Wednesday, March 9, 2011

Perinatal hypoxic-ischemic encephalopathy (EHIP) Treatment

Perinatal hypoxic-ischemic encephalopathy (EHIP)
Prophylactic treatment is mandatory and includes: - Prevention of fetal asphyxia; - Recognition of risk factors; - Antepartum fetal monitoring during labor; - Prompt in delivery room resuscitation.
Supportive treatment consists of: - Adequate ventilation; - Prevention of hypoxemia, hypercapny, hyperammonaemia; - Maintaining an optimal infusion; - Keeping blood sugar within normal limits; - Seizure control; - Avoidance of fluid overload.
Experimental therapies can be applied as follows: - Antagonists of free radicals; - Amino acid antagonists inhibitors; - Calcium channel blockers; - Magnesium sulfate; - Hypothermia in the brain; - Nitric oxide synthesis inhibitors; - Transplant.
In evoultia disease can occur a number of complications such as selective neuronal necrosis, status marmoratus, brain damage parasagitale, periventricular leukomalacia, multifocal ischemic brain injury.
Prognosis is impossible to determine because they did not know the duration and extension of brain insult and injury. Among the useful prognostic factors include: - Monitoring data and fetal cord pH; - Apgar at 5, 10 and 15 minutes; - Neonatal neurological syndromes (severity, duration 1-2 weeks, early-onset seizures in 12 hours, difficulty in treatment); - Signs of intracranial hypertension; - Imaging data; - Electroencephalogram; - Biochemical markers. The prognosis is good for determining the severity and duration of neurological syndrome and seizures.

No comments:

Post a Comment