Neonatal asphyxia

Within 9 months, parents are looking forward to the birth of a little miracle. Future mom and dad are experiencing diverse feelings during this time: joy, happiness and fear. The birth of a baby is the happiest moment in the mother’s life, which is sometimes overshadowed by the news that the newborn has health problems. For example, a baby may develop asphyxia. Many moms and dads get very nervous about this. In most cases, the parents’ nervousness gets too strong, because they do not know what is happening at this time with their baby and how modern medicine deals with this situation.

Neonatal asphyxia

The term newborn asphyxia refers to a pathological condition in newborns, in which the breathing is disturbed and oxygen deficiency develops. This dangerous and serious condition can occur during delivery or on the first days of life.

Causes of neonatal asphyxia

The asphyxia of newborn cannot occur without any reasons, but before talking about them, let’s pay attention to the types of this pathological condition. Neonatal asphyxia is classified into primary and secondary. Primary asphyxia occurs in the fetus during delivery. This type of asphyxia is caused by:

  • chronic or acute fetal hypoxia;
  • intracranial injury inflicted during delivery;
  • malformations of the fetus, affecting breathing;
  • immunological incompatibility between the baby and mother;
  • respiratory tract blockage with mucus or amniotic fluid.

Extragenital diseases during pregnancy can also cause primary asphyxia. For example, the fetus may develop primary asphyxia if the pregnant woman has cardiovascular system diseases, diabetes mellitus, iron deficiency anemia. The fetus may also develop asphyxia if the mother is suffering from preeclampsia (late toxicosis), which is accompanied by increased blood pressure and swelling in the limbs.

Quite often, pathological structure of placenta, umbilical cord or fetal membranes are the causes of newborn primary asphyxia. Risk factors include premature rupture of amniotic fluid, premature detachment of placenta and improper head position of the fetus during labor.

Secondary asphyxia occurs in a few hours or days after birth. Its causes can be:

  • newborn’s heart diseases;
  • cerebral blood flow disturbance;
  • CNS damage.

The most common cause of secondary asphyxia is pneumopathy — scattered and polysegmental atelectasis, hemorrhage in the lungs. Pneumopathy occurs during pregnancy or while delivering and results in the syndrome of respiratory disorders.

What happens in the body of newborns with asphyxia?

Metabolic processes in the organism of a newborn start changing, the severity of this condition depends on the intensity and duration of asphyxia

Symptoms of asphyxia in a newborn

In case of acute asphyxia, which developed on the background of chronic hypoxia, there is hypovolemia. This term refers to the reduction of circulating blood volume. The blood becomes more dense and viscous.

In the brain, heart, liver, kidneys, hemorrhage and edema are possible, which develop due to the lack of oxygen. Hypoxia and asphyxia of the newborn leads to the lowering of blood pressure. The number of heartbeats reduces significantly. Urinary kidney function is impaired.

Signs of asphyxia in the newborn

Doctors identify this pathological condition in the first seconds of a newborn’s life. They estimate frequency and adequacy of breathing, skin color, muscle tone, heart rate and reflex irritability.

The main sign of asphyxia in a baby is respiratory problems, leading to major changes in the body. Immediately after the baby was born, doctors conduct a thorough inspection. The newborn’s health condition is assessed according to the Apgar score.

The doctors can distinguish the following forms of asphyxia:

  • Light;
  • Medium;
  • Difficult;
  • Clinical death.

The state of a newborn with light form of asphyxia is estimated 6−7 Apgar score. The baby makes his first breath, but his breath is weakened, muscle tone is reduced, and nasolabial triangle is bluish.

With the medium form of asphyxia Apgar range is 4−5 points. The newborn baby makes the first breath within the first 60 seconds of life. His breath is weakened (irregular or regular). The baby may show tachycardia, loss of reflexes, decreased muscle tone or bradycardia. The skin of the face, hands and feet is bluish.

The child with severe asphyxia is estimated at 1−3 Apgar score. Breathing is absent or has erratic nature. The baby doesn’t cry, only sometimes moans. Heartbeat is slow, reflexes are absent. Doctors observe muscular atony or hypotension. The skin is pale. The umbilical cord is not pulsating. Quite often adrenal insufficiency develops.

During clinical death, the doctors give the baby zero (0) according to the Apgar score. Specialists immediately start complex resuscitation procedures for saving the life of a baby.

It should be noted that asphyxia in newborn is revealed not only by external examination and Apgar score assessment. The study of acid-base status of blood confirms the diagnosis. Using ultrasound and neurological research methods, doctors can detect damage to the Central nervous system.

Neonatal asphyxia treatment

Neonatal asphyxia treatmentAll babies, born with this pathological condition, need intensive therapy. Doctors carry out certain activities in the delivery room during the first minutes of the baby’s life. They assess the main parameters of life:

  • heart rate;
  • frequency and depth of breaths;
  • hematocrit.

So what do the doctors do after a baby with asphyxia is born? First, when they see the baby’s head, they insert a special probe into the nasal cavity and mouth. With its help, they remove the remains of mucus and amniotic fluid out of the upper respiratory tract. After the baby is fully born, the doctors cut the umbilical cord. The baby is put on the resuscitation table and re-aspiration procedures continue.

After restoring cardiac and respiratory activity, the baby will be transferred to an intensive care unit. Further activities will be aimed at elimination of asphyxia consequences. They will restore metabolism, eliminate the swelling of the brain and normalize kidney functions.

Baby care after asphyxia

After asphyxia the baby requires special medical care. The newborn needs complete rest. His head must be in raised position. Oxygen therapy also plays an important role.

After severe asphyxia, babies are put into special boxes with high oxygen level inside. Babies stay in such boxes from several hours up to a few days. The concentration of oxygen in such a box must be about 40%. Sometimes special nasal cannula or breathing masks are used. Doctors need to control body temperature and bowel functions.

Neonatal asphyxia: after-effects

You can breastfeed the baby, who underwent light or moderate form of asphyxia, 16 hours after birth. After more severe forms, newborns are fed on the next day after birth through a special probe. Usually the time to start breastfeeding is determined individually depending on the condition of the baby.

What to do after discharge from maternity hospital?

After the discharge from the hospital, the baby must be under medical supervision of a neurologist and pediatrician. The goal of medical control is to prevent any possible complications.

Medical prognosis depends on the following factors:

  • severity of pathological condition;
  • timely treatment;
  • adequacy of medical treatment.

If a baby is born with asphyxia, the prognosis depends on the Apgar score secondary evaluation, which is performed 5 minutes after birth. The prognosis is favorable if the second result is higher than the first.

During the first years of life the baby may experience the following consequences of asphyxia:

  • hydrocephalic syndrome;
  • diencephalic disorders;
  • convulsive syndrome;
  • hypo — or hyperactivity.

The above complications often occur after severe asphyxia. In order to prevent this condition, every pregnant woman needs medical supervision.

Measures for the prevention of asphyxia in the newborns

Asphyxia can cause serious health problems, but this dangerous pathological condition can be prevented, if you keep some rules. They don’t always help, but still they are necessary to follow. In 40% of cases, keeping the rules gives a positive result.

It has been mentioned above, that often neonatal asphyxia is caused by intrauterine hypoxia. It can be avoided if you regularly visit a doctor.

During the pregnancy, we need to identify all the risk factors:

  • infectious and somatic diseases (acute respiratory diseases, flu, cold);
  • your age;
  • disorders of the endocrine system;
  • hormonal changes;
  • constant stress;
  • harmful habits (alcohol, smoking).

You should not forget about monitoring your placenta and fetus. It is very important, because it helps to detect various disorders. The condition of the placenta can help define fetal anoxia. The presence of meconium in amniotic fluid is the danger signal. At first signs of hypoxia, you need appropriate therapy. Visit your gynecologist regularly.

Healthy lifestyle of a pregnant woman plays an important role in the prevention of hypoxia and asphyxia of the fetus. Any expectant mother should follow a few simple rules:

Walk more. While walking, your blood is saturated with oxygen, which is then transported to the fetus. Oxygen is necessary for proper development and growth of your baby. Some women believe that only walking in the country is useful, but not in the city. This view is incorrect. You must go for walks anywhere you can, certainly, it’s better to walk in parks if you live in a big city.

Have a healthy daily routine. A pregnant woman should forget about the previous «crazy rhythm of life», when she sat night at the computer, went to bed late, woke up early in the morning and went to work. Now you need to sleep not less than 9 hours at night and even during the daytime it is recommended to find a couple of hours to sleep.

Take vitamin-mineral complexes. A pregnant woman and her fetus need vitamins and nutrients. Unfortunately, sometimes the quality of modern food products doesn’t allow you to get all the necessary minerals and vitamins. Vitamin-mineral complexes can become a «Magic wand» while you are pregnant. However, your doctor must prescribe the complex. You mustn’t decide on your own, because not all pregnant women need additional vitamins and minerals, and their excess can harm both the mother and the fetus.

Peace of mind and positive mood. Pregnancy is an unforgettable period in a woman’s life. It is associated not only with happy moments, but also with emotions and additional stress. The expectant mother should try to worry less. You just need to learn how to do it. Just eliminate from negative emotions. Dreams of the future baby will help maintain positive mood and emotional balance. Make your life brighter by watching good comedies, reading funny books, socializing with positive people.

In conclusion, it is worth noting that neonatal birth asphyxia is quite a serious pathological condition, but don’t worry. Today doctors have all the modern devices to quickly notice that something is wrong with your fetus and they will take all the necessary measures that will protect the newborns from the after-effects of asphyxia and save their lives.

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