Hypoxic-ischemic encephalopathy (HIE) is a neurological complication following lack of oxygen to a baby’s brain (asphyxia) before, during or after delivery.
Careful monitoring of the mother during pregnancy and labour and appropriate and timely interventions if there are any signs of foetal distress reduces the risk of asphyxia. Timely and appropriate resuscitation at birth is essential at restoring oxygen supply to the brain and other organs. There is clear evidence that Cooling the baby (Therapeutic Hypothermia) for 72 hours after birth can limit the severity of brain injury. Ensuring that further injury to the vulnerable brain from low blood sugar, infection and seizures is limited prevents compounding of brain injury.
Acute disruption of blood supply and oxygen delivery to the foetus ( e.g. antepartum haemorrhage, cord prolapse, shoulder dystocia), foetal distress, infection and meconium aspiration, poor maternal and foetal health are contributory factors
Diagnosis is on the basis of history, condition of the baby at birth, clinical examination and information from recording of brain activity (CFM) following the baby’s admission to the NICU.
Definitive treatment of moderate to severe HIE is Therapeutic Hypothermia and good supportive care paying particular attention to ventilator support, blood pressure and blood sugar management etc.
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