Haematological features in babies with perinatal asphyxia in Zimbabwe

N. Mabaera, S. Mubaira, A. Mandisodza
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Abstract

Background: Perinatal asphyxia is failure to establish breathing at birth. It is a common cause of neonatal mortality in developing countries. Hypoxic Ischemic Encephalopathy (HIE) is the major complication of asphyxia, resulting in permanent neurological and other multi-organ damages. Some haematological changes have also been observed in patients with this disease. Objectives: The objective of this study was to investigate the haematological features in babies with perinatal asphyxia in Zimbabwe. Methodology: A prospective laboratory based cross sectional study was carried out at the Sally Mugabe Hospital Neonatal Unit from December 2018 to April 2019. Routine full blood counts on samples from babies with perinatal asphyxia on their first day of life. Peripheral blood smears were examined on all those with abnormal full blood count results. Results: Full blood counts were done on 180 babies with perinatal asphyxia of whom 103 (57%) and 77 (43%) were females and males respectively. The median white cell count and nucleated red cell count were elevated. The platelet and red cell count were decreased. Haemoglobin, haematocrit, and Mean Corpuscular Haemoglobin Concentration (MCHC) were within normal range. The Mean Corpuscular Volume (MCV) and Mean Corpuscular Haemoglobin (MCH) were increased. There was a correlation between increased nucleated red blood and white cell counts with the severity of perinatal asphyxia in the order of Asphyxia Without Hypoxic Ischemic Encephalopathy (AWHIE), Hypoxic Ischemic Encephalopathy (HIE I), HIE II, and HEI III. The most common haematological abnormalities were thrombocytopaenia 52(29%), anaemia 51(28%) and leukopaenia 28(16%). Twenty-four (47%) of anaemia patients had microcytic hypochromic anaemia. Thirty-one (47%) of 65 blood films examined exhibited immature granulocytes and 28(43%) had burr red blood cells. Conclusion: Babies with perinatal asphyxia may present with haematological abnormalities such as anaemia, thrombocytopaenia, leukocytosis and elevated nucleated red cell count as complications of sever hypoxia. Full blood count may be a useful in the effective management of perinatal asphyxia.
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津巴布韦围产期窒息婴儿的血液学特征
背景:围产期窒息是指出生时无法建立呼吸。它是发展中国家新生儿死亡的常见原因。缺氧缺血性脑病(HIE)是窒息的主要并发症,可导致永久性神经系统和其他多器官损伤。在这种疾病的患者中也观察到了一些血液学变化。目的:本研究的目的是调查津巴布韦围产期窒息婴儿的血液学特征。方法:2018年12月至2019年4月,在Sally Mugabe医院新生儿病房进行了一项前瞻性的实验室横断面研究。围产期窒息婴儿出生第一天的常规全血计数。对所有全血细胞计数结果异常的患者进行外周血涂片检查。结果:对180例围产期窒息婴儿进行了全血细胞计数,其中女性103例(57%),男性77例(43%)。中位白细胞计数和有核红细胞计数升高。血小板和红细胞计数下降。血红蛋白、红细胞压积和平均肌注血红蛋白浓度(MCHC)均在正常范围内。平均肌注量(MCV)和平均肌注血红蛋白(MCH)增加。有核红细胞和白细胞计数的增加与围产期窒息的严重程度相关,依次为无缺氧缺血性脑病窒息(AWHIE)、缺氧缺血性脑病(HIE I)、HIE II和HEI III。最常见的血液学异常是血小板减少52(29%)、贫血51(28%)和白细胞减少28(16%)。二十四名(47%)贫血患者患有微细胞低色素性贫血。在检查的65张血液胶片中,31张(47%)显示为未成熟粒细胞,28张(43%)显示为毛刺红细胞。结论:围产期窒息的婴儿可能会出现血液学异常,如贫血、血小板减少、白细胞增多和有核红细胞计数升高,这些都是严重缺氧的并发症。全血细胞计数可能有助于有效管理围产期窒息。
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