Background: From a forensic pathologist’s perspective, there
are several aspects of the perinatal postmortem that are particularly
important if the baby was born alive or dead. In cases of litigation for
perinatal morbidities occurring in hospitals, access to the obstetric and
neonatal notes if the baby is born alive and dies a few hours or days
later is essential to reach a correct interpretation and conclusion.
Hypoxic ischemic encephalopathy (HIE) after prenatal asphyxia is an
important cause of neonatal morbidity and long-term neurological
disability. It has many causes including intrauterine strangulation by
umbilical cord (nuchal cord). Failure of early diagnosis of neonatal
asphyxia and its treatment is considered a medicolegal negligence
against the doctors. Aim: The present study aimed to use cord blood
lactate & S100 protein levels as early markers of neonatal hypoxia
caused by nuchal cord to minimize the risk of medicolegal liabilities
against the doctors and hospitals. Methods: This is a comparative
cross-sectional study conducted on 30 hypoxic neonates due to
intrauterine cord strangulation. Lactate & S100 protein levels in the
cord blood were measured. These were compared to 30 apparently
healthy neonates matched in age, sex and body weight as a control
group. Results: Lactate & S100 protein levels in cord blood were a
higher significant difference in HIE neonates than control group. In
conclusion: lactate & S100 protein levels in cord blood could be used
as an early marker for diagnosis of neonatal HIE.
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