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NEONATOLOGY: MANAGEMENT, PROCEDURES, ON-CALL PROBLEMS, DISEASES, AND DRUGS - part 3

nong (có hoặc không có xuất huyết), teo vỏ não, u nang intraparenchymal (leukomalacia quanh não thất), và các dấu hiệu của tổn thương chất trắng, có tiên lượng kém hơn. Tỷ lệ khuyết tật là rất cao với u nang intraparenchymal, đặc biệt là nếu họ đang song phương và lớn. B. tăng trưởng chậm phát triển trong tử cung (IUGR). | dilatation with or without hemorrhage cortical atrophy intraparenchymal cysts periventricular leukomalacia and other signs of white matter injury have a poorer prognosis. The incidence of disabilities is very high with intraparenchymal cysts especially if they are bilateral and large. B. Intrauterine growth retardation IUGR . Although full-term infants who are small for gestational age SGA appear to have only a slightly higher risk of cerebral palsy and mental retardation they have an increased incidence of disorders of higher cortical function especially learning disability. Preterm SGA infants have a high incidence of cerebral palsy and mental retardation more similar to appropriate for gestational age AGA preterm infants with the same birth weight than to AGA preterm infants with the same gestational age Pena et al 1988 . The risk of neurodevelopmental disability in SGA infants is usually determined by the cause of IUGR timing of the insult and subsequent perinatal complications eg asphyxia hypoglycemia or polycythemia Allen 1984 . C. Asphyxia. Perinatal asphyxia is associated with later developmental disability but is frequently difficult to define. Apgar scores are useful in predicting the outcome only when they are very low score of 0-3 for extended periods of time 10 min in full-term newborns Nelson Ellenberg 1981 . Most outcome studies have focused on severely asphyxiated infants who required prolonged resuscitation or who were symptomatic as newborns. The mortality rate for this group is high 50 however 75 of the survivors are free of major handicaps. Those with handicaps usually have multiple handicaps including severe mental retardation spastic quadriplegia microcephaly seizures and sensory impairment. The degree of abnormality on neonatal examination electroencephalogram EEG and neuroimaging studies predicts neurodevelopmental outcome. D. Other risk factors. Other perinatal factors are less common but are associated with a high risk of disability. 1. .