Table 2.

ACOG essential criteria

ACOG essential criteria to conclude NE related to “an acute intrapartum event” (must meet all four)
1. Evidence of a metabolic acidosis in fetal umbilical cord arterial blood obtained at delivery (pH < 7 and base deficit ≥ 12 mMol/L)
2. Early onset of severe or moderate neonatal encephalopathy in infants born at 34 or more weeks of gestation
3. Cerebral palsy of the spastic quadriplegic or dyskinetic type
4. Exclusion of other identifiable etiologies such as trauma, coagulation disorders, infectious conditions, or “genetic disorders”
Criteria that collectively suggest an intrapartum timing (within close proximity to labor and delivery (e.g., 0–48 h) but are nonspecific as to axphyxial insults
1. A sentinel (signal) hypoxic event occurring immediately before or during labor
2. A sudden and sustained fetal bradycardia or the absence of fetal heart rate variability in the presence of persistent, late, or variable decelerations, usually after a hypoxic sentinel event when the pattern was previously normal
3. Apgar scores of 0–3 beyond 5 min
4. Onset of multisystem involvement within 72 h of birth
5. Early imaging study showing evidence of acute non-focal “cerebral abnormality”