Pat Number | G A (weeks) | Age at scan | Gender | A/natal sonar | A/natal risk fact | Prolonged labour | Epidural | Delivery | HIE (grade) | BW (g) | A/S 1 min | A/S 5 min | Vent | Seizures | Postnatal Ultrasound | Post-natal or Follow-up MRI/CT | Other |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
007 | 38/40 | 6 | 1 | Nil performed | HIV, Prior C/S X2 for CPD | 1st and 2nd stage | Yes | C/S | 3 | 3000 | 0 | 1 | Bag and SIMV | Early and severe | Not recorded | Not recorded | Foetal decelerations/severe bradycardia. Prolonged labour followed by delay in C/S (40 min) Severe maternal blood loss during C/S |
95 | 41/40 | 12 | 1 | Normal 18-week scan | Post-mature Nil else | 1st and 2nd stage | No | NVD | 3 | 3500 | 4 | 5 | Oxygen by NP | Early and severe | U/s on day 15 and at 3 months showed hypoxic–ischaemic brain injury | Not recorded | CPD in a primigravida. Neonatal anaemia required transfusion. LP on Day 5 was normal |
109 | 38/40 | 6 | 1 | Normal scan performed at local clinic | HIV on antiretroviral therapy | 1st and 2nd stage | No | NVD with vacuum | 3 | 4400 | 6 | 9 | Oxygen by NP | Early and severe | Post-natal ultrasound was normal on day 2 | CT scan demonstrated fronto-parietal cortical atrophy at 5 months age | Prolonged second stage with failed vaginal delivery of large baby. Required vacuum extraction with multiple attempts |
149 | 38/40 | 9 | 0 | Normal scan performed at local clinic | Nil | 1st and 2nd stage | No | NVD | 3 | 2500 | 4 | 8 | Oxygen by NP | Early and severe | Not recorded | CT Scan confirmed hypoxic brain injury with basal ganglia and cortical involvement | CPD in a primigravida Prolonged labour Normal LP |
150 | 41/40 | 7 | 1 | Normal scan at 25 weeks—by radiologist | Hyper Tension Post-mature | 2nd stage | Yes | C/S | 3 | 3800 | 3 | 5 | SIMV | Early and severe | Normal ultrasound on day 2 | Not recorded | Decreased foetal movement, tachycardia and complex variable decelerations. Late Foetal bradycardia, maternal hypotension |
177 | 40/40 | 7 | 0 | Normal scan performed at local clinic | Prior intra-uterine death | 2nd stage | No | NVD With forceps | 3 | 3400 | 3 | 5 | Oxygen by NP | Early and severe | Not recorded | Not recorded | Severe delay in second stage—140 min. Intravenous Pitocin. Repeated forceps application needed to deliver. Cord found wrapped around neck |
190 | 38/40 | 9 | 0 | Normal scan performed at local clinic | Nil | 1st and 2nd stage | No | NVD | 3 | 3500 | 3 | 4 | Oxygen by NP | Early and severe | Not recorded | Not recorded | Severe caput and moulding related to CPD |
219 | 41/40 | 5 | 0 | Normal scan performed at local clinic at 17 weeks | Maternal obesity BMI 45 | 1st and 2nd stage | No | NVD | 3 | 2860 | 4 | 5 | NCPAP | Early and severe | Post-natal ultrasound was normal | MRI showed diffuse severe cortical atrophy, white matter loss and corpus callosum thinning | Pitocin augmented delivery. Whole body cooling commenced at 2 h of life, continued for 72 h after delivery. Required intravenous inotropic support |
229 | 40/40 | 5 | 0 | Normal scan performed at local clinic | HIV positive on antiretroviral therapy | 1st and 2nd stage | Yes | C/S | 3 | 2260 | 2 | 3 | Oxygen by NP | Early and severe | Not recorded | Not recorded | IUGR is suspected given the foetal weight and gestational age. HIV may be associated with chorioamnionitis. Prolonged first and second stage, augmented by oxytocin and epidural used |
234 | 40/40 | 3 | 0 | Normal scan performed at Clinic at 20 weeks | Nil | 2nd stage | No | NVD | 3 | 3430 | 6 | 7 | Bag | Early and severe | U/S normal after birth. U/S on day 8 showed oedema | CT scan showed no features of metabolic or genetic disorders. Thin Corpus callosum | Prolonged second stage of labour Foetal distress. MSL. Aspiration |
297 | 38/40 | 2 | 1 | Normal second trimester scan by ob/gynae | Nil | 2nd stage | Yes | C/S | 3 | 3130 | 1 | 3 | Bag | Early and severe | U/S on day 1 was normal. U/S on day 3 showed oedema | MRI on day 15 showed APA changes CT scan at 6 months showed no progressive changes | Prolonged 2nd stage. Foetal distress. Failed forceps extraction. Cephalhematoma. Head cooling done |