Neonatal encephalopathy following fetal distress. A clinical and electroencephalographic study.

Twenty-one neonates of over 36 weeks' gestation suffered perinatal asphyxia but not chronic hypoxia. Three clinical stages of postanoxic encephalopathy were distinguished. Stage 1 lasted less than 24 hours and was characterized by hyperalertness, uninhibited Moro and stretch reflexes, sympathetic effects, and a normal electroencephalogram. Stage 2 was marked by obtundation, hypotonia, strong distal flexion, and multifocal seizures. The EEG showed a periodic pattern sometimes preceded by continuous delta activity. Infants in stage 3 were stuporous, flaccid, and brain stem and autonomic functions were suppressed. The EEG was isopotential or had infrequent periodic discharges. Infants who did not enter stage 3 and who had signs of stage 2 for less than five days appeared normal in later infancy. Persistence of stage 2 for more than seven days or failure of the EEG to revert to normal was associated with later neurologic impairment or death.

[1]  C. Randt,et al.  Diagnosis of Stupor and Coma. , 1967 .

[2]  R. Behrman,et al.  Plasma nonesterified fatty acid and blood glucose levels in healthy and hypoxemic newborn infants. , 1974, The Journal of pediatrics.

[3]  K. Hammacher,et al.  Foetal heart frequency and perinatal condition of the foetus and newborn. , 1968, Gynaecologia. International monthly review of obstetrics and gynecology. Revue internationale mensuelle d'obstetrique et de gynecologie. Monatsschrift fur Geburtshilfe und Gynakologie.

[4]  D. Cheek,et al.  Plasma adrenaline and noradrenaline in the neonatal period, and infants with respiratory distress syndrome and placental insufficiency. , 1963, Pediatrics.

[5]  N. Zeghal,et al.  Adrenal catecholamines content in fetal and newborn rats. , 1975, Biology of the neonate.

[6]  C. Dreyfus-Brisac,et al.  L’électroencéphalogramme: Critère d’âge conceptionnel du nouveau-né à terme et prématuré , 1962 .

[7]  J. Lind,et al.  Hypoxia as a Stimulus to Catecholamine Excretion in the Newborn Infant:II. The Effect of Exposure to 10% O2 1 , 1964 .

[8]  R. B. Young,et al.  Plasma pressors in the normal and stressed newborn infant. , 1972, Pediatrics.

[9]  R. Schwab,et al.  ELECTROENCEPHALOGRAPHIC CHANGES IN ACUTE CEREBRAL ANOXIA FROM CARDIAC OR RESPIRATORY ARREST. , 1965, Electroencephalography and clinical neurophysiology.

[10]  P. Huttenlocher,et al.  Development of cortical neuronal activity in the neonatal cat. , 1967, Experimental neurology.

[11]  N Monod,et al.  The neonatal EEG: statistical studies and prognostic value in full-term and pre-term babies. , 1972, Electroencephalography and clinical neurophysiology.

[12]  J. Prichard,et al.  EEG, ECG, and acid-base observations during acute fetal hypoxia. , 1970, American journal of obstetrics and gynecology.

[13]  J. Simpson THE EEG IN ACUTE CEREBRAL ANOXIA , 1975 .

[14]  R. Engel Abnormal electroencephalograms in the neonatal period , 1975 .

[15]  E. Saling Foetal and neonatal hypoxia in relation to clinical obstetric practice , 1968 .

[16]  E. Scarpelli,et al.  Fetal breathing: induction in utero and effects of vagotomy and barbiturates. , 1976 .