Portman et al developed a scoring system that could be used to predict organ dysfunction associated with perinatal asphyxia. The study was done at the Childrens' Hospital in Denver Colorado.
Multi-organ dysfunction associated with perinatal asphyxia:
(1) renal failure
(2) meconium aspiration
(3) respiratory distress
(4) hepatic damage
(5) shock
(6) heart failure
(7) necrotizing enterocolitis
(8) intracranial hemorrhage
(9) coagulopathy
(10) acute encephalopathy (seizures, apnea, abnormal muscular tone)
(11) death
Infant selection criteria for score development:
(1) >= 36 weeks gestation
(2) excluded if congenital anomalies or sepsis present
Parameters:
(1) 5 minute Apgar score
(2) base deficit in mEq/L in an arterial blood gas sample during first hour after birth
(3) fetal monitoring in the 2 hours prior to delivery
|
Parameter |
Finding |
Points |
|
5 minute Apgar score |
> 6 |
0 |
|
|
5 - 6 |
1 |
|
|
3 - 4 |
2 |
|
|
0 -2 |
3 |
|
base deficit in mEq/L during first hour |
< 10 |
0 |
|
|
10 - 14 |
1 |
|
|
15 - 19 |
2 |
|
|
>= 20 |
3 |
|
fetal monitoring |
normal |
0 |
|
|
variable decelerations |
1 |
|
|
severe or atypical variable decelerations |
2 |
|
|
late decelerations |
2 |
|
|
prolonged bradycardia |
3 |
score =
= (points for Apgar score) + (points for base deficit) + (points for fetal monitoring)
Interpretation:
• minimum score: 0
• maximum score: 9
|
Score |
Morbidity |
|
>= 6 |
severe |
|
<= 5 |
moderate |
where:
• I would assume a score of 0 might be associated with no or mild morbidity.
Specialty: Pedatrics, Neurology
ICD-10: ,
