Case 4.2

An infant was born at 34 weeks and 5 days via emergency caesarean section due to fetal bradycardia and placental abruption. The baby was flaccid at birth. Apgar scores were 1, 2, and 7 at 1, 5, and 10 minutes, respectively. The umbilical venous gas pH was 7.0, with a base deficit of -23 mmol/L and lactate of 16 mmol/L.

You connected the baby to the aEEG, which showed the following:

What is the background activity?

Baby had an initial normal cUS (A). On the second day of life, after a drop in hematocrit, a massive Grade III intraventricular hemorrhage (IVH) with parenchymal involvement was detected (B).

And the aEEG now shows the following pattern:

What is your diagnosis?

What would be your first line of treatment?