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Foal Birth Transitions & Neonatal Maladjustment Syndrome

Neonatal maladjustment syndrome (NMS), also known as hypoxic-ischaemic encephalopathy, perinatal asphyxia syndrome, and neonatal encephalopathy [1,2], is reportedly the most common problem observed in neonatal foals during the first 72 h after birth [2]. Neurological signs of NMS can range from subtle to severe and may include convulsions/seizures, weakness, and behavioural abnormalities [3]. While in severe cases an early death is likely, recovery is possible with human

intervention, especially in less severe cases [1,4]. Neonatal maladjustment syndrome is mainly attributed to cerebral hypoxia and ischaemia leading to neuronal cell death shortly before, during

or after birth [1,2,4]. Signs of central nervous system (CNS) disease in equine neonatal patients have been attributed to hypoxic encephalopathy in 92% of cases, of which 59% experienced dystocia or premature placental separation [5]. Other possible causes may include post natal persistence

of or reversion to an inhibited fetal state of cerebral cortical function [2] and meningitis, congenital lesions, CNS haemorrhage or oedema, metabolic insults, sepsis, endotoxins, and in utero infections [6]. Thus, NMS appears to represent a number of different but related conditions that reflect untoward responses to the exceptional physiological challenges that precede, accompany and follow expulsion from the uterus at birth.

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