Background

Hypoxic-ischemic encephalopathy (HIE) is still a relevant cause of neonatal mortality and morbidities. HIE severity can predict long-term outcomes. Sarnat staging is one of the most common methods applied to evaluate HIE severity; However, there is an ongoing urge to find other accurate and affordable ways to accompany this clinical staging for staging of HIE. The aim of this study was to evaluate the relationship between cerebral arteries resistive indices and other hypoxic ischemic encephalopathy indicators with Sarnat scoring of newborns subjected to perinatal asphyxia.

Methods and results

In this retrospective study, 76 neonates with gestational age ≥34 weeks affected with HIE were investigated. The patients were categorized into three groups according to Sarnat staging: I, II and III. At first, the perinatal data were investigated; the relationship between HIE severity and gestational age, childbirth types, Apgar score or need for resuscitations and respiratory support were significant. examining various symptoms in different HIE stages shows that incidence of coagulopathies were significantly higher in severe HIE neonates compared to mild ones. Finally, it was suggested that cranial arterial Doppler indices i.e. resistive index (RI) of anterior cerebral artery is significantly different in HIE stage groups.

Conclusion

Here represented a combination of some available and affordable data to reach early HIE staging; including: perinatal data, clinical symptoms a bedside Doppler ultrasonography of cerebral perfusion. Higher cranial arteries RI was associated with severe HIE and could be considered for therapeutic hypothermia which may lessen HIE mortality and morbidities.

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