Table 1 Participants’ Inclusion and exclusion criteria for treatment

1. Enrollment criteria will include:

• All term newborns (≥ 37 weeks gestation) diagnosed of moderate/ severe HIE at admission and who are < 24 h of age.

• Evidence of perinatal depression based on delayed cry at birth and at least one of the following:

 1. Apgar score ≤ 3 at 5 min.

 2. Need for resuscitation at 10 min.

 3. PH < 7.1 in cord or Base deficit ≥15 mmol/L.

 4. Moderate or severe encephalopathy according to Sarnat and Sarnat staging [43]. (Table 2)

 5. History of an adverse intrapartum sentinel event such as abruptio placenta, uterine rupture, fetal distress, etc

2. Exclusion criteria:

• Severe congenital anomalies

• Preterm babies

• Infants > 24 h of age at time of presentation /consent

• Those in which consent could not be obtained

• Evidence of sepsis (confirmed according to unit protocol)