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. If the infant is delivered
alive and dies a few hours or days later, access to the obstetric and
neonatal notes is required to achieve a correct interpretation and
conclusion in situations of perinatal morbidities occurring in hospitals.
After prenatal hypoxia, hypoxic ischemic encephalopathy (HIE) is a
common 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 carried out 30 hypoxic neonates due to
intrauterine cord strangulation. Lactate & S100 protein levels in the
cord blood were evaluated. As a control group, 30 apparently healthy
neonates were compared in age, sex, and body weight. 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. |
