PERINATAL ASPHYXIA

Perinatal asphyxia, neonatal asphyxia, or birth asphyxia is the medical condition resulting from deprivation of oxygen to a newborn infant that lasts long enough during the birth process to cause physical harm, usually to the brain. Low oxygen can cause damage to most of the infant’s organs (heart, lungs, liver, gut, kidneys), but brain damage is of most concern and perhaps the least likely to quickly or completely heal. In more pronounced cases, an infant will survive, but with damage to the brain manifested as either mental, such as developmental delay or intellectual disability, or physical, such as spasticity (An unusual "tightness", stiffness, or "pull" of muscles).

Asphyxia results most commonly from a drop in maternal blood pressure or some other substantial interference with blood flow to the infant's brain during delivery. This can occur due to inadequate circulation or perfussion, impaired respiratory effort, or inadequate ventilation. Perinatal asphyxia happens in 2 to 10 per 1000 newborns that are born at term, and more for those that are born prematurely.

An infant suffering severe perinatal asphyxia usually has poor color (cyanosis), perfusion, responsiveness, muscle tone, and respiratory effort. Extreme degrees of asphyxia can cause cardiac arrest and death. If resuscitation is successful, the infant is usually transferred to a neonatal intensive care unit.

Causes
  • Inadequate oxygenation of maternal blood due to hypoventilation during anesthesia, heart diseases, pneumonia, respiratory failure
  • Low maternal blood pressure due to hypotension e.g. compression of vena cava and aorta., excess anaesthesia
  • Inadequate relaxation of uterus due to excess oxytoxin
  • Premature separation of placenta
  • Placental insufficiency
  • Knotting of umbilical cord around the neck of infant
Delivery Room Treatment
  • A= Establish Patent airway: Suctioning, if necessary endotracheal intubation (the placement of a flexible plastic tube into the trachea (windpipe) to maintain an open airway or to serve as a conduit through which to administer certain drugs. It is frequently performed in critically injured, ill or anesthetized patients to facilitate ventilation of the lungs, including mechanical ventilation, and to prevent the possibility of asphyxiation or airway obstruction).
  • B= Breathing: Through tactile stimulation, PPV, bag and mask, or through endotracheal tube
  • C= Circulation: Through chest compressions and medications if needed
Source:

"Brain damage from perinatal asphyxia: correlation of MR findings with gestational age -- Barkovich and Truwit 11 (6): 1087 -- American Journal of Neuroradiology". www.ajnr.org. Retrieved 2008-03-27.