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Papers by Matthew Ellis
Seminars in Neonatology, 1999
Neonatal encephalopathy (NE) is a more specific marker than low Apgar score for significant perin... more Neonatal encephalopathy (NE) is a more specific marker than low Apgar score for significant perinatal asphyxia in term infants. The proportion of NE associated with intrapartum hypoxia is probably higher in low income than high income settings. The perinatal mortality rate associated with asphyxia ranges typically between 10 and 20 per 1000, and the prevalence of neonatal encephalopathy between 5 and 25 per 1000 total births in low income countries. The impact of traditional birth attendant programmes is limited by the low specificity of maternal risk assessment schemes and poor referral pathways, although there is emerging evidence of a role for domiciliary resuscitation. Primary prevention in hospital settings should focus on intrapartum monitoring and appropriate management guidelines, including amnioinfusion for meconium-stained liquor. Resuscitation guidelines should emphasize measures to minimize meconium aspiration in the depressed infant. Neuroprotective strategies are entering the stage of clinical trials. Appropriate neonatal management guidelines for the developing country clinician are described.
Seminars in Neonatology, 1999
Neonatal encephalopathy (NE) is a more specific marker than low Apgar score for significant perin... more Neonatal encephalopathy (NE) is a more specific marker than low Apgar score for significant perinatal asphyxia in term infants. The proportion of NE associated with intrapartum hypoxia is probably higher in low income than high income settings. The perinatal mortality rate associated with asphyxia ranges typically between 10 and 20 per 1000, and the prevalence of neonatal encephalopathy between 5 and 25 per 1000 total births in low income countries. The impact of traditional birth attendant programmes is limited by the low specificity of maternal risk assessment schemes and poor referral pathways, although there is emerging evidence of a role for domiciliary resuscitation. Primary prevention in hospital settings should focus on intrapartum monitoring and appropriate management guidelines, including amnioinfusion for meconium-stained liquor. Resuscitation guidelines should emphasize measures to minimize meconium aspiration in the depressed infant. Neuroprotective strategies are entering the stage of clinical trials. Appropriate neonatal management guidelines for the developing country clinician are described.