Neonatal encephalopathy

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Neonatal encephalopathy
Classification and external resources
ICD-10 P91.60
ICD-9-CM 768.70

Neonatal encephalopathy (NE), also known as hypoxic ischemic encephalopathy (HIE), is defined by signs and symptoms of abnormal neurological function in the first few days of life in an infant born at term.[1] It is commonly caused by birth asphyxia.[1]

Signs and symptoms[edit]

In neonates born at or beyond 35 weeks, neonatal encephalopathy may present itself as the following symptoms:

  • Reduced level of consciousness
  • Seizures (which peak at 48 hours)
  • Difficulty initiating and maintaining respiration
  • Depression of tone and reflexes[2]

Diagnosis[edit]

Cord blood gas analysis can be used to determine if there is perinatal hypoxia/asphyxia, which are potential causes of hypoxic-ischemic encephalopathy or cerebral palsy, and give insight into causes of intrapartum fetal distress.[3] Cord blood gas analysis is indicated for high-risk pregnancies, in cases where C-sections occurred due to fetal compromise, if there were abnormal fetal heart rate patterns, Apgar scores of 3 or lower, intrapartum fever, or multifetal gestation.

Evidence of brain injury related to the hypoxic-ischemic events that cause neonatal encephalopathy can be seen with brain MRIs or magnetic resonance spectroscopy imaging.[4]

Neonatal encephalopathy may be assessed using Sarnat staging.

Treatment[edit]

Neonatal encephalopathy is treated using hypothermia therapy.[5]

Epidemiology[edit]

Overall, the relative incidence of neonatal encephalopathy is estimated to be between 2 and 9 per 1000 term births.[2] In 2013 it was estimated to have resulted in 644,000 deaths down from 874,000 deaths in 1990.[6]

References[edit]

  1. ^ a b "Neonatal Encephalopathy". http://www.adhb.govt.nz/. Retrieved 7 March 2015.  External link in |website= (help)
  2. ^ a b "Clinical features, diagnosis, and treatment of neonatal encephalopathy". www.uptodate.com. Retrieved 2016-03-24. 
  3. ^ Armstrong, L; Stenson, BJ (November 2007). "Use of umbilical cord blood gas analysis in the assessment of the newborn.". Archives of disease in childhood. Fetal and neonatal edition. 92 (6): F430–4. doi:10.1136/adc.2006.099846. PMC 2675384Freely accessible. PMID 17951550. 
  4. ^ Pediatrics, American Academy of (2014-05-01). "Neonatal Encephalopathy and Neurologic Outcome, Second EditionReport of the American College of Obstetricians and Gynecologists' Task Force on Neonatal Encephalopathy". Pediatrics. 133 (5): e1482–e1488. doi:10.1542/peds.2014-0724. ISSN 0031-4005. 
  5. ^ Services, c=AU; st=Victoria; o=State Government of Victoria; ou1=Department of Health and Human. "Encephalopathy in neonates: Neonatal ehandbook - Department of Health and Human Services, Victoria, Australia". www.health.vic.gov.au. Retrieved 2016-03-24. 
  6. ^ GBD 2013 Mortality and Causes of Death, Collaborators (17 December 2014). "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.". Lancet. 385: 117–71. doi:10.1016/S0140-6736(14)61682-2. PMC 4340604Freely accessible. PMID 25530442.