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Nursing Diagnosis & Midwifery 2018
S e p t e m b e r 1 0 - 1 1 , 2 0 1 8
P r a g u e , C z e c h R e p u b l i c
Page 34
Journal of Nursing and Health Studies
ISSN: 2574-2825
E u r o S c i C o n E v e n t o n
Nursing Diagnosis &
Midwifery
Neonatal encephalopathy (NE) is a heterogeneous syndrome characterized
by sign of central nervous system dysfunction in newborn infants. It
can result from a wide variety of conditions but often remains unexplained.
Approximately 70% of NE cases are associated with events arising before the
onset of labor. On the other hand Hypoxic-ischemic Encephalopathy (HIE) is
one of the many possible contributors to NE. The term is appropriately used
when NE due to hypoxic ischemic brain injury. Guidelines from the American
Academy of Pediatrics and the American College of Obstetrics and Gynecology
for HIE indicate that all of the following must be present for the designation of
perinatal asphyxia or HIE: profound metabolic or mixed acidemia (pH <7) in
an umbilical artery blood sample; persistence of an Apgar score of 0 to 3 for
more than 5 minutes; neonatal neurologic abnormalities and multiple organ
involvement. The asphyxia insult is due to impaired cerebral blood flow, as a
consequence of interrupted maternal and/or fetal placental blood flow and
gas exchange. The most important effects appear to include apoptosis and
inflammation, which occur in the sub-acute phase after injury (hours to days
after a hypoxic-ischemic event) Figure. There should be a comprehensive
evaluation including assessment of neonatal clinical status, all potentially
contributing factors and radiological studies. Therapeutic hypothermia
is the only treatment currently shown to reduce death and/or disability
after a hypoxic-ischemic insult in newborn infants with moderate to severe
encephalopathy in the first 6 hours after birth. This intervention needs to be
implemented according to the established published protocols and guidelines.
Newborns with mild encephalopathy usually develop normally, while infants
with moderate to severe encephalopathy are more likely to develop long-term
neurologic sequela and morbidity.
Figure: Pathogenesis. The downward pointing blue line represents cascade of
events that occurs with oxidative stress and the downward black line depict
events associated with energy failure
Biography
Amal Zubani is a Consultant at King Faisal Specialist Hospital
and Research center, Jaddah, which is a tertiary care Hospital
located in Jeddah on the West Coast of the Kingdom of Saudi
Arabia. She is an Advisor and Active Member in different
committees in the Ministry of Health in Saudi Arabia. She
has graduated from King AbdulAziz University in Jeddah in
2000, and then she joined University of Manitoba, Winnipeg,
Canada as Resident then fellow. She has her Canadian board
in Paediatric and Perinatal Neonatal medicine in 2005 and
2007. Her major interest and research subjects are Nutrition
in Preterm Infant and their Nuero Developmental Outcome.
She has several publications and presentations nationally and
internationally.
Neonatal encephalopathy
Amal Zubani
King Faial Specialist Hospital and Research Center ), Saudi Arabia
Amal Zubani, J Nurs Health Stud 2018 Volume: 3
DOI: 10.21767/2574-2825-C4-011