Author(s): Ramesh Chand1, Rupa Dalmia Singh2, Soniya Vishwakarma3
Asphyxia is a leading cause of foetal neonatal mortality and morbidity. Nucleated red blood cell count (NRBC) produced as compensatory response to asphyxia in foetus and NRBC level can be correlated to asphyxia. Because the present indices are unhelpful in the diagnosis and prediction of the severity of asphyxia, we wished to investigate the relationship between the nucleated RBC count and the severity & immediate outcome of perinatal asphyxia.
This prospective comparative study was conducted in maternity ward of Obstetrics & Gynaecology Department and Paediatric Department of GSVM Medical College, Kanpur (Central UP), from January 2014 to September 2014. Newborns of term gestation were selected after satisfying inclusion criteria and were divided in 2 groups. The control group consisted 60 normal newborns and case group had 60 asphyxiated newborns. The cord blood was collected soon after birth, investigated for pH and making smears that were stained with Leishman’s stain. NRBCs were counted against 100 WBCs. The statistical analysis was done using IMSTAT.
The mean NRBC count in the study group was 22.63±6.95 as compared to 4.75±2.04 in the control group (p=<0.0001). The NRBC count was significantly higher in low pH, neonates with low Apgar scores of < 3 at 1 minutes, newborns with HIE stage III & in neonates who were neurological abnormal at discharge (P=0.0001).
A simple, easy to do, cost effective bedside test, such as NRBC count at time of delivery is a good marker of perinatal asphyxia & its forthcoming immediate neurological outcome.