Skip to main content
Log in

Newer concepts and approaches to neonatal brain asphyxia

  • Symposium: Advances in Neonatology — I
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

The asphyxial injury to neonate brain seems to be mediated through a cascade of biochemical events during ischaemia—reperfusion which includes excitatory amino acids, free radicals and accelerated programmed cell death (Apoptosis). The diagnosis of asphyxia requires rigorous approach based on background clinical information, certain diagnostic tests and exclusion of alternative diagnosis which may have similar clinical presentation. The treatment currently employed for the management of birth asphyxia controversial and requires critical appraisal. The future strategies for management include a number of approaches based on putative mechanism for asphyxial brain injury but they are still being evaluated as research and should not be used for clinical purposes in human newborns as yet.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Committee on Obstetrics, Maternal and Fetal Medicine of the American College of Obstetrics: Utility of umbilical cord blood acid-based assessment.ACOG Committee Opinion, February 1991.

  2. Bax M, Nelson KB. Birth Asphyxia: A Statement.Dev Med Child Neurol 1993; 35: 1023–1024.

    Google Scholar 

  3. Birth Asphyxia. MI Levene. In: David TJ, Ed.Recent Advances in Pediatrics No. 13. Churchill Livingstone 1995. pp. 13–27.

  4. Lou HC. Hypoxic-haemodynamic pathogenesis of brain lesions in the newborn.Brain and Development 1994; 16: 423–431.

    Article  PubMed  CAS  Google Scholar 

  5. Predictors of neonatal encephalopathy in full term infants. Adamson SJ, Alessandri LM, Badawai N, Burton PR, Pemberton PJ, Stanley F.BMJ 1995; 2: 598–602.

    Google Scholar 

  6. Lou HC, Hansen D, Jensen F,et al. Prenatal maternal stress affects human fetal brain development. In: Lou H, Greisen G, Larsen F eds.Benzon Symposium No. 37 Brain lesions in the newborn. Copenhagen: Munksgaard, 1994: 247–252.

    Google Scholar 

  7. Marks KA, Edwards AD. Cerebral protection after hypoxia-ischaemia in newborn infants. In:Current Medical Literature— padiatrics. The Royal Society of Medicine. Vol. 7, No. 4, 1994.

  8. D'Souza SWD. Excitatory amino acids in neonatal brain: Contributions to pathology and therapeutic strategies.Arch Dis Child 1995; 72: F147–150.

    Google Scholar 

  9. Saugstad OD. Neonatal oxygen radical disease. In: David TJ, Ed..Recent advances in padiatrics, Vol 10 Edinburgh: Churchill Livingstone, 1991; 173–187.

    Google Scholar 

  10. Raff MC, Barres BA, Burne JF, Coles HS, Ishizaki Y, Jacobson MD. Programmed cell death and the control of cell survival— lesson from the nervous system.Science 1993; 262: 695–700.

    Article  PubMed  CAS  Google Scholar 

  11. Proceedings of the 5th International Conference on Fetal and Neonatal Physiological Measurement. Keele University, Keele, Staffordshirdshire, UK, 2–5 September 1995.

  12. Staub F, Mackert B, Kempski O, Peters J, Baethmann. A swelling and death of neuronal cells by lactic acid.J Neurol Sci 1993; 119: 79–84.

    Article  PubMed  CAS  Google Scholar 

  13. Reeves I, Mujsce D, Vannucci RC. Extreme hyperglycaemia protects the perinatal brain from hypoxic-ischaemic damage.Pediatr Res 1992; 31: 352 A.

    Google Scholar 

  14. Busto R, Globus My, Dietrich WD, Martinez E, Valdes I, Ginsberg MD. Effect of mild hypothermia on ischaemia-induced release of neurotransmitters and free fatty acids in rat brain.Stroke 1989; 20: 904–910.

    PubMed  CAS  Google Scholar 

  15. Whitelaw A, Karlsson BR, Haaland K, Dahlin I, steen PA, Thoresen M. Hypocapnia and cerebral ischaemia in hypotensive newborn piglets.Arch Dis Child 1991; 66: F1110–1114.

    Article  Google Scholar 

  16. Levene MI. Role of excitatory amino acid antagonists in the management of birth asphyxia.Biol Neonate 1992; 62: 248–251.

    Article  PubMed  CAS  Google Scholar 

  17. Randomised Asphyxia Study (RAST) Pilot phase 1995.Yorkshire Clinical Trials and Research Unit, Arthington House, Hospital Lane, Leeds, UK.

  18. Palmer C, Towfighi J, Roberts RL. Heitjan DF. Allupurinol Administered After inducing Hypoxia-ischaemic reduces brain injury in 7-day-old rats.Pediatr Res 1993; 33: 405–411.

    Article  PubMed  CAS  Google Scholar 

  19. Dragunow M, Beilharz EJ, Mason B, Lawlor P, Abraham W, Gluckman PD. Brain-derived neurotrophic factor expression after long-term potentiation.Neurosci Lett 1993; 160: 232–236.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sinha, S.K., Singh, J. Newer concepts and approaches to neonatal brain asphyxia. Indian J Pediatr 65, 55–62 (1998). https://doi.org/10.1007/BF02849695

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02849695

Key words

Navigation