Study of Liver Function Test in Perinatal Asphyxia at a Tertiary Care Center in Haryana
Background: Perinatal asphyxia is an insult to the fetus or newborn due to lack of oxygen (hypoxia) and /or a lack of perfusion (ischemia) to various organs. The diagnosis of perinatal asphyxia is mostly established retrospectively. But it is difficult to diagnose perinatal asphyxia retrospectively in the absence of perinatal records. As because of hypoxaemia, different organ systems of the body are affected in perinatal asphyxia, this study was done to assess the hepatic function in the cases of perinatal asphyxia which could prove useful in diagnosing perinatal asphyxia.
Methods: The study included 25 asphyxiated neonates as cases and 25 healthy neonates as control group. Venous blood was analyzed between 2nd and 5th day of life to estimate serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP), serum total bilirubin (STB), direct bilirubin (DSB) and prothrombin time (PT). Unpaired student’s ‘t’ test was used for data analysis and P value of <0.05 were considered significant.
Results: Serum ALT and AST were found significantly higher in asphyxiated babies compared to reference groups (p<0.001). The mean ALT and AST of asphyxiated babies were 100.17±35.50 and 84.13±44.49 U/L, respectively and those of normal babies were 30.25±9.49 U/L and 41.97±11.49 U/L respectively.
Conclusions: Estimation of liver enzymes can prove helpful in diagnosing perinatal asphyxia in absence of birth details especially in developing country like India.
2. Costello AM, Manandhar DS. Perinatal asphyxia in less developed countries. Arch Dis Child Fetal Neonatal Ed. 1994 Jul;71 (1): F1-3.
3. NNPD network. National Neonatal Pernatal Database – report for the year 2002-2003. NNF NNPD network, New Delhi; 2005.
4. Shah P, Riphagen S, Beyene J, Perlman M. Multiorgan dysfunction in infants with post asphyxial hypoxic-ischaemic encephalopathy. Arch Dis Child Fetal Neonatal Ed. 2004 Mar;89(2):F152-5.
5. Karlsson M, Blennow M, Nemeth A, Winbladh B. Dynamics of hepatic enzyme activity following birth asphyxia. Acta Pediatrica 2006; 95: 1405-11.
6. Schumann G, Bonora R, Ceriotti F, Ferard G, Ferrero CA, Frank PFH, et al. IFCC primary reference procedures for the measurements of catalytic activity concentrations of enzymes at 370 C. Part 4. Reference procedure for the measurement of catalytic concentration of alanine amino transferase. Clin Chem Lab Med. 2002;40:718-24.
7. Schumann G, Bonora R, Ceriotti F, Ferard G, Ferrero CA, , et al. IFCC primary reference procedures for the measurements of catalytic activity concentrations of enzymes at 3 70 C. Part 5. Reference procedure for the measurement of catalytic concentration of aspartate aminotransferase. Clin Chem Lab Med. 2002;40:725-33
8. Wilkinson JH, Boutwell JH and Winsten S. Evaluation of new system for Kinetic measurement of serum alkaline phosphatase. Clin Chem. 1969;15(6):487-95.
9. Jendrassik L, Grof P. Vereinfachte photometrische Methoden Zur Bestimmung dis Blutbilirubins. Biochem Z. 1938;297:81-9
10. Quick AJ. The Thromboplastin Reagent for the determination of Prothrombin. Science. 1940; 92(2379): 113-14.
11. Zanardo V, Bondio M, Perini G, Temporin GF. Serum glutamic- oxaloacetic transaminase and glutamic-pyruvic transaminase activity in premature and full-term asphyxiated newborns. Biol Neonate 1985;47:61-69
12. Bemmel LA, Hack WW, Seldenrijk CA, Kneepkens CM. Extensive hepatic necrosis in a premature infant. J Pediatr Gastroenterol Nutr 1992; 14: 228-31.
13. Sanjay A, Evan Y. S. Perinatal asphyxia. In: Cloherty PJ, Elchenwald CE, Stark RA, editors. Manual of Neonatal care. 5th Ed. Philadelphia: Lippincott Williams & Wilkins; 2004. p- 536-55.
14. Reddy S, Dutta S, Narang A. Evaluation of lactate dehydrogenase, creatine kinase and hepatic enzymes for the retrospective diagnosis of asphyxia among sick neonates. Indian Pediatr 2008; 45:144-7.
15. Paliwal P, Verma M, Sheikh MKS, Mulye S, Paliwal MN. Study of hepatic function in neonate asphyxia. J Evol Med Dent Sci. 2013;2(31);5764-67.
16. Khreisat WH, Habahbeh Z. Risk factors of birth asphyxia: A study at Prince AliBen Al-Hussein Hospital, Jordan.Pak. J Med Sci. 2005; 21(1):30-4.
17. Islam MT, Islam MN, Mollah AH, Hoque MA, Hossain MA, Nazir F, Ahsan MM. Status of liver enzymes in babies with perinatal asphyxia. Mymensingh Med J. 2011;20(3):446-9.
18. Godambe SV, Udani RH, Malik S, Kandalkar BM. Hepatic profile in asphyxia neonatorum. Indian Pediatr. 1997;34(10):927-30.
19. Saili A, Sarna MS, Gathwala G, Kumari S, Dutta AK. Liver dysfunction in severe birth asphyxia. Indian Pediatr. 1990;27(12):1291-4.
20. Goldberg RN, Cabal LA, Sinatra FR, Plajstek CE, Hodgman JE. Hyperammonia associated with Perinatal asphyxia. Pediatrics 1979;64: 336-41.
21. Beckett GJ, Hayes JD. Plasma Glutathione S-transferase measurements and Liver disease in Man. J Clin Biochem Nutr. 1986;11:21-4.
22. Fekete M, Horváth M, Vincellér M. Perinatal asphyxia and jaundice in newborn infants. Acta Paediatr Acad Sci Hung. 1978;19(1):17-26.
23. Vajro P, Amelio A, Stagni A, Paludetto R,Genovese E, Giuffre M, et al. Cholestasis in newborn infants with Perinatal asphyxia. Acta Paediatr 1997;86:895-98.
24. Seeto RK, Fenn B, Rockey DC. Ischemic hepatitis: Clinical presentation and pathogenesis. Am J Med. 2000;109:109-13.
Copyright (c) 2016 International Archives of BioMedical and Clinical Research
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.