Cause, Signs, Management and Prevention of Birth Asphyxia

Definition of Birth asphyxia or Neonatal 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. It may be defined as the failure of a newborn to establish spontaneous respiration immediately following complete delivery.

Birth Asphyxia
Fig: Birth Asphyxia

Causes of Fetal Asphyxia:

Asphyxia can result from:

  • A lack of oxygen in the mother’s blood before or during birth.
  • Separation of the placenta from the uterus too quickly.
  • Long or difficult deliveries.
  • Infections in the mother or baby.
  • High or low blood sugar in the mother.
  • Child with a blocked airway or airway that is not properly developed.
  • Anemia in the baby (where the infant’s cells cannot properly carry oxygen to the organs.

Sign and Symptoms of Fetal Asphyxia:

When a child suffers from oxygen deprivation they may experience:

  • Weak breathing or not breathing at all,
  • Bluish and pale in color,
  • Low heart rate,
  • Poor reflexes and muscle tone,
  • Seizures,
  • Acidosis (a condition where there is too much acid in the blood).

Management of Birth Asphyxia or Asphyxiated Newborn:

A. Proper resuscitation:

1. Dry baby with clean cloth and place where the baby will be warm.

2. Look for- breathing or crying, good muscle tone, color.

If the baby is not so well (blue color, weak, breathing, heart rate<100 bit/min) then-

  • Position the head of the baby in neutral position to open the airway.
  • Clean airway if necessary.
  • Stimulate, reposition.
  • Give Oxygen as necessary.

4. If still not breathing and baby is cyanosed, then

  • Use of a correctly fitting mask and give the baby 5 slow ventilations with bag.

5. If still not breathing –

  • Check the position and mask fit.
  • Provide ventilation with bag and mask.
  • Adjust position if necessary.
  • If chest not moving well – suction airway.

6. Check the heart rate (cord pulsation or by listening with a stethoscope).

If heart rate < 60/ min: compress the chest.

If heart rate > 60/ min:

  • Make sure the chest is moving adequately.
  • Continue to bag at a rate of40 breaths/min.
  • Use oxygen if available.

B. Supportive treatment:

  • Oxygen: 1-2 L/Min.
  • Drugs: Na- bicarbonate (only after establishment of respiration), adrenalin, dextrose, naloxone (if apnoea is due to matemal opiates).
  • Intravenous fluid: 10% DA.
  • Phenobarbitone: If convulsion.

Prevention of Birth Asphyxia:

By the below ways, asphyxia can be prevented:

  • Antenatal detection of high risk patients.
  • Frequent fetal monitoring to ensure early detection of fetal distress and timely delivery.
  • Avoidance of difficult and traumatic delivery.
  • Co-operation between obstetrician and paediatrician.
  • Judicial administration of anaesthetic agents and sedatives during labour.

More questions related to this article:

  1. What do you mean by asphyxia?
  2. What is meant by neonatal asphyxia?
  3. What are the main causes of birth asphyxia?
  4. What are most common sign and symptoms of birth asphyxia?
  5. What are the clinical features of birth asphyxia?
  6. Discuss the management of birth asphyxia?
  7. How will you resuscitate an asphyxiated newborn?
  8. How can you prevent births asphyxia?
  9. How to prevent births asphyxia?

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