Document Detail


[Cerebral palsy and perinatal asphyxia (I--diagnosis)].
MedLine Citation:
PMID:  20378389     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cerebral palsy (CP) is a group of disorders of the development of movement and posture, causing activity limitations, that are attributed to nonprogressing disturbances that occurred in the developing fetal or infant brain. The motor abnormalies are often accompanied by disturbances of sensation, perception, cognition, behavior and/or by a seizure disorder. The prevalence of CP has not decreased in developed countries over the past 30 years, despite the widespread use of electronic fetal heart rate monitoring and a 5- to 6-fold increase in the cesarean delivery rate. In the term newborn, CP may be attributed to perinatal asphyxia in case of metabolic acidosis in the cord blood (pH<7,00 and base deficit>12 mmol/L), followed by a moderate or severe neonatal encephalopathy within 24 hours and a further neurological impairement characterized by spastic quadriplegia and dyskinesia/dystonia. Dating the time of fetal asphyxia during delivery is possible when there are acute catastrophic complications during labor and unexpected acute or progressive fetal heart rate anomalies after a normal admission test, when there is a need for intensive neonatal resuscitation, a multi-organ failure within 72 hours of birth and visualization of acute non focal cerebral abnormalities, mainly by early magnetic resonance imaging (MRI). MRI sequences show either a brain-damaged pattern of the central basal ganglia, thalami and posterior limbs of internal capsules with relative cortical sparing, in acute, near-total asphyxial insults manifested by a continuous bradycardia or a pattern of cortical injury in the watershed zones and relative sparing of the central grey matter, in prolonged partial asphyxia, manifested by late or atypical variable decelerations with progressive fetal tachycardia, loss of reactivity and absent fluctuation. Prolongation of either type of asphyxial insult results in more global brain damage. In order to differentiate a CP occurring after perinatal asphyxia from other neurological sequelae in relation with infection, hemorrhage, stroke, malformations, genetic or metabolic diseases, it is essential that a definitive information from the brain by MRI and an extensive histological examination of the placenta are at disposal.
Authors:
G Boog
Publication Detail:
Type:  English Abstract; Journal Article     Date:  2010-04-07
Journal Detail:
Title:  Gynécologie, obstétrique & fertilité     Volume:  38     ISSN:  1769-6682     ISO Abbreviation:  Gynecol Obstet Fertil     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-26     Completed Date:  2010-10-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100936305     Medline TA:  Gynecol Obstet Fertil     Country:  France    
Other Details:
Languages:  fre     Pagination:  261-77     Citation Subset:  IM    
Copyright Information:
Copyright 2010. Published by Elsevier SAS.
Affiliation:
Service de gynécologie-obstétrique, hôpital Mère-Enfant, CHU de Nantes, Nantes, France. georges.boog@wanadoo.fr
Vernacular Title:
Asphyxie périnatale et infirmité motrice d'origine cérébrale (I--le diagnostic).
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MeSH Terms
Descriptor/Qualifier:
Acidosis / diagnosis
Adult
Asphyxia Neonatorum / diagnosis*
Basal Ganglia Diseases / diagnosis
Cerebral Palsy / diagnosis*
Cerebrum / injuries
Female
Fetal Hypoxia / complications,  diagnosis
Humans
Hypoxia, Brain / diagnosis
Infant, Newborn
Magnetic Resonance Imaging
Male
Maternal Age
Multiple Organ Failure / complications,  diagnosis
Pregnancy
Risk Factors
Thalamic Diseases / diagnosis

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


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