563 O Audit of the Use of Cerebral Function Monitoring (CFM) in the Management of Term Neonates with Encephalopathy

Abstract

Objectives: To determine the indications for cerebral function monitoring, the characteristics of babies who had CFM and their outcomes at discharge. Methods: The records of all term newborn babies born between June 2006 - April 2009 who underwent cerebral function monitoring were reviewed. Results: Sixty six term (55% male) babies underwent cerebral function monitoring. Their mean GA was 39.2±1.6wk. The average birth weight was 3.09±0.75kg. 58% of these babies were delivered operatively. The apgar scores were 4± 3, 1min, 6.2± 2.8 ,5min and 7 ± 2.6 ,10min. 46% of these babies were intubated at birth. 43% of the babies had clinical seizures. 3 groups of babies were identified: Group 1- 11 babies had both the lower margin of CFM trace less than 5µV and the upper margin less than 10µV. Group 2- 8 babies had the lower margin less than 5µV but upper margin higher than 10µV. Group 3 - 46 babies had appropriate voltages on CFM tracing. 14 babies from groups 1&2 had moderate or severe encephalopathy and 2 had normal neurological signs at discharge. Normal CFM tracing in encephalopathic babies obviated the need for neuro-protective treatment. CFM was useful in evaluating encephalopathic babies from other causes. These included persistent hypoglycaemia, cortical haemorrhage, periventricular echodensities, kernicterus, propionic acidaemia, middle cerebral artery infarct, generalised hypotonia of unknown cause and moebius syndrome. Conclusion: Majority of babies with encephalopathy had a CFM trace with normal voltages. It is an important tool in the clinical assessment of term neonates with encephalopathy.