Hypoxic-Ischaemic Encephalopathy (HIE)

HIE is where there's brain damage resulting from hypoxia around birth. It can become permanent brain damage, which can in-turn present with Cerebral Palsy.

HIE should be suspected when there are events that could cause hypoxia during birth, acidosis, poor APGAR scores, or evidence of multi-organ failure shortly after birth.

Causes of this include anything that leads to hypoxia of the brain:

• Maternal shock

• Antepartum haemorrhage

• Cord prolapse

• Nuchal cord (Umbilical cord wrapped about neck)

Management

Therapeutic Hypothermia - This helps protect the brain as it reduces inflammation and prevents further damage by a secondary re-perfusion injury after the acute hypoxic injury.

Complications

The main complication here is Cerebral Palsy. Features that indicate that there's an increased risk of this are lethargy, hypotonia/flaccidity, seizures, reduced consciousness, and reduced/absent reflexes.