Background and Objectives: Diagnosis of perinatal asphyxia is mostly establishedretrospectively. But it is difficult to diagnose perinatal asphyxia retrospectively in theabsence of perinatal records. As because of hypoxaemia, different organ systems ofthe body are affected in perinatal asphyxia, this study was done to assess the hepaticfunction for the diagnosis of perinatal asphyxia and to find out any correlation existingbetween hepatic enzyme change and the severity of perinatal asphyxia.Methods: A total of 70 full-term asphyxiated newborns (study group) were studiedduring January 2008 to December 2008 in the department of Paediatrics, MymensinghMedical College Hospital. After enrolment these babies were grouped according toSarnat and Sarnat stages of HIE as stage I, II and III. Another 50 healthy newbornswere also studied as reference group. Venous blood was analyzed between 2nd and5th day of life to estimate serum AST, ALT and alkaline phosphatase (ALP), serumtotal bilirubin (STB), serum total protein (STP), serum albumin and prothrombin time(PT). Unpaired student’s 't' test and Spearman's rank correlation was used for dataanalysis and P value of <0.05 were considered significant.Results: The mean AST, ALT, ALP, STP, S. albumin and TSB of asphyxiated babieswere 76.3±37.4 U/L, 82.2±48.08 U/L, 369.6±123.05 U/L, 55.7±8.8 U/L, 32.6±5.5 g/L& 5.5±2.01mg/dL respectively and those of normal babies were 23.5±8.5 U/L, 26.5±7.8U/L, 208.2±46.9 U/L, 66.3±10.4 g/L, 40.9±6.5 g/L and 4.5±1.2 mg/dl respectively andthese differences were statistically significant (P <0.001). On the other hand nosignificant changes were noted in prothrombin time. The rise of AST, ALT, ALP andPT also showed a significant positive correlation with the severity of asphyxia and thestages of HIE.Conclusion: It is concluded that estimation of hepatic enzymes can be used todiagnose perinatal asphyxia and also to assess its severity.Key words: Alanine aminotransferase; aspartate aminotransferase; newborn; perinatalasphyxia.DOI: 10.3329/bjch.v34i1.5695Bangladesh Journal of Child Health 2010; Vol.34(1): 7-10

Abstract:Background: Elaborate Cardiotocography (CTG) is the most commonly used test for antepartum and intrapartum fetal surveillance because it gives information via the cerebro-cardiac response of fetal cerebral activity, which is modified by the hypoxia. Objective: This study was designed to compare the perinatal outcomes among the normal and abnormal CTG groups. Method: It was a prospective observational study carried out in the Department of obstetrics, BSMMU during the period July 2006 to July 2008. Hundred consecutive normal and hundred consecutive abnormal CTC tracings were collected from patients who were advised to perform CTG after admission. Both labour and non-labour patients were included. Interpretation of CTG was done based on FlGO recommendation (1987). Pregnancy and neonatal data were obtained and the findings were correlated with the FHR tracing. Statistical analysis was carried out by student's unpaired t-test, X 2 and Z-test. Level of significance was set at P value < 0.05. Results: Out of 100 abnormal CTG, 30% had tachycardia, 42% had deceleration, 38% was non reactive, 4% had absence beat-to-beat variability and 4% had fetal bradycardia. There was significantly higher caesarean delivery, lower apgar score, higher requirement of neonatal resuscitation and admission at neonatal unit and higher perinatal death among the abnormal CTG group. The abnormal fetal outcome was found highest in heart rate deceleration group. Conclusion: CTG can be continued as a good screening test of fetal surveillance but it is not the sole criteria to influence the management of high-risk pregnancies. Abnormal CTG should be supplemented with other test before intervention.

Abstract:Background and Objectives: Because of hypoxemia, different organ systems of the body are affected in perinatal asphyxia. This study was carried out to see the status of Serum bilirubin, Serum Proteins and Prothrombin time in asphyxiated babies and to know any correlation existing between hepatic dysfunction and the severity of perinatal asphyxia.