Table 1.

Current and possible future tools for assessing neonatal brain health in the delivery room (DR).

	Method	Strengths	Limitations
Clinical assessment	Muscle tone and reflex irritability as part of the APGAR score	Immediate score	Subject to inter- and intra-rater variability
Cerebral blood flow	Ultrasound Doppler of cerebral or carotid artery	Immediate assessment of cerebral blood flow	Technically challenging and continuous data acquisition not feasible
Near infrared spectroscopy (NIRS)	Non-invasive monitoring of cerebral tissue oxygenation by application of NIRS pad to frontal area	Feasible to obtain continuous reliable data in the DR	Wide range for normative values
		Normative values established
Fetal electroencephalography (EEG)	Application of >1 EEG electrodes to fetal scalp during labor	Would allow for real time assessment of fetal brain health	Technically challenging
			Can only be applied during late stages of labor
			Not established as method for assessing fetal health
			Paucity of normative data
EEG	Application of >1 EEG electrodes to neonatal scalp after delivery	Would allow for real time assessment of neonatal brain health	Technically challenging
			Paucity of normative data
		Established method for monitoring neonatal brain health in neonatal care