TY - CHAP M1 - Book, Section TI - Neonatal Encephalopathy A1 - Gomella, Tricia Lacy A1 - Eyal, Fabien G. A1 - Bany-Mohammed, Fayez PY - 2020 T2 - Gomella's Neonatology: Management, Procedures, On-Call Problems, Diseases, and Drugs, 8e AB - Neonatal encephalopathy (NE) is a clinically defined syndrome of disturbed neurologic function in the earliest days of life in infants born ≥35 weeks’ gestation, demonstrated by an altered level of consciousness or seizures and frequently associated with depressed respiratory drive, hypotonia, and depressed or absent reflexes. NE may result from a metabolic disorder, infection, drug exposure, hypoxic ischemic encephalopathy (HIE), or neonatal stroke. NE is the preferred terminology to describe a depressed newborn from any cause at the time of birth.Perinatal asphyxia is a condition of impaired blood gas exchange that, if it persistent, leads to progressive hypoxemia and hypercapnia. HIE, which is a subset of NE, can result from perinatal asphyxia whereby inadequate oxygen delivery to the brain leads to compromised brain metabolismThe likelihood that acute intrapartum or peripartum hypoxia-ischemia (HI) may have contributed to NE is based on the following factors identified by the American College of Obstetricians and Gynecologists (ACOG) task force on NE:Neonatal signsApgar score 12 mmol/L or both.Neuroimaging evidence of acute brain injury seen on brain magnetic resonance imaging (MRI) or magnetic resonance spectroscopy consistent with HI.Presence of multisystem organ failure consistent with HIE.Type and timing of contributing factorsA sentinel hypoxic or ischemic event occurring immediately before or during labor and delivery.Fetal heart rate monitor patterns consistent with an acute peripartum or intrapartum event.Timing and type of brain injury patterns based on imaging studies consistent with an etiology of an acute peripartum or intrapartum event.No evidence of other proximal or distal factors that could be contributing factors.Developmental outcomeDevelopmental outcome is spastic quadriplegia or dyskinetic cerebral palsy. Other subtypes of cerebral palsy (CP) and other developmental abnormalities are not specific to acute intrapartum HIE. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/04 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1168358050 ER -