Lesson of the week: Perinatal asphyxia and inadvertent neonatal intoxication from local anaesthetics given to the mother during labour

摘要

In 1998, Edwards and Nelson discussed whether asphyxia at birth really is an important cause of neonatal encephalopathy and wondered how often neurological impairment in children is due to perinatal hypoxia-ischaemia and how often to entirely different causes. We describe two cases of neonatal intoxication resulting from the administration of local anaesthetic to the mother during labour but which we initially diagnosed as perinatal asphyxia. We analyse here the major manifestations of acute poisoning in newborns and the clinical picture that could be misdiagnosed as perinatal asphyxia Early and correct diagnosis is recommended for allowing adequate treatment and a positive outcome and for ruling out the medicolegal aspect of perinatal asphyxias (law courts often have to decide whether a child's neurological impairment is the result of mismanagement of labour, leading to asphyxia).