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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
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Markers of an acute peripartum or intrapartum hypoxic-ischemic event

Markers of an acute peripartum or intrapartum hypoxic-ischemic event
Neonatal signs consistent with an acute peripartum or intrapartum event:
  • Apgar score of <5 at 5 minutes and 10 minutes
  • Fetal umbilical artery acidemia – Fetal umbilical artery pH <7.0, or base deficit ≥12 mmol/L, or both
  • Neuroimaging evidence of acute brain injury seen on brain MRI or MRS consistent with hypoxia-ischemia
  • Presence of multisystem organ failure consistent with hypoxic-ischemic encephalopathy
Type and timing of contributing factors that are consistent with an acute peripartum or intrapartum event:
  • A sentinel hypoxic or ischemic event occurring immediately before or during labor and delivery:
    • Ruptured uterus
    • Severe abruptio placentae
    • Umbilical cord prolapse
    • Amniotic fluid embolus with coincident severe and prolonged maternal hypotension and hypoxemia
    • Maternal cardiovascular collapse
    • Fetal exsanguination from either vasa previa or massive fetomaternal hemorrhage
  • Fetal heart rate monitor patterns consistent with an acute peripartum or intrapartum event, particularly a category I fetal heart rate pattern on presentation that converts to one of the following patterns:
    • Category III pattern
    • Tachycardia with recurrent decelerations
    • Persistent minimal variability with recurrent decelerations
  • Timing and type of brain injury patterns based on imaging studies consistent with an etiology of an acute peripartum or intrapartum event. Well-defined patterns on brain MRI typical of hypoxic-ischemic cerebral injury in the newborn are:
    • Deep nuclear gray matter (ie, basal ganglia or thalamus) injury
    • Watershed (borderzone) cortical injury
  • No evidence of other proximal or distal factors that could be contributing
Developmental outcome is spastic quadriplegia or dyskinetic cerebral palsy:
  • Other subtypes of cerebral palsy are less likely to be associated with acute intrapartum hypoxic-ischemic events
  • Other developmental abnormalities may occur, but they are not specific to acute intrapartum hypoxic-ischemic encephalopathy and may arise from a variety of other causes
MRI: magnetic resonance imaging; MRS: magnetic resonance spectroscopy.
Source: Neonatal encephalopathy and neurologic outcome, second edition. Report of the American College of Obstetricians and Gynecologists' Task Force on Neonatal Encephalopathy. Obstet Gynecol 2014; 123:896.
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