Dr. Namusoke Hellen is a Postgraduate Student at Mother Kevin Postgraduate Medical School –Nsambya (Uganda Martyrs University) and a Graduate of Mbarara University of Science and Technology.Hellen has worked with St. Francis Hospital Nsambya –Uganda as a Medical Officer for one year and is interested in Emergency Paediatric Care (Newborn Health inclusive).
INCIDENCE, SHORT TERM OUTCOME AND FACTORS ASSOCIATED WITH HYPOXIC ISCHEMIC ENCEPHALOPATHY IN NEWBORNS DELIVERED AT ST. FRANCIS HOSPITAL, NSAMBYA
Introduction: Hypoxic Ischemic Encephalopathy (HIE) carries a high case fatality rate of 10 – 60% and at least 25% of survivors have an adverse long-term neurodevelopment outcome. However few studies have studied its magnitude, associated factors and short term outcomes in Uganda.
Objective: To determine the incidence, associated factors and short term outcome of HIE in Newborns delivered at St. Francis hospital, Nsambya.
Methodology: A prospective cohort study was conducted at St. Francis Hospital, Nsambya between 13th October 2015 and 19th January 2016. Inborn term newborn babies whose mothers consented to the study were enrolled. Umbilical cord arterial blood gas done was for newborns with low Apgar Scores at five minutes. A clinical examination was done on all participants for features of encephalopathy within 48 hours of life. Newborns with HIE were followed up by a daily clinical examination and short term outcomes were documented at one week of follow up.
Results: The incidence of Hypoxic Ischemic Encephalopathy was 30.6 cases per 1000 live births and among these, 56.5% had moderate to severe HIE. The factors significantly associated with HIE included: Referred mother (AOR :4.058,CL:1.0-15.7,P =0.043), Antepartum hemorrhage (AOR: 5.2,CL:1.0-26.2,P=0.045), Prime Parity (AOR: 3.2 CL:1.3-7.9, P =0.01), and history of herbal use (AOR :5.2,CL:2.1-13.4,P=0.048). A total of (6) 26% died and the majority (15) 65.2% of those with HIE were discharged without complications by day 7. The short term complications seen by day seven included: lack of a nutritive suckling reflex (nasogatric feeding), poor Moro reflex, and requirement for respiratory support (oxygen therapy by nasal prongs) among two participants.
Conclusions: The incidence of HIE at St. Francis Hospital, Nsambya was 30.6 per 1000 live births and 26% of the Babies with HIE died. .
Recommendation: Appropriate use of Partograph to monitor labor especially for prime gravida mothers. Early and timely referral of mothers with complications will reduce the magnitude of HIE as well as Newborn mortality