Which clinical history findings indicate hypoxic-ischemic encephalopathy (HIE)?

Updated: Jul 18, 2018
  • Author: Santina A Zanelli, MD; Chief Editor: Dharmendra J Nimavat, MD, FAAP  more...
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The 1996 guidelines from the American Academy of Pediatrics (AAP) and American College of Obstetrics and Gynecology (ACOG) for hypoxic-ischemic encephalopathy (HIE) indicate that all of the following must be present for the designation of perinatal asphyxia severe enough to result in acute neurologic injury [8, 9] :

  • Profound metabolic or mixed acidemia (pH < 7) in an umbilical artery blood sample, if obtained

  • Persistence of an Apgar score of 0-3 for longer than 5 minutes

  • Neonatal neurologic sequelae (eg, seizures, coma, hypotonia)

  • Multiple organ involvements (eg, kidney, lungs, liver, heart, intestines)

In rare instances, some babies will not fit the aforementioned criteria and the timing of the insult cannot be precisely known; however early magnetic resonance imaging of the brain can sometimes provide some insights.

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