Elsevier

Seminars in Neonatology

Volume 5, Issue 1, February 2000, Pages 17-32
Seminars in Neonatology

Regular Article
Selection of babies for intervention after birth asphyxia

https://doi.org/10.1053/siny.1999.0119Get rights and content

Abstract

Based on animal experiments, the therapeutic window for neonates with signs of perinatal hypoxia-ischaemia is probably less than 6 h, and early selection of patients is of utmost importance. In term neonates, fetal heart rate and blood flow patterns, the Apgar score, and other clinical scoring systems are insufficient to select patients for intervention, whereas umbilical artery pH<7.0 combined with umbilical arteriovenous differences in Pco2, lactate/pyruvate ratios in cord blood, and CSF interleukin-1β have a better predictive value. At present, neurophysiological methods such as (amplitude-integrated) EEG and evoked potentials have the best predictive value. In preterm neonates, lactate/pyruvate and uric acid measurements in cord blood, as well as neurophysiology appear to be helpful to predict brain injury, and might be used to select patients for intervention.

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    Correspondence Dr Floris Groenendaal, Department of Neonatology, Wilhelmina Children's Hospital, Room KE 04.123.1, P.O. Box 85090, NL-3508 AB Utrecht, the Netherlands. Tel: +31 30 2504545; Fax: +31 30 2505320; Email:[email protected]

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