ASFIKSIA BERAT PADA NEONATUS ATERM

Abstract

Tujuan Penelitian : Mengetahui dampak asfiksia berat pada neonatus aterm Rancangan Penelitian : studi deskriptif, prospektif. li Cara Kcrja : Dilakukan alloanamnesis, pemeriksaan tisik, dan pemeriksaan penunjang laboratorium darah dan urin, x-foto dada, serta pengamatan dan pencatatan terhadap semua komplikasii yang terjadi serta keadaan akhir subyek. Hash! : Dad bulan September 2001 hingga Mei 2002 diperoleh 25 bayi aterm lahir dengan asfiksia berat dan memenuhi kriteria inklusi penelitian. Komplikasi sepsis terjadi pada 19 (76%), ensefalopati hipoksik iskemik 17 (68%), gagal ginjal akut 9 (36%), syok kardiogenik 7 (28%), sindrom aspirasi mekonium 6 (24%), pembekuan intravaskular menyeluruh 2 (8%), hiperbilirubinemia 1 (4%), dan enterokolitis nekrotikan pada 1 (4%) subyek. Lima dari 9 gagal ginjal akut (55,6%) merupakan gagal ginjal prerenal, dan 4 (44,4%) renal. Empat belas (56%) neonatus meninggal dengan penyebab terbanyak syok kardiogenik (55,6%) yang menyertai ensefalopati hipoksik-iskemik. Kesimpulan : Komplikasi asfiksia berat pada neonatus aterm adalah sepsis 76%, ensefalopati hipoksik iskemik 68%, gagal ginjal akut 36%, syok kardiogenik 28%, sindroma aspirasi mekonium 24%, pembekuan intravaskular menyeluruh 8%, hiperbilirubinemia 4%, dan enterokolitis nekrotikan 4%. Kematian terjadi pada 56% subyek. Kata Kunci : asfiksia begat, neonatus, komplikasi. Objectives: To define complications of full-term neonates with severe birth asphyxia. Study Design: A Descriptive prospective study. Methods: Alloanamnesis, physical examination, blood and urine samples examination, chest x-ray were performed in severe asphyxiated neonates, followed by close follow-up and all complications were recorded and outcomes were assessed. Result: During the study from September 2001 through May 2002, there were 25 neonates fulfilled the inclusion criteria. The complications found were sepsis in 19 (76%), hypoxic ischemic encephalopathy in 17 (68%), acute renal failure in 9 (36%), cardiogenic shock in 7 (28%), meconium aspiration syndrome in 6 (24%), disseminated intravascular coagulation in 2 (8%), hyperbilirubinemia in 1 (4%), and necrotizing enterocolitis in 1 (4%) subject. Five of 9 subject with acute renal failure (55,6%) were prerenal type, and 4 (44,4%) were renal. type. Fourteen (56%) deaths occurred, the majority caused by cardiogenic shock (55,6%) accompanied by hypoxic ischemic encephalopathy. Conclusion : Complications of severe asphyxiated full-term neonates includes sepsis 76%, hypoxic ischemic encephalopathy 68%, acute renal failure 36%, cardiogenic shock 28%, meconium aspiration syndrome 24%, disseininated intravascular coagulation 8%, hyperbilirubinemia 4%, and necrotizing enterocolitis 4%. Death occured in 56% subject. Key words : severe birth asphyxia, neonates, complications.