Neonatal therapeutic hypothermia from an obstetrician’s perspective: risk factors and opportunities for the prevention of perinatal asphyxia
Authors:   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Ignatko I.V. , Bogomazova I.M. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Fedyunina I.A. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Timokhina E.V. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Belousova V.S. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Kardanova M.A. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Marenkov V.V. ,   S.S.Yudin City Clinical Hospital, Moscow, Russian Federation, Alieva F.N. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Melek M.I. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Romanova E.M. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Salakhutdinova A.N. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Rogova E.A. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
Published: January 2025

Objective. To study obstetric risk factors for hypoxic-ischemic encephalopathy to develop preventive measures for perinatal asphyxia.
Patients and methods. A retrospective analysis of obstetric histories of 50 patients, including data on delivery and complications in the early neonatal period, was performed. Patients were divided into two groups: the study group included 12 patients whose children had perinatal asphyxia, which was an indication for therapeutic hypothermia; the control group included 38 patients whose children were born without complications.
Results. Differences in age and somatic history in patients in the study and control groups were not statistically significant. In the analysis of obstetric histories, only patients in the study group were found to have high parity, fetal hypotrophy, spontaneous miscarriage, and antenatal fetal death. In the third trimester of pregnancy, patients in the study group significantly more often had infectious and inflammatory diseases, impaired blood circulation in the maternal-placental-fetal system, and oligohydramnios. In terms of the preparation, course and management of labor, patients in the study group significantly more often had pathological preliminary period and premature rupture of membranes. Labor pre-induction was performed only in patients in the study group. In half of the cases, the direct causes of perinatal asphyxia in patients in the study group were emergency events – placental abruption and threatened uterine rupture.
Conclusion. Obstetric and gynecologic history and pregnancy characteristics are not fundamental in predicting perinatal asphyxia, but they should be considered when determining the plan of labor management, as they are predisposing factors for the development of emergency events.
Key words: hypoxic-ischemic encephalopathy, perinatal asphyxia, therapeutic hypothermia