ACOG Criteria


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  • In 2003, the American College of Obstetrics and Gynecology and the American Academy of Pediatrics recommended adoption of a definition of term intrapartum asphyxia developed by an international task force.
  • The definition requires that all four parameters must be met in order to diagnose intrapartum asphyxiation in a term fetus. These include metabolic acidosis, diagnosis of specific types of cerebral palsy correlated with the types of asphyxia damage seen in term fetal brains, early seizures and other neurological signs, and exclusion of all other causes.
  • There are other criteria that suggest an intrapartum timing of injury, nonspecific to asphyxia event. These include a hypoxic event immediately before or during birth, sudden, sustained bradycardia or loss of variability along with persistent, late, or variable decelerations, low APGAR scores (<3) beyond 5 minutes, multisystem organ involvement within 72 hours of birth, and early brain imaging showing acute, non-focal cerebral abnormalities.