A 34-week gestation infant is delivered via emergency C-section for placental abruption. Apgar scores are 1 at 1 minute and 4 at 5 minutes. Therapeutic hypothermia (cooling) is initiated. Which of the following is a CONTRAINDICATION to therapeutic hypothermia?
- A Birth weight 2100 grams
- B Gestational age 34 weeks ✓
- C Seizures within first hour of life
- D pH 6.95 on cord blood gas
Correct answer: B. Gestational age 34 weeks
Explanation
Therapeutic hypothermia (whole-body cooling to 33–34°C for 72 hours) is indicated for hypoxic-ischaemic encephalopathy in infants ≥36 weeks gestation. A gestational age of 34 weeks is a contraindication because safety and efficacy data for hypothermia in infants <36 weeks are lacking, and these infants have immature thermoregulatory mechanisms and greater vulnerability to complications of cooling. Seizures, low pH, and low birth weight are not contraindications per se.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.