The early prediction of the prognosis of perinatal hypoxic brain damage

Abstract

Objective To find out ways of early prediction of the prognosis of perinatal hypoxic brain damage. Methods Data of 58 patients suffered from moderate to severe hypoxic-ischemic encephalopathy (HIE) were retrospectively analyzed. Of these patients, 25 had obvious nervous system sequelae compared with 33 controls who showed no nervous system sequelae. Factors related to sequelae included history of hypoxia, onset time and duration of nervous system symptoms, state of convulsion and brain function ( EEG, near infrared spectroscopy) , and image changes after the acute phase of the disease. Results Marked differences between the study and control groups were observed. The study group showed severe inhibited state after birth, early onset of nervous system symptoms and 48% occurrence within 6 hours after birth. Symptoms lasted for more than10 days in 40%, convulsion occurred within 24 hours in 54%, and 85% showed frequent onset. It was revealed that severe brain function disorders (EEG) , including multifocal long time abnormal discharge, subclinical discharge, low voltage, burst suppression waves, and spontaneous lowered brain oxygenation (near infrared spectroscopy) ; and extensive parenchymal or ventricular or periventricular image changes which occurred in 88 % of the cases. Conclusion The inhibited state, onset time and duration of nervous system symptoms, severity of convulsion, brain function and image changes in later phase were valuable indicators for early prediction of the prognosis. Key words: Perinatology; Cerbral anoxia; Nervous system; Prediction