Study of cord blood nucleated RBC’s as a marker for fetal asphyxia

Authors

  • Suvarna Jyothi Ganta Department of Obstetrics and Gynaecology, Chinmaya Mission Hospital, Bangalore, Karnataka, India
  • Sunanda R. Kulkarni Department of Obstetrics and Gynaecology, Chinmaya Mission Hospital, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20170402

Keywords:

Cord blood, HIE, Hypoxia, Nucleated red blood cells, Perinatal asphyxia

Abstract

Background: Perinatal asphyxia is a serious problem globally and is a common cause of neonatal mortality and long term morbidity. Various Parameters are being used as predictors for birth asphyxia but the correlation between clinical presentation and the biochemical results has been unsatisfactory. NRBC count of the cord blood is reported in literature as a possible marker of perinatal asphyxia. In-utero hypoxic episode may induce a haemopoetic response of exaggerated erythropoiesis leading to the presence of nucleated RBC's in fetal circulation. The aim of this study was to investigate whether NRBC count of the cord blood can be a useful parameter to determine perinatal asphyxia.

Methods: This prospective case control study was conducted in Chinmaya Mission hospital, Bangalore, India between July 2015 to June 2016.we have studied the NRBC counts from the cord blood of 50 neonates with perinatal asphyxia and 50 healthy neonates, thus comparing the results.

Results: The mean NRBC /100 WBC for cases with birth asphyxia was 11.6 and that of the control group was 5.6. NRBC count was found to be significantly higher in neonates with low Apgar scores. There was correlation between the Apgar scores at 1st and at 5 minutes, the degree of Hypoxic Ischemic Encephalopathy and the NRBC counts.

Conclusions: Therefore NRBC counts of the cord blood can be used as an effective tool to confirm perinatal asphyxia. It is a simple, quick, accurate and clinically effective test to diagnose and initiate treatment to prevent long term sequel of perinatal asphyxia.

References

National Neonatal and Perinatal Database Report. 2002-2003;1-58.

World Health organization. Neonatal and Perinatal Mortality; Country, Regional and Global estimates, 2004; WHO, Geneva. 2006;1-25.

Antonucci R, Porcella A, Pilloni MD. Perinatal asphyxia in the term newborn. Division of Neonatology and Pediatrics, “Nostra Signora di Bonaria”. J Ped Neona Indivi Med. 2014;3(2):e030269.

Tung lag L, Gerelmaa Z. Nucleated red blood cell counts in asphyxiated newborns. Open Science J Clin Med. 2014;2(1):33-8.

Buonocore G, Perrone S, Gioia D, Gatti MG, Massafra C, Agosta R, et al. Nucleated red blood cell count at birth as an index of perinatal brain damage. Am J Obstet Gynecol. 1999;181:1500-5.

Roland Axt-Fliedner, KubilayErtan, Hans-Joachim Hendrik, Werner Schmidt, Neonatal Nucleated Red Blood Cell Counts Relationship to Abnormal Fetoplacental Circulation Detected by Doppler Studies, 2001 by the American Institute of Ultrasound in Medicine, J Ultrasound Med. 2001;20:183-90.

Sarnat HB, Sarnat MS. Neonatal Encephalopathy Following Fetal Distress. A Clinical and Electroencephalographic Study. Arch Neurol. 1976;33(10):696-705.

Hebbar S, Misha M, Rai L. Significance of Maternal and Cord Blood Nucleated Red Blood Cell Count in Pregnancies Complicated by Preeclampsia. India J Preg. 2014 (2014)

Hermansen MC. Nucleated red blood cells in the fetus and newborn. Arch Dis Child Fetal and Neonatal Ed. 2001;84(3)F211-5.

Jazayeri A, Tsibris JC, Spellacy WN. Elevated umbilical cord plasma erythropoietin levels in prolonged pregnancies. Obstet Gynecol. 1998;92(1):61-3.

Sikarwar S, Gupta S. The correlation of clinical perinatal asphyxia with counts of NRBC/100 WBC in cord blood.Web med Central Obstet Gynaecol. 2011;2(1):WMC001511.

Phelan JP, Kiekendall C, Korst LM, Martin G. Nucleated red blood cell and platelet counts in asphyxiated neonates sufficient to result in permanent neurological impairment in Maternal Fetal Neonatal Med. 2007;20:377-80.

Boskabadi H, Maamouri G, Sadeghain MH, Ghayour-Mobarhan M, Heidarzade M, Shakeri MT, et al. Early diagnosis of perinatal asphyxia by nucleated red blood cell count: a case-control study. Arch Iran Med. 2010;13(4):275-81.

Goel M, Dwivedi R, Gohiya P, Hegde D. Nucleated red blood cell in cord blood as a marker of perinatal asphyxia. J ClinNeonatol. 2013;2(4):179-82.

Ghosh B, Mittal S, Kumar S, Dadhwal V. Prediction of perinatal asphyxia with nucleated red blood cells in cord blood of new borns. Int J Gynaecol Obstet 2003;81(3):267-71.

Colacoa SM, Ahmeda M, Kshirsagara VY, Bajpaib R. Study of Nucleated Red Blood Cell Counts in Asphyxiated Newborns and the Fetal Outcome, Int J Clin Ped. 1927:1263.

Mohanty AK, Das L, Pradhan S, Meher B, Beriha SS. Cord Blood Nucleated RBC as a Predictor of Perinatal Asphyxia, Severity and Outcome. Ind J Clin Pra. 2014;24(10).

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Published

2017-01-31

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Original Research Articles