新生儿生后突发意外衰竭

Sudden unexpected postnatal collapse in a neonate

摘要:

3日龄健康足月顺产女婴，Apgar评分：1 min 10分、5 min 10分，生后第3天凌晨母婴同床时突发心跳、呼吸停止，经积极抢救恢复自主呼吸及心跳，复苏时间持续约10 min，复苏后患儿反应差并出现抽搐，血气分析提示代谢性酸中毒，振幅整合脑电图提示爆发-抑制图形，诊断为新生儿生后突发意外衰竭。该患儿经亚低温及对症支持治疗，病情好转。该文首次报道国内1例新生儿生后突发意外衰竭，并对其危险因素、病理生理机制、预防和治疗措施进行总结。

Abstract:

A healthy full-term female neonate, aged 3 days and born by vaginal delivery (with a 1-minute Apgar score of 10 and a 5-minute Apgar score of 10), had unexpected cardiac and respiratory arrests in the early morning on day 3 after birth and recovered to spontaneous breathing and heartbeat after a 10-minute resuscitation. The child had poor response and convulsion after resuscitation. Blood gas analysis showed metabolic acidosis, and amplitude-integrated EEG showed a burst-suppression pattern. She was diagnosed with sudden unexpected postnatal collapse but improved after hypothermia and symptomatic/supportive treatment. This article reports the first case of sudden unexpected postnatal collapse in China and summarizes related risk factors, pathophysiological mechanisms, and preventive and treatment measures of this disorder.