Birth Asphyxia

Birth asphyxia is defined as the lack of blood flow or oxygen to and from the fetus that happens immediately before, during, or after the birth process. Let us have a look on its symptoms, causes and treatment of this condition.

Last Updated: Oct 22, 2020 11:29 GMT

Birth Asphyxia
Birth Asphyxia
What is Birth Asphyxia?

Asphyxia is the lack of oxygen and blood flow to the brain. Birth Asphyxia is defined as the lack of oxygen and blood supply to the brain and other vital organs that happens before or during the birthing process or after the process. Without oxygen and nutrient supply, cells cannot function properly and waste products tend to accumulate in the cells, resulting in damage. The severity of this condition depends on how low the levels of oxygen are and for how long the oxygen supply is low. Babies with mild forms of asphyxia may recover and if the oxygen deprivation is for a longer duration, it can affect the vital organs.

Incidence

According to the data from Seattle Children’s Hospital, Birth asphyxia occurs in about 4 out of every 1,000 full-term live births in the United States. Premature babies are at risk of developing this condition and mothers who have complications like diabetes and preeclampsia may be at a greater risk.

Causes

The following can be the causes of birth asphyxia.

·         Any heart or respiratory problems can lead to low levels of oxygen in the mother’s blood before or during the birth of the baby. Sometimes lowered respirations are caused by anesthesia.

·         Placental abruption- early separation of placenta from the uterus

·         During the labor, inadequate relaxation of the uterus can prevent oxygen circulation to the placenta

·         Compression of umbilical cord can lead to decrease in blood flow

·         Heavy maternal bleeding and fetal distress, resulting in maternal shock

·         During post term pregnancies, due to an increased blood pressure, placental function may be poor which can result in low oxygen supply

·         Longer duration of delivery

·         If the baby is in breech position, the process of delivery may be difficult

·         Mother’s blood pressure is either high or low during delivery

·         Any serious infection that affects the mother or the baby

Lower oxygen levels in a baby can be due the following

·         Baby’s airway is improperly formed or blocked

·         When a baby’s blood cells cannot carry enough oxygen, resulting in anemia

·         Low blood pressure or shock

·         Respiratory, heart or lung problems that results in insufficient oxygen intake

·         Prolonged delivery can be due to large infant size with a larger head.

Symptoms

Before delivery, you doctor may notice an abnormal heart rate or rhythm and increased levels of acid in your baby’s blood.

After the birth of the baby, the following symptoms can be noticed.

  • Skin color is bluish or pale
  • Low heart rate
  • Poor muscle tone and weak reflexes
  • Weak cry
  • Very weak breathing
  • Acidosis- too much acid in the blood
  • Amniotic fluid can be mixed with meconium, which can affect baby’s airways and interfere with breathing
  • Seizures
  • Hypotonia

 

Diagnosis

Your baby’s symptoms are monitored and a score called Apgar is calculated by considering five factors like breathing, pulse, appearance, response to stimulus and muscle tone.  If the Apgar score is 3 or lower for more than five minutes, a doctor may suspect for birth asphyxia. Your baby’s blood will also be tested for acid levels. High acid levels indicate poor oxygenation. Blood tests to detect the extent of damage in heart, kidneys and liver will also be analyzed.

Treatment

A very prompt and immediate treatment is necessary to prevent the long term damages. Treatment depends on the baby’s age, severity of the condition and baby’s tolerance level to the medications.

A mother may require extra oxygen before delivery. A baby may require assisted ventilation and medications to support breathing and blood pressure. In unprecedented situations, a C-section will be done.

Babies with severe asphyxia require

·         Body cooling (hypothermia)

  • Medicine to control blood pressure and seizures.
  • Kidney support with dialysis.
  • High frequency ventilation
  •  Inhaled Nitric oxide is provided by a breathing tube into the baby’s wind pipe to help lower blood pressure and open the blood vessels in the lungs.
  • Extracorporeal Membrane Oxygenation (ECMO) - this machine delivers oxygen to baby’s brain and body as a transient support.

Not all babies develop brain damage due to this condition. Early diagnosis is highly essential in preventing long term complications.

 

 

 

 

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