Medicine for life

  Hypoxic Ischemic Encephalopathy : state of hypoxia (arterial O2 lack), Ischemia (lack of perfusion) affecting CNS (Hypoxic Ischemic Encephalopathy) wich occurs in infants exposed to perinatal asphyxia presented by decreased Apgar score, cyanosis, pallor, convolutions, hypotonia, apnea within 12 hours after birth (variable severity). Perinatal asphyxia:   hypoxemia-hypercapnia and metabolic acidosis due to disturbed gas exchange in the placenta or lungs. lung expansion doesn't occur within minutes after birth and is unable to establish ventilation and pulmonary perfusion. manifested by increase respiratory effort(1ry hyperpnea) followed by 1ry apnea 1minute then rythmic gasping 8-10 gasps/min. for several minutes then 2ry apnea occurs. Criteria of diagnosis ( profound metabolic or mixed acidosis and low Apgar score < 3 in 1st 5 minutes). Pathology of HIE: Hypoxia increases glycolysis in brain cells and decreases cerebral ATP leading to an increased amount of lactate, ...

 HISTORY taking and Neonatal examination: Perinatal history: Prenatal: ( maternal history during pregnancy): -Age. -Blood group. -Illness. -Drugs, X-rays. -Trauma. Natal: _Anathesthesia. -Site of labor. -Type of labor. -Duration. -Premature rupture of the membrane. Postnatal: _Condition of the baby. -resuscitation. Past history: -History of abortions. -IUFD or premature. Family history: -Number of kids. -Similar condition. -Consanguinity. -Inherited diseases. ** Newborns are examined immediately after birth to check for major abnormalities and then should be examined with a complete physical examination within 24 hours of delivery. EXAMINATION: Quick examination. Detailed examination. Special examination. Quick examination : (in the delivery room). Agar score : -At 1 and 5 minutes. -At 10 and 20 minutes if the score at 5 minutes <7. -Check the baby's activity, pulse, grimace, appearance, and respiratory rate. -Placed on the servo with neck baby. Color: -An indicator of cardiopul...