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Antenatal antecedents of moderate or severe neonatal encephalopathy in term infants – a regional review
Author(s) -
WEST Claire R.,
CURR Liz,
BATTIN Malcolm R.,
HARDING Jane E.,
MCCOWAN Lesley M.,
BELGRAVE Sue,
KNIGHT David B.,
WESTGATE Jenny A.
Publication year - 2005
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.2005.00390.x
Subject(s) - medicine , neonatal encephalopathy , encephalopathy , pediatrics , audit , pregnancy , cohort , gestation , obstetrics , gestational age , cohort study , management , biology , economics , genetics
Background: Regional audits of term infants with neonatal encephalopathy (NE) provide an opportunity to examine issues related to causation and quality of care. Aim: To document antenatal and intrapartum antecedents in a contemporary cohort of term infants with moderate or severe neonatal encephalopathy. Methods: Term infants admitted with moderate‐severe neonatal encephalopathy over 4 years were identified. The clinical records were reviewed for information about the pregnancy and birth including interpretation of monitoring and subsequent management of the labour and delivery. Results: Fifty‐two maternal records were reviewed. No mothers were diabetic or had gestations > 42 weeks, but 17% of the babies were small for gestational age (SGA). The cohort had evidence of antenatal hypoxia in 15%, a sentinel event in 25% and suboptimal fetal monitoring practice in at least 42% of cases. Conclusions: Peripartum events were the major contributors to neurological damage in infants with neonatal encephalopathy. Suboptimal fetal monitoring practice and sentinel events remain the most common contributors. Ongoing education and training to address these issues should be available to all involved with intrapartum care in New Zealand.