Birth Asphyxia/ Hypoxic ischaemic encephalopathy Flashcards
what is cause of birth asphyxia?
how likely are they to recover?
if it is severe what can birth asphyxia become?
how is being a foetus protective against hypoxia
- intrapartum foetal hypoxia
- quick recovery with rapid resuscitation
- HIE
- High Hb (18) with left shift Hb curve
- High cardiac output
What parameters are used for diagnosis?
- pH <7.05
- depression of apgar scores (0-5 at 10 mins)
- delay in respiration >10 mins
- HIE (abnormal neurological signs including convulsions)
How can this be managed?
- rapid resuscitation
- avoiding cerebral oedema
- treating convulsions
what is the management of HIE
- death and severe handicap in 25%
- controlled therapeutic cooling can improve outcomes
- admission to ICU
- 20% of cerebral palsy is due to HIE
what criteria are in apgar score?
- Activity
- Pulse
- Grimace (reflex irritability)
- Appearance (skin colour)
- Respirations (crying or not)
what are the signs of moderate HIE?
severe HIE?
- lethargic
- hypotonic
- poor feeding
- 40% risk of Cerebral palsy
- Diminished consciousness
- no movement
- multiple seizures
- organ failure
what age do pigmented navei tend to appear?
what is the malignancy risk?
how should they appear?
- 2 years of age
- very low unless large congenital naevi
- flat or slightly elevated large surface area
What are cafe au lait spots a feature of ?
describe them
- neurofibromatosis
- sharply demarcated macular lesions
- uniformly pigmented
what is another name for a strawberry naevus?
describe them
what should be done?
- superficial haemangioma
- bright red
- protuberant
- compressible
- sharply demarcated
- don’t intervene unless impacting function
what does a naevus flammeus look like?
where does it commonly present?
what happens to them?
- salmon patch
- small, pink, flat lesion
- eyelids, neck forehead
- fade and disappear
what do mongolian blue spots look like?
where do they most commonly present and in who?
what happens to them?
- blue or slate grey lesions
- sacral area, asians
- fade in first few years
when do port wine stains present?
what are they like?
if they are located in the trigeminal area what might it be an indicator of?
- at birth
- pink/ purple
- sharply circumscribed
- macular lesions
- mature dilated dermal capillaries
- Sturge-Weber syndrome
