Encephalopathy (antenatal period)

Encephalopathy is a term that means brain disease, damage, or malfunction. A very broad range of symptoms may be seen in patients with this diagnosis. The symptoms can be mild, such as memory loss or subtle personality changes, or they can be more severe and include dementia, seizures, coma, and death. In general, encephalopathy is manifested by an altered mental state that is sometimes accompanied by physical manifestations (for example, poor coordination of limb movements).

The term “encephalopathy” is very broad and in most cases, is preceded by various terms that describe the reason, cause, or special condition of the patient which led to brain malfunction. For example, anoxic encephalopathy means brain damage due to lack of oxygen.

Encephalopathy occurs in newborns when there is a diminished supply of oxygen to the brain during childbirth. This damage is often permanent and can be fatal.

What Causes Encephalopathy during Childbirth?

Oxygen deprivation to a baby’s brain can take place during childbirth due to many different events. The umbilical cord may be compressed or prolapsed; there may be abdominal trauma, placental abruption, or seizures in the mother. Sometimes the baby’s time in the birth canal has been prolonged, or a C-section has been delayed. Although the exact cause will require careful investigation, serious damage may have resulted to the infant’s brain due to a prolonged reduction in oxygen. Signs indicating the condition has occurred may be tone and reflex abnormalities, apnea, or seizures. Some birth injuries that result from this disorder are cerebral palsy, asphyxia, and hypoxic-ischemic encephalopathy. Hypoxia involves a lack of oxygen to organs and tissues; ischemia is a restriction of oxygen and blood flow, which results in organ or tissue damage.

How is Neonatal Encephalopathy Diagnosed?

Encephalopathy can be extremely difficult to diagnose during childbirth, as many factors may contribute to this condition. Health care professionals are responsible for exercising care throughout labor and delivery, and have such tools available to them as the electronic fetal monitor, which is used to follow the condition of the fetus, as well as the mother. Fetal tracings will show any sudden decrease in the baby’s heart rate, alerting staff of the possible need for immediate action.

Situations involving any compromise to the baby’s oxygen supply during labor and delivery can cause very serious brain injury. For this reason, baby’s who have suffered from encephalopathy, as a result of negligent care, must have means to ensure future medical needs are satisfied.

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