Emeritus Full Professor of Pediatrics and Neurology, Rainbow Babies and Children's Hospital/MacDonald Hospital for Women, University Hospitals Cleveland Medical Center, Case Western Reserve University, School of Medicine, 11100 Euclid Avenue Cleveland, Ohio, 44106, USA.
Semin Fetal Neonatal Med. 2020 Aug;25(4):101137. doi: 10.1016/j.siny.2020.101137. Epub 2020 Jul 4.
Clinical signs and neuroimaging patterns associated with the fetal inflammatory response syndrome (FIRS) worsen or mimic the clinical repertoire after intrapartum hypoxic-ischemic encephalopathy (HIE) during labor and/or parturition. Diagnostic considerations expressed as neonatal encephalopathy (NE) must consider chronic as well as acute factors associated with FIRS. Trimester-specific factors adversely alter the interactions of the maternal/placental/fetal (MPF) triad and influence the postnatal phenotype of FIRS. Anticipatory guidance for families by clinicians caring for survivors with FIRS, as well as researchers, must consider acute and chronic effects that influence neurologic outcome. Novel neurotherapeutic interventions must include prenatal preventive as well as peripartum/postnatal rescue and repair strategies to effectively reduce the presence and severity of sequelae from FIRS.
与分娩期间和/或分娩期间缺氧缺血性脑病 (HIE) 相关的胎儿炎症反应综合征 (FIRS) 的临床体征和神经影像学模式会恶化或模仿临床疾病谱。作为新生儿脑病 (NE) 表达的诊断注意事项必须考虑与 FIRS 相关的慢性和急性因素。特定于妊娠中期的因素会改变母体/胎盘/胎儿 (MPF) 三联体的相互作用,并影响 FIRS 的产后表型。为 FIRS 幸存者提供护理的临床医生和研究人员必须为家属提供预期指导,必须考虑影响神经结局的急性和慢性影响。新型神经治疗干预措施必须包括产前预防以及围产期/产后救援和修复策略,以有效减少 FIRS 后遗症的存在和严重程度。