Quality of survival after severe birth asphyxia.

Thomson, Andrew J.; Searle, Margaret; Russell, George

doi:10.1136/adc.52.8.620

Cited by 87 publications

(12 citation statements)

References 13 publications

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“…1 However, this study grouped babies with absent heart beat at birth with others who had Apgar scores of between 1 and 4; only 15 babies were given a 1 minute Apgar score of zero and, of these, eight survived; their subsequent neurodevelopmental status is not reported separately. Similar data were reported by Steiner and Neligan, 3 and Thompson et al, 4 from severely asphyxiated births between 1964 and 1974. Both neonatal survival and intensive care techniques have changed substantially since then and it seems appropriate to re-evaluate this particular risk group.…”

Section: Discussionsupporting

confidence: 79%

Outcome of Resuscitation Following Unexpected Apparent Stillbirth

Casalaz

Marlow

Speidel

1998

Obstetrical & Gynecological Survey

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There are few data to inform a decision to resuscitate babies who are unexpectedly stillborn. The outcome for 42 successfully resuscitated stillborn children, of whom 62% survived to be discharged home, is reported. Of the survivors, a poor outcome with severe disability was found in 23% (including one postneonatal death), equivocal outcome was found in 15% (two mild hypertonia; two with mild hemiplegia and no associated other disability) and 62% were free of any impairment at follow up 20 months to 8 years later. In 39 (93%) fetal problems had been identified and the resuscitation team was present at delivery. Poor outcome was associated with late return of heart beat, delayed respirations, neonatal acidaemia and early onset of seizures. Of the unexpected apparent stillbirths successfully resuscitated, 52% died or survived severely disabled, 10% had an equivocal outcome, but 36% survived apparently intact. Therefore, vigorous resuscitation is clearly indicated in these circumstances. (Arch Dis Child Fetal Neonatal Ed 1998;78:F112-F115)

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Section: Discussionsupporting

confidence: 79%

Outcome of Resuscitation Following Unexpected Apparent Stillbirth

Casalaz

Marlow

Speidel

1998

Obstetrical & Gynecological Survey

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“…Two previous studies (Brown et al, 1974;Thomson et al, 1977) have reported a higher incidence of feeding difficulties, persistent vomiting, convulsions, hypothermia, a high pitched cerebral cry, or abnormal muscle tone in the newborn period, in children who manifested neurological abnormalities. In the present study there was an increased incidence of similar conditions in newborn babies who were initially apathetic but were subsequently hyperexcitable and had extensor hypertonia.…”

Section: Methodsmentioning

confidence: 99%

“…Three (6%) children showed definite abnormalities but no handicap-I child with epilepsy and 2 with nerve deafness. (Berendes, 1975)-but there is still uncertainty about the precise role of asphyxia in causing these conditions since most babies surviving severe asphyxia do so as normal children (Fraser and Wilks, 1959;Benaron et al, 1960;Scott, 1976;Thomson et al, 1977). There are several other perinatal conditionssuch as prematurity, intrauterine growth retardation, apnoeic attacks, hypoglycaemia, or hyperbilirubinaemia-that may also increase the risk of handicaps in childhood.…”

Section: Methodsmentioning

confidence: 99%

“…The children have been followed up for between 2 and 5 years. Each child was given an overall rating on a 4-point scale according to the presence and severity of neurological abnormality and resulting handicap (Rutter et al, 1970;Thomson et al, 1977 Clinical conditions in the newborn period. The clinical conditions in the newborn period are shown in Table 3.…”

Section: Methodsmentioning

confidence: 99%

“…With advances in neonatal care the outlook for babies surviving severe perinatal asphyxia appears to have improved (Scott, 1976;Thomson et al, 1977), making it more difficult to identify the precise role of asphyxia in causing brain damage. The present study was undertaken in a set of neurologically abnormal babies with a history of fetal distress in labour, to find out whether the types of neurological signs exhibited by such babies have any bearing on their outcome in later infancy or childhood.…”

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confidence: 99%

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Neurological Sequelae in Newborn Babies after Perinatal Asphyxia

Souza

Richards

1979

Obstetrical & Gynecological Survey

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(Scott, 1976;Thomson et al., 1977), making it more difficult to identify the precise role of asphyxia in causing brain damage. The present study was undertaken in a set of neurologically abnormal babies with a history of fetal distress in labour, to find out whether the types of neurological signs exhibited by such babies have any bearing on their outcome in later infancy or childhood. MethodsSubjects. Newborn babies, 37 to 44 weeks' gestational age, with a history of fetal distress, were diagnosed as severely neurologically abnormal in the early newborn period by colleagues working at the same hospital, because of the unequivocal presence of abnormal tone (hypertonia or hypotonia), irritability on handling (marked increase in spontaneous activity with alteration in respiration, or crying), a 'cerebral' (high-pitched) cry, or convulsions. These Birthweight. The relationship of birthweight to gestational age was studied using charts constructed by Milner and Richards (1974). 564

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Seizures, hypoxic‐ischemic brain injury, and intraventricular hemorrhage in the newborn

Hill¹,

Volpe²

1981

Annals of Neurology

122

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The review deals with neonatal seizures, perinatal hypoxic-ischemic brain injury, and neonatal intraventricular hemorrhage. neonatal seizures are the most prominent signals of the largest number of neonatal neurological disorders. The convulsive phenomena may be subtle. The predominant etiological process is hypoxic-ischemic encephalopathy. Prognosis is related primarily to the neurological disease responsible for the seizures. Treatment may be specific for the underlying disorder (e.g., glucose or calcium) or less specific (i.e., therapy with anticonvulsant drugs). Prompt control of the seizures is important to avoid brain injury secondary to the effects of the seizures on ventilation, perfusion, and brain metabolism. Hypoxic-ischemic encephalopathy in the newborn most often is a consequence of intrauterine asphyxia. Diagnosis depends primarily on recognition of the clinical syndrome but also on a variety of neurodiagnostic techniques, including radionuclide and CT brain scans. Prognosis is estimated best by a combination of clinical analysis and specialized neurodiagnostic studies. management is based principally on vigorous support, particularly of ventilation and perfusion, maintenance of adequate glucose influx, and control of seizures. Intraventricular hemorrhage is the most common type of neonatal intracranial hemorrhage. The neuropathology is characterized by bleeding from capillaries of the subependymal germinal matrix. Secondary rupture of the ependymal lining then causes intraventricular hemorrhage. Pathogenesis relates to the anatomy of the germinal matrix, the distribution and regulation of cerebral blood flow, and the structure and vulnerability of periventricular capillaries. Precise diagnosis requires a brain imaging procedure; portable, real-time ultrasound is the preferred approach for critically ill infants. Prognosis relates to the severity of the hemorrhage as well as any preceding hypoxic-ischemic insults and the subsequent occurrence of hydrocephalus. Choice of therapy for posthemorrhagic ventricular dilatation depends upon severity and rapidity of progression and ranges from close observation only to ventriculoperitoneal shunting.

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Quality of survival after severe birth asphyxia.

Cited by 87 publications

References 13 publications

Outcome of Resuscitation Following Unexpected Apparent Stillbirth

Outcome of Resuscitation Following Unexpected Apparent Stillbirth

Neurological Sequelae in Newborn Babies after Perinatal Asphyxia

Seizures, hypoxic‐ischemic brain injury, and intraventricular hemorrhage in the newborn

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