On 17/7, a representative from Phu Tho Obstetrics and Pediatrics Hospital stated that the mother experienced no abnormalities during her pregnancy and delivered at 39 weeks gestation. After birth, the infant cried weakly, showed whole-body cyanosis, and achieved an Apgar score of only 5 points at the first minute.

Doctors initiated intensive neonatal resuscitation immediately in the delivery room. Three minutes later, the infant's circulatory and respiratory conditions improved. The patient received oxygen support and was transferred to Phu Tho Obstetrics and Pediatrics Hospital for further treatment.

At the hospital, the infant's respiratory distress progressed, sucking reflexes diminished, and seizures began. Recognizing these as symptoms of hypoxic-ischemic encephalopathy after birth asphyxia, the treatment team held an urgent consultation with the Neonatal Center at the National Children's Hospital. Experts unanimously diagnosed the infant with moderate to severe hypoxic-ischemic encephalopathy and prescribed controlled hypothermia (cooling) during the "golden window" after birth.

Controlled hypothermia, also known as the "winter sleep" technique, uses specialized equipment to precisely maintain the infant's body temperature at 33.5°C for 72 hours, followed by gradual rewarming according to a standard protocol. This controlled reduction in body temperature slows down brain cell metabolism, limits secondary damage reactions after oxygen deprivation, thereby reducing the risk of neuronal necrosis and improving long-term neurological prognosis.

Throughout the treatment, the infant's vital signs, respiratory function, circulation, neurological status, and potential metabolic disorders during hypothermia were continuously monitored. After 72 hours of combined resuscitation and intensive care, the infant breathed normally, and sucking and other neonatal reflexes showed significant improvement; seizures no longer occurred.

A post-treatment magnetic resonance imaging (MRI) scan of the brain confirmed good control over brain parenchymal lesions. Tests evaluating infection status, liver and kidney function, and other organs all fell within normal limits.

The infant receiving treatment at the hospital. Photo: Hospital provided

Doctor Duong Thi Ha, from the Neonatal Department, explained that controlled hypothermia is a recommended treatment in international guidelines for full-term or near-term newborns with moderate to severe hypoxic-ischemic encephalopathy. Treatment effectiveness largely depends on appropriate patient selection and implementation within the golden window, ideally within the initial six hours after birth. When performed correctly, this technique significantly reduces mortality rates and the risk of neurological sequelae such as cerebral palsy, epilepsy, or psychomotor developmental delay.

Hypoxic-ischemic encephalopathy is a leading cause of mortality and neurological sequelae in newborns. Therefore, early identification, proper initial resuscitation, timely referral, and implementing controlled hypothermia during the golden window are crucial for treatment outcomes.

Thuy Quynh