyxia. Indian
J Pediatr. 2000;67: 529-32.
13. Herdy GV, Lopez VG, Aragao ML, Pinto CA, Tavares JPA,
Azeredo FB, et a!. Perinatal asphyxia and heart problems.
Arq Bras Cardia!. 1998;71:121-6.
14. Madiyono B, Rahayuningsih SE, Sukardi R. Penyakit jantung
bawaan. In: Penanganan penyakit jantung pada bayi dan
anak. 1st ed. Jakarta: Balai penerbit FKUI, 2005; p. 1-36.
15. Karimi E, Tuncer 0, Atas B, Sakarya ME, Ceylan A. Clinical
value of color Doppler ultrasonography measurements of
full-term newborns with perinatal asphyxia and hypoxic
ischemic encephalopathy in first 12 hours of life and long
term prognosis. Tohoku J Exp Med. 2002; 197:27-33.
16. Ancel AM, Alix AG, Gaya F, Cabanas F, Burgueros M, Quero
J. Multiple organ involvement in perinatal asphyxia. J Pediatr.
1995; 127:786-93.
17. Low JA, Killen H, Derrick EJ. The prediction and prevention
of intrapartum fetal asphyxia in pre term pregnancies. Am J
Obstet Gynecol. 2002; 187:279-82.
18. Gordon B, Avery. Pathophysiology of intrapartum asphyxia
and resuscitation. In: Neonatology. Pathophysiology and
Management of the Newborn. 2nd ed. Philadelphia: JB
Lippincott Company, 1981; p. 183-9.
19. Skinner J. Diagnosis of patent ductus arteriosus. Semin
Neonatal. 2001;6:49-61.
20. Barberi I, Calabro M.P, Cordaro S, Gitto E, Sottile A,
Prudente D, et al. Myocardial ischaemia in neonates with
perinatal asphyxia, electrocardiographic, echocardiographic
and enzymatic correlations. Eur J Pediatr. 1999;158:742-7.
21. Hankins GDV, KoenS, Gei AF, Lopez SM, Van Hook J'W,
Anderson GD. Neonatal organ system injury in acute birth
asphyxia sufficient to result in neonatal encephalopathy. Am
Col Obst Gyn. 2002;99:688-91.
22. Deselina B, Putra ST, Suradi R. Prevalence of patent
ductus arteriosus in premature infants at neonatal ward,
Cipto Mangunkusumo Hospital, Jakarta. Paediatr lndones.
2004;44: 11-2.
23. Nakanishi T. Interventional catheterization. Curr Opin
Cardiol. 2000;15:211-5.
24. Reller MD, Rice GM, Me Donald RW. Review of studies
evaluating ductal patency in premature infant. J Pediatr.
1993;122:559-62.
25. Evans NJ, Arcel NJ. Postnatal circulatory adaptation in
healthy term and preterm neonates. Arch Dis Child.
1990;65:24-6.
26. Tricuspid regurgitation. The encyclopedia of medical
imaging volume V2. [cited 2005 Jul15th]. Available from:
URL: http://www.amershamhealth.com/medcylopaedia/
medical/article.asp ?vol:volume + V + 2&article = tricusp
id regurgitation.htm.
27. Myung KP. Transient myocardial ischemia. In: Pediatric
cardiology for practitioners. 3th ed. United States: Mosbyyears,
1996; p. 390-2.
28. Mancini MC. Tricuspid regurgitation. [cited 2005 Jul15th].
Available from: URL: http://www.emedicine.com/med/
topic2314.htm
Published
2009-08-31
How to Cite
1.
Masyhur M, Amir I, Putra S, Tumbelaka A. Echocardiographic patterns in asphyxiated neonates. PI [Internet]. 31Aug.2009 [cited 23Dec.2024];49(4):214-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/559
Section
Articles
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Received 2016-09-10
Accepted 2016-09-10
Published 2009-08-31
Accepted 2016-09-10
Published 2009-08-31
