Head Trauma and Birth Asphyxia

Question 1

What is the difference between a cephalohaematoma and caput succundum in these areas?

1. Does it cross the suture line?
2. How long to resolve?
3. When it presents?

Answer 1

1. Cephalohaematoma - no, weeks-months, after birth

2. Caput succundum - yes, days, at birth

Question 2

What is birth asphyxia?

Answer 2

Neonate is unable to start or sustain breathing at birth, resulting in hypoxia lasting for long enough to cause physical harm to the child.

Question 3

What is this a presentation of?

Foetal blood sampling in intrapartum period shows acidosis (pH <7.2), baby will have low APGAR score.

Answer 3

Birth asphyxia

Question 4

What is this describing?

Brian injury caused by systemic hypoxaemia and/or reduced cerebral blood flow in the foetus.

Answer 4

Hypoxic-ischaemic encephalopathy

Question 5

How is hypoxic-ischaemic encephalopathy diagnosed?

Answer 5

1. History of foetal distress in utero/during delivery (placental abruption, cord prolapse etc).
2. Use cerebral function monitor to assess baseline activity and detect seizures.
3. MRI day 7

Question 6

What is this a presentation of?
Foetal distress in utero/during delivery, respiratory depression at birth, acidosis, neurological abnormalities which evolve.

Answer 6

Hypoxic-ischaemic encephalopathy

Question 7

What is the management for hypoxic-ischaemic encephalopathy?

Answer 7

Therapeutic hypothermia, anticonvulsants, adequate ventilation.