Neurological damage arising from intrapartum hypoxia/acidosis

Best Pract Res Clin Obstet Gynaecol. 2016 Jan:30:79-86. doi: 10.1016/j.bpobgyn.2015.04.011. Epub 2015 Jun 21.

Abstract

Complications occurring at any level of foetal oxygen supply will result in hypoxaemia, and this may ultimately lead to hypoxia/acidosis and neurological damage. Hypoxic-ischaemic encephalopathy (HIE) is the short-term neurological dysfunction caused by intrapartum hypoxia/acidosis, and this diagnosis requires the presence of a number of findings, including the confirmation of newborn metabolic acidosis, low Apgar scores, early imaging evidence of cerebral oedema and the appearance of clinical signs of neurological dysfunction in the first 48 h of life. Cerebral palsy (CP) consists of a heterogeneous group of nonprogressive movement and posture disorders, frequently accompanied by cognitive and sensory impairments, epilepsy, nutritional deficiencies and secondary musculoskeletal lesions. Although CP is the most common long-term neurological complication associated with intrapartum hypoxia/acidosis, >80% of cases are caused by other phenomena. Data on minor long-term neurological deficits are scarce, but they suggest that less serious intellectual and motor impairments may result from intrapartum hypoxia/acidosis. This chapter focuses on the existing evidence of neurological damage associated with poor foetal oxygenation during labour.

Keywords: cerebral palsy; foetal hypoxia/acidosis; hypoxic–ischaemic encephalopathy; neonatal acidosis.

Publication types

  • Review

MeSH terms

  • Acidosis / complications
  • Acidosis / diagnosis*
  • Brain / pathology
  • Cardiotocography
  • Cerebral Palsy / etiology
  • Cerebral Palsy / pathology
  • Cerebral Palsy / prevention & control*
  • Female
  • Fetal Hypoxia / complications
  • Fetal Hypoxia / diagnosis*
  • Fetal Monitoring
  • Humans
  • Hypoxia-Ischemia, Brain / etiology
  • Hypoxia-Ischemia, Brain / pathology
  • Hypoxia-Ischemia, Brain / prevention & control*
  • Infant, Newborn
  • Magnetic Resonance Imaging
  • Neuroimaging
  • Pregnancy