Document Detail


Application of criteria developed by the Task Force on Neonatal Encephalopathy and Cerebral Palsy to acutely asphyxiated neonates.
MedLine Citation:
PMID:  21934445     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To estimate whether term neonates with acute intrapartum hypoxic ischemic encephalopathy and permanent brain injury satisfied the criteria for causation of cerebral palsy developed by the Task Force on Neonatal Encephalopathy and Cerebral Palsy.
METHODS: In this descriptive study, patients in the case group were obtained from a registry of singleton, liveborn, term, neurologically impaired neonates. Entry criteria included a reactive intrapartum fetal heart rate pattern followed by a sudden, rapid, and sustained deterioration of the fetal heart rate that lasted until delivery and an umbilical artery cord pH. All patients in the case group were then assessed to determine if they met the criteria developed by the Task Force on Neonatal Encephalopathy and Cerebral Palsy.
RESULTS: Thirty-nine neonates met the entry criteria, and the proportion meeting each essential criterion was as follows: 38 of 39 (97.4%) had umbilical artery pH of less than 7.00 and 30 of 30 (100%) had a base deficit of 12 mmol/L or higher; 33 of 34 (97%) had either moderate or severe encephalopathy; 34 of 36 (94%) had spastic quadriplegia or dyskinetic cerebral palsy or death attributable to brain injury; and 39 of 39 (100%) had no identifiable reason for exclusion.
CONCLUSION: Fetuses that underwent a sudden and sustained deterioration of the fetal heart rate and that subsequently were found to have cerebral palsy demonstrated characteristics consistent with criteria developed by the Task Force on Neonatal Encephalopathy and Cerebral Palsy for intrapartum asphyxial injury.
LEVEL OF EVIDENCE: III.
Authors:
Jeffrey P Phelan; Lisa Marie Korst; Gilbert I Martin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  118     ISSN:  1873-233X     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-09-21     Completed Date:  2011-11-15     Revised Date:  2012-06-04    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  824-30     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, Citrus Valley Medical Center, West Covina, CA, USA. phelanjp@earthlink.net
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MeSH Terms
Descriptor/Qualifier:
Adult
Asphyxia Neonatorum / classification,  complications*,  diagnosis*
Cerebral Palsy / blood,  etiology*
Female
Fetal Blood / chemistry
Heart Rate, Fetal
Humans
Hydrogen-Ion Concentration
Hypoxia-Ischemia, Brain / complications*,  physiopathology
Infant, Newborn
Male
Practice Guidelines as Topic*
Pregnancy
Severity of Illness Index
Umbilical Arteries / physiopathology
Young Adult
Comments/Corrections
Comment In:
Obstet Gynecol. 2012 May;119(5):1056; author reply 1056-7   [PMID:  22525923 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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