Levene et al graded post-asphyxial encephalopathy in full-term infants using a modification of the Fenichel grading scheme. The authors are from Leicester University in England.
Full term = 37 to 42 weeks of gestation
The clinical features typically progress in severity before recovery. The assigned grade is based on the most severe abnormalities seen.
Parameters:
(1) mental status
(2) muscle tone
(3) seizure activity
(4) sucking and feeding
(5) respirations
(6) recovery
Parameter
Grade I (mild)
Grade II (moderate)
Grade III (severe)
mental status
hyperalert, irritable
lethargic
comatose
muscle tone
mild hypotonia
marked abnormalities
marked hypotonia
seizure activity
none
present
prolonged
sucking and feeding
poor sucking
disinterest in feeding, requires tube feeding
requires prolonged tube feedings
respirations
normal
failure to maintain spontaneous respirations
recovery
within 3 days after birth
improved more than 3 days after birth
very slow or not at all
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