Question
Patient Age: A 40-day-old full-term baby born via cesarean section due to premature rupture of membranes. Jaundice appeared within 24 hours, and was treated in the neonatal department. Since we are in a small county town and there are no facilities for further diagnosis, I would like to ask, what are the symptoms of hypoxic encephalopathy, could it be a misdiagnosis, and what should the next step of treatment be?
Answer
Neonatal hypoxic-ischemic encephalopathy refers to hypoxic-ischemic damage (indicating gestational age from 28 weeks to 1 week post-birth) caused by perinatal asphyxia. According to the severity of the condition, it is classified into mild, moderate, and severe: Mild: Overly excited state, irritability, excitement, and hyperactivity (trembling, shaking), normal muscle tone, active Moro reflex, normal reflexes, and smooth breathing without fear. Symptoms gradually disappear within 3 days, with a good prognosis. Moderate: Depressed state, drowsiness or coma, low muscle tone; 50% of cases have seizures, apnea, and decreased suckling reflex. Full-term infants have higher lower limb muscle tension than the severity of the lower limbs. If symptoms persist for 7 to 10 days, there may be sequelae. Severe: The child is in a coma state with extremely low muscle tone