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HIE — RACP Paediatrics MCQ

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EasyNeonatalHIERACP Paediatrics

A term newborn has a difficult delivery with shoulder dystocia and low Apgar scores (2 at 1 min, 5 at 5 min). Cord pH is 6.9. At 6 hours of age the infant develops subtle seizures (lip smacking, cycling movements). What is the most likely cause?

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Correct answer: E — Hypoxic ischaemic encephalopathy

Seizures in the first 24 hours of life following a difficult delivery with evidence of perinatal asphyxia (low Apgar scores, cord acidosis) are most commonly due to hypoxic ischaemic encephalopathy (HIE). If ≥35 weeks gestation with moderate-severe HIE, therapeutic hypothermia (cooling to 33.5°C for 72 hours) should be commenced within 6 hours of birth.

Reference: RCH Melbourne – 2023 – Neonatal Seizures CPG; ANZCOR – 2024 – Guideline 13.9 Post-resuscitation Care