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Iranian Journal of Pediatrics
Tehran University of Medical Sciences Press
ISSN: 1018-4406
EISSN: 2008-2150
Vol. 16, No. 3, 2006, pp. 265-270
Bioline Code: pe06034
Full paper language: Farsi
Document type: Research Article
Document available free of charge

Iranian Journal of Pediatrics, Vol. 16, No. 3, 2006, pp. 265-270

 en Comparison of Creatin Phosphokinase changes between newborns delivered by vaginal and cesarean section
Sakha, K; Hoseinian, MH; Saiahmeli, M & Sadegnia, AR

Abstract


Background: Creatin Kinase (CK) is an enzyme that participates in the usage and storage of energy cycle in tissue especially the muscles. Elevation of CK in the serum of the newborns is due to CK-MB isoenzyme, which increases in skeletal muscles of the fetus. Muscle activity has an important role in the elevation of creatin kinase level, and there is a direct relationship between muscular activity and CK level, since vaginal delivery leads to increased pressure on skeletal muscles of the newborns this study was done to determine CK changes among newborns delivered by vaginal and Cesarean section.
Methods: 180 term neonates who were born in Al-Zahra hospital of Tabriz University of Medical Sciences from March to August 2005 were chosen. This selection was done in such a manner that we could divide cases into three groups of 60 neonates upon their method of delivery including vaginal, elective and urgent Cesarean Section, and every group was divided in two subgroups upon their Apgar score as being low or high each containing 30 newborns. One hour after delivery 1 milliliter blood was taken from the umbilical cord of neonates and titers of CK were analyzed by spectrophotometer method.
Findings: There was a meaningful difference between the mean level of Creatin Kinase in the group of neonates with low Apgar score in comparison with high Apgar score (P=0.001). Also the mean level of CK was higher in neonates delivered via elective Cesarean (P=0.002) and this difference was meaningful in Cesarean section with labor pain (P=0.001) in comparison with vaginal delivery. As a whole there was a meaningful difference between Cesarean section and vaginal delivery (P=0.001), but no difference was found between elective and Cesarean section with labor pain (P=0.1).
Conclusions: This study shows that the level of CK is higher in neonates with low Apgar score regardless of the method of delivery and probably this finding is the results of brain, cardiac and muscles hypoxia of the newborns. Also total CK is elevated in neonates born via Cesarean section (elective and urgent), this alteration may be the result of anesthesia and or mother tissue injury by surgerical procedure and that was transferred to the neonates.

Keywords
Creatin Kinase , Apgar Score , Vaginal Delivery , Cesarean section , Elective Cesarean

 
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