Hypoxic-Ischemic Encephalopathy (HIE)

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INTRODUCTION

It is also known as hypoxic-ischemic encephalopathy, is a clinically defined syndrome (Kurinczuk, White-Koning, & Badawi, 2010). It is a condition in which neonates are unable to perform normal neurologic functions and are unable to maintain normal breathing, possible seizures and unconsciousness is common (Sarnat & Sarnat, 1976).
It occurs due to brain injury as a result of which oxygen supply to the brain is below normal known as asphyxia and if this condition persists brain tissues can get damaged.


OCCURRENCE

It occurs mostly in premature infants and if it occurs in about 35th week of fetal development it is likely to cause periventricular leukomalacia.


SYMPTOMS

Babies with HIE might exhibit the following signs and symptoms: (Nelson & Leviton, 1991)

  1. Seizures
  2. Unconsciousness
  3. Difficulty in breathing
  4. Missing reflexes
  5. Low or high muscle tone
  6. Feeding problems


RISK FACTORS

The following are the risk factors associated with HIE: (Spain et al., 2015)

  1. Medical negligence
  2. Trauma
  3. Injury from umbilical cord complications
  4. Cardiac complications
  5. Stress of labour and delivery
  6. Blockage in blood flow through the placenta


Possible Antecedents of Neonatal Encephalopathy

  1. Infection
  2. Intracranial haemorrhage
  3. Genetic syndromes
  4. Inborn errors of metabolism


DIAGNOSIS

Once suspected, techniques such as neuroimaging, medical resonance imaging, diffusion weight imaging and MR spectroscopy are there for diagnosis. If there was any sort of trauma or risk factor such as the fetal stroke then it is suspected otherwise doctors monitor growth and development (Hankins et al., 2002).


TREATMENT

Therapies are there to treat Cerebral Palsy due to hypoxic-ischemic encephalopathy (Shankaran, 2009) but it is currently being treated by hypothermia in which baby is being cooled for about three days at around 33 degree Celsius thus it reduces brain damage and enhances the stability of newborn.


By: Zoha Khan

 

REFERENCES

  1. Hankins, G. D., Koen, S., Gei, A. F., Lopez, S. M., Van Hook, J. W., & Anderson, G. D. (2002). Neonatal organ system injury in acute birth asphyxia sufficient to result in neonatal encephalopathy. Obstetrics & Gynecology, 99(5), 688-691.
  2. Kurinczuk, J. J., White-Koning, M., & Badawi, N. (2010). Epidemiology of neonatal encephalopathy and hypoxic-ischaemic encephalopathy. Early human development, 86(6), 329-338.
  3. Nelson, K. B., & Leviton, A. (1991). How much of neonatal encephalopathy is due to birth asphyxia? American journal of diseases of children, 145(11), 1325-1331.
  4. Sarnat, H. B., & Sarnat, M. S. (1976). Neonatal encephalopathy following fetal distress: a clinical and electroencephalographic study. Archives of neurology, 33(10), 696-705.
  5. Shankaran, S. (2009). Neonatal encephalopathy: treatment with hypothermia. Journal of neurotrauma, 26(3), 437-443.
  6. Spain, J. E., Tuuli, M. G., Macones, G. A., Roehl, K. A., Odibo, A. O., & Cahill, A. G. (2015). Risk factors for serious morbidity in term nonanomalous neonates. American journal of obstetrics and gynaecology, 212(6), 799. e791-799. e797.

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