RT Book, Section
A1 Gomella, Tricia Lacy
A1 Eyal, Fabien G.
A1 Bany-Mohammed, Fayez
SR Print(0)
ID 1168358050
T1 Neonatal Encephalopathy
T2 Gomella's Neonatology: Management, Procedures, On-Call Problems, Diseases, and Drugs, 8e
YR 2020
FD 2020
PB McGraw-Hill Education
PP New York, NY
SN 9781259644818
LK accesspediatrics.mhmedical.com/content.aspx?aid=1168358050
RD 2024/10/10
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.