Comparison of Two Methods of Predicting Outcome in Perinatal Asphyxia

Levene, Malcolm I.; Grindulis, H; Sands, Caroline; Moore, Joseph

doi:10.1016/s0140-6736(86)90718-x

Cited by 262 publications

(101 citation statements)

References 15 publications

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“…The Sarnat classification [18] divides HIE into three grades, which in a simplified version can be described as: Grade 1: no seizures present-the vast majority of newborns do not develop major long-term neurological sequelae; Grade 2: seizures-associated with a 20%−30% risk of death or major neurological sequelae; Grade 3: coma-the majority of newborns die or develop long-term neurological sequelae [19,20]. Importantly, there are other nonhypoxic causes for neonatal encephalopathy, and the hypoxicischemic nature of this entity needs to be confirmed by the documentation of metabolic acidosis in the umbilical artery or in the newborn circulation during the first minutes of life [21].…”

Section: What Are We Trying To Avoid With Intrapartum Fetal Monitoring?mentioning

confidence: 99%

FIGO consensus guidelines on intrapartum fetal monitoring: Physiology of fetal oxygenation and the main goals of intrapartum fetal monitoring

Ayres-de-Campos

Arulkumaran

2015

Intl J Gynecology & Obste

105

102

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Section: What Are We Trying To Avoid With Intrapartum Fetal Monitoring?mentioning

confidence: 99%

FIGO consensus guidelines on intrapartum fetal monitoring: Physiology of fetal oxygenation and the main goals of intrapartum fetal monitoring

Ayres-de-Campos

Arulkumaran

2015

Intl J Gynecology & Obste

105

102

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“…Levene e cols. 13 demonstraram que a EHI grau II apresenta 96% de sensibilidade para prognóstico de paralisia cerebral.…”

Section: Discussionunclassified

Encefalopatia hipóxico-isquêmica em recém-nascidos a termo: aspectos da fase aguda e evolução

Funayama

Moura-Ribeiro

Gonçalves

1997

Arq. Neuro-Psiquiatr.

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RESUMO -Noventa e quatro recém-nascidos com encefalopatia hipóxico-isquêmica (EHI), Perinatal hypoxic-ischemic encephalopathy: acute period and outcomeABSTRACT -Ninety four neonates with hypoxic ischemic encephalopathy HIE attended at the University of Ribeirão Preto since 1982 were studied in terms of the neurological alterations during the acute phase and outcome over a mean period of 47 months. From 43 newborns with HIE I, 40 recovered within 96 hours and 3 died. Among 40 infants with HIE II, 37.5% recovered within the first week, and the others continued abnormal beyond the 7 th day. All 11 infants with HIE III died before the second month of life. The HIE I group had no motor sequelae. Among the HIE II group, 34.5% showed cerebral palsy and 17.7% neuromotor retardation. 80.0% of those with sequelae persisted abnormal beyond 7 th day of life, during the acute phase of the HIE. Epilepsy occurred in 17.5% of cases with HIE grade II, only among those with neuromotor sequelae. The 1Q test did not show statistically significant difference between the HIE I, II without motor sequelae and the control groups. The authors reaffirm the value of the findings in the acute phase of HIE on the outcome of these patients.

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“…1,2 Half of these infants develop moderate or severe hypoxic-ischemic encephalopathy (HIE) symptoms [1][2][3] and 25% will develop neurological impairments. 4,5 The degree of subsequent neurological problems has been found to be related to the severity of HIE.…”

Section: Introductionmentioning

confidence: 99%

“…The HIE grade 2 outcome varies widely from normal development to severe impairment. 3,6,7 The prediction of long-term neurodevelopmental outcome has been difficult. The relationship between conventional clinical parameters (Apgar scores, cord blood pH and HIE symptoms) and outcome has been assessed in a number of studies.…”

Section: Introductionmentioning

confidence: 99%

Obstetric parameters and Doppler findings in cerebral circulation as predictors of 1 year neurodevelopmental outcome in asphyxiated infants

et al. 2011

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Objective: To establish the association of cardiotocography (CTG) and other obstetric parameters with pulsed Doppler findings in cerebral arteries during the first day of life, and to compare the cerebral artery Doppler with other determinants of asphyxia in predicting 1-year neurological outcome in asphyxiated full-term infants.Study Design: Cerebral blood flow velocity (CBFV) were measured from the anterior cerebral (ACA) and basilar (BA) arteries in 30 asphyxiated and 30 healthy-term infants using pulsed Doppler ultrasonography at approximately 24 h of age. CTG, cord artery pH, Apgar scores, biochemical asphyxia markers and symptoms of hypoxic-ischemic encephalopathy (HIE) were compared with the Doppler findings in respect of the ability to predict the outcome, defined by death or impaired neurological performance at 1 year of age.Result: In all, 20% of the asphyxiated infants but none in the control group had increased peak systolic CBFVs (mean þ 3 s.d.) in the ACA or BA. The sensitivity of increased systolic CBFV to predict abnormal outcome in the asphyxia group was 83%, specificity 95% and the sensitivity of the combination of HIE grade from 2 to 3 and increased systolic CBFV in the ACA or BA was 100% and specificity was 95%, respectively. Pathological CTG and low cord artery pH or low Apgar scores showed low predictive power. Conclusion:Grade from 2 to 3 HIE and the systolic CBFV (mean þ 3 s.d.) in the ACA or BA by Doppler ultrasound seemed to predict the outcome in asphyxiated infants at 1 year of age better than CTG, acid basement status, Apgar scores or asphyxia markers. If an increase of more than þ 3 s.d. in the systolic CBFV does not occur within the first 24 h of life, a good 1-year neurological outcome may be anticipated.

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Comparison of Two Methods of Predicting Outcome in Perinatal Asphyxia

Cited by 262 publications

References 15 publications

FIGO consensus guidelines on intrapartum fetal monitoring: Physiology of fetal oxygenation and the main goals of intrapartum fetal monitoring

FIGO consensus guidelines on intrapartum fetal monitoring: Physiology of fetal oxygenation and the main goals of intrapartum fetal monitoring

Encefalopatia hipóxico-isquêmica em recém-nascidos a termo: aspectos da fase aguda e evolução

Obstetric parameters and Doppler findings in cerebral circulation as predictors of 1 year neurodevelopmental outcome in asphyxiated infants

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