Abstract:
A male infant was born at 40 and 4/7 weeks of gestation via caesarean section for non-reassuring foetal heart tracing. The infant was non-responsive in the delivery room. with no heart rate detected until 40 min of life. The infant\'s physical examination and laboratory findings were consistent with severe hypoxic-ischaemic encephalopathy. Given the presumption of a very poor neurological prognosis, redirection to comfort care was recommended to the family. However, the family opted for intensive care. The infant underwent therapeutic hypothermia and management of multiorgan dysfunction. The infant survived with no findings of ischaemic injury on MRI and was discharged with no respiratory support and taking all feeds by mouth, with normal development at a year and a half of age. This case report demonstrates the imperative to understand family goals and to acknowledge the need for ongoing humility in providing prognostication for families.
摘要:
一名男婴在妊娠40周和4/7周时通过剖腹产出生,以进行不放心的胎儿心脏追踪。婴儿在分娩室没有反应。直到生命40分钟才检测到心率。婴儿的体格检查和实验室检查结果与严重缺氧缺血性脑病一致。假设神经预后很差,建议家人重定向到舒适护理。然而,这个家庭选择了重症监护。婴儿接受了治疗性低温和多器官功能障碍的管理。婴儿幸存下来,MRI没有发现缺血性损伤,出院时没有呼吸支持,所有的进食都是通过口。一岁半的正常发育。本案例报告表明,必须了解家庭目标,并承认在为家庭提供预测方面需要持续谦卑。