NMH

50 Neonatal Encephalopa y 2020 | NMH Annual Rep t Hypoxic Ischaemic Encephalopathy: Outborn (4) Case No. EGA BW (g) Delivery Method Delivery Method Indication Apgars 1, 5, 10, 15, 20 PPV at 10 mins Min pH within 60 min Max BE within 60 min Sei- zures Y/N TH Grade of NE Summary of MRI brain Organ Involve- ment Outcome Placental Histology Classification 1 36+ 1 2540 Emergen- cy C-Sec- tion (not in labour) Em LSCS for fetal bradycardia in this twin and twin 2 demise 2,3,6,7,7 Yes 6.83 -20 Yes Yes 3 Not per- formed (Point-of- care CRUSS = bilateral thalamic increased echogenicity suggestive of ischaemic injury) Ventilated, Inotro- pes, Coagulpathy, Thrombocytope- nia, AKI, elevated LFTs Died D2. (Cor- oner's case) MCDA. Acute perimortem transfusion. 1,2,3,4 2 36+ 1 2940 Emergen- cy C-Sec- tion (not in labour) Em LSCS for reduced fetal movements and fetal bradycardia 4,8,8 Yes 6.88 Incal- culable Yes Yes 2 Not per- formed (CRUSS = subtle increased echogenicity throughout the cerebral parenchy- ma, and effacement of the lateral ventricles, suggesting a degree of cerebral swelling) Ventilated, iNO, Inotropes, Coagu- lopathy, Thrombo- cytopenia, SIADH, AKI, Elevated LFTs Died D4 (Cor- oner's case) No placenta in NMH. 2,3,4 (postna- tal diagnosis of T21) 3 36+ 4 2500 Sponta- neous vaginal PPROM for 4 days. Rapid onset of preterm labour. Foul smelling liqour. Clini- cal suspicion for chorio- amnionitis. 6,8,9 No 7.02 -17.6 Yes Yes 2 Not per- formed (CRUSS normal) Ventilated, inhaled Nitric Oxide, Ino- tropes, Thrombo- cytopenia, Neu- tropenia (WCC 3.5), Lymphopenia (1.09), Raised CRP (39), No growth on blood cultures but sepsis strongly suspected Transferred to Paediat- ric Hospital consideration of ECMO for PPHN. Survived. Follow-up at referring hospital No placenta in NMH. 4 (PPHN) 4 38+ 4 3840 Operative vaginal (Ventouse) Failure To Progress 6,8,8 No 6.98 -13 No Yes 2 Normal No Transferred to referring hospital D5 and refer- ring hospital follow-up No placenta in NMH. 3

• Cover
• Blank Page
• Blank Page (1)