Neonatal Encephalopathy Following Fetal Distress

Abstract

Twenty-one neonates of over 36 weeks' gestation suffered perinatal asphyxia but not chronic hypoxia. Three clinical stages of postanoxic encephalopathy were distinguished. Stage 1 lasted less than 24 hours and was characterized by hyperalertness, uninhibited Moro and stretch reflexes, sympathetic effects, and a normal electroencephalogram. Stage 2 was marked by obtundation, hypotonia, strong distal flexion, and multifocal seizures. The EEG showed a periodic pattern sometimes preceded by continuous delta activity. Infants in stage 3 were stuporous, flaccid, and brain stem and autonomic functions were suppressed. The EEG was isopotential or had infrequent periodic discharges. Infants who did not enter stage 3 and who had signs of stage 2 for less than five days appeared normal in later infancy. Persistence of stage 2 for more than seven days or failure of the EEG to revert to normal was associated with later neurologic impairment or death.

Clinical and Epidemiological Features and Management of Neonatal Hypoglycemia at the University Teaching Hospital of Treichville (Abidjan-Côte d’Ivoire)

“…Clinical manifestations were dominated by prematurity (31.8%), cerebral suffering according to the clinical classification of SARNAT [9] (25.4%) and respiratory distress (20.6%). The estimate of the mean time to analysis of blood samples was 1.45 hours and that only 6.5% of samples were analyzed less than one hour after collection, 82.5% analyzed between 1 hour and 2 hours and 11% after 2 hours (Table 2).…”

Introduction of Hypothermia for Neonates with Perinatal Asphyxia in the Netherlands and Flanders

“…Neonatal encephalopathy was based on either clinical signs of encephalopathy, including a depressed level of consciousness or seizures, a Sarnat II or III score [23], a high Thompson score [6], or on aEEG criteria [5], which is different from another large randomised trial where only one criterion (clinical encephalopathy [12]) was used. Although the Thompson score used in the neo.nEURO.network-trial [24] was an inclusion criterion for treatment with hypothermia, many units started hypothermia without actual recording of Thompson scores.…”

Cerebral Lactate and N-Acetyl-Aspartate/Choline Ratios in Asphyxiated Full-Term Neonates Demonstrated In Vivo Using Proton Magnetic Resonance Spectroscopy

“…and grade 3 in 5 neonates. according to the criteria of Sarnat and Sarnat (10). Ethical approval was granted by the Ethical Committee of the Wilhelmina Children's Hospital and of the Utrecht University Hospital.…”