Abit DEMİR, Halil DOLAP, Nurgül ATAŞ, Yasin ÖZCAN, Müslüm TOPTAN

Mortalite Gelişen Perinatal Asfiksi Olguların Retrospektif İncelenmesi

Bu çalışmada perinatal asfiksi (PA) tanısı alan ve mortalite gelişen olguların pH, baz eksikliği (BD), retina değişiklikleri ve amplitüd-entegre elektroensefalografi (aEEG) bulgularını araştırmayı amaçladık. Materyal ve metod: Çalışmaya perinatal asfiksi nedeniyle mortalite gelişen yedi hasta dahil edildi. Olguların kan gazı analizi, 72 saatlik aEEG bulguları kaydedildi. Tüm bebekler aynı göz doktoru tarafından muayene edildi. Veri analizleri SPSS Statistics yazılımı kullanılarak yapıldı. Bulgular: Takip sırasında mortalite gelişen yedi perinatal asfiksi olgusu çalışmaya dahil edildi. Olguların pH değeri 6.30-6.98 (6.84) ve BD 18-40 (23) mmol / L arasındaydı. İki hastada masif retinal kanama saptandı. Bir hastada, spot kanama odakları sağ göz retinasında daha belirgindi. Olguların postnatal 24. saatteki aEEG bulguları değerlendirildiğinde, altı hastada düşük voltaj (LV), bir hastada patlama bastırma (BS) paterni saptandı. İki olgumuz 24. ve 48. saatler arasında öldü ve her iki olgu da LV modelindeydi. Dört olgunun takibinde mortalitenin 72 saat sonra geliştiği gözlendi. Bu dört vakadan biri LV paterni ve ikisi BS paterniydi. Son vakanın 24-48 ve 72. saatteki paternleri sırasıyla BS-LV ve DNV idi. Sonuçlar: Çalışmamızda mortalite gelişen olgularda ciddi anormal aEEG bulguları olduğu bulundu. 24-48 saat devam eden LV ve BS paterninin mortalite gelişimi ile ilişkili olduğu ve bu sonuçların literatürle uyumlu olduğu belirlendi.

Anahtar Kelimeler:

mortalite, baz defisiti, aEEG, retinal kanama, Perinatal asfiksi

Retrospective Study of the Perinatal Asphyctic Cases That Developed Mortality

In this study, we aimed to investigate the pH, base deficit (BD), retinal changes, and amplitude-integrated electroencephalography (aEEG) findings of cases diagnosed with perinatal asphyxia (PA) and developing mortality. Material – Methods Seven patients with mortality due to perinatal asphyxia were included in this study. Blood gas analysis of cases, 72-hour aEEG findings were recorded. All babies were examined by the same ophthalmologist. Data analyses were performed using SPSS Statistics software Results Seven cases with perinatal asphyxia who developed mortality during follow-up were included in this study. The pH value of the cases was between 6.30-6.98 (6.84) and the BD was between 18-40 (23) mmol / L. Massive retinal hemorrhage was detected in 2 patients. In one patient, spot bleeding foci were more prominent in the right eye retina. When the aEEG findings of the postnatal 24th hour of the cases were evaluated, it was found that six patients had low voltage (LV) and one patient had burst suppression (BS) pattern. Our two cases died between the 24th and 48th hours and both cases were in the LV pattern. In the follow-up of four cases, it was observed that mortality developed after 72 hours. One of these four cases was the LV pattern and two were BS patterns. The patterns of the last case at 24-48 and 72 hours were BS-LV and DNV, respectively. Conclusions In our study, it was found that cases with developed mortality had severe abnormal aEEG findings. It was determined that the LV and BS pattern, which continued for 24-48 hours, were associated with the development of mortality and these results were consistent with the literature.

Keywords:

perinatal asphyxia, aEEG, mortality, base deficit, retinal hemorrhage,

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