Perinatal asphyxia is a condition in which a baby’s brain does not receive enough oxygen before, during, or after birth. This results in cardiorespiratory or brain damage.
Asphyxia can be fatal. Brain cells can begin dying within as little as 5 minutes without oxygen. It can also cause permanent, long-term damage, including
intellectual disability, delayed development,
seizure disorder, and
Perinatal asphyxia can caused by a number of conditions that stop or slow the normal blood and oxygen flow to the infants brain before or during labor and delivery. Some factors that may cause these problems include: Drop in the mother's blood pressure, which can decrease flow to the babyPressure on the umbilical cord—interrupts flow of oxygen rich blood to the babyProblems with the placenta, such as placental abruption when placenta moves away from the wall of the uterus
Factors that may increase your baby’s chance of perinatal asphyxia include: Fetal heart rate abnormalitiesWater breaking more than 12 hours before deliveryMeconium in the fluid surrounding the baby before birthHemorrhage occurring prior to childbirthInfection in the mother that may cause breathing problems, such as pneumoniaProlonged first and second stages of laborPre- or post-term laborDelivery with forceps or a vacuum device
Mild asphyxia may cause: Poor muscle toneIrritabilityExtreme drowsinessFeeding difficulties, including poor suck
Severe asphyxia may cause:
Poor arousalBlue-colored skin or lipsDifficulty breathing
A physical exam will be done. Typically, the history is the most important factor in making the diagnosis.
Your baby’s bodily fluids may be tested. This can be done with blood tests.
Images may need to be taken of your baby’s bodily structures. This can be done with: MRI scanUltrasoundCT scanEchocardiogram
Your baby’s heart and brain activity may also be tested. This can be done with: Electrocardiogram
Evoked potential test for hearing and, rarely, vision
Life-sustaining treatment may be used if reduced brain function has happened, but there is no extensive damage yet. Treatment options include mechanical ventilation to take over or support breathing and oxygen therapy. These treatments will be stopped as your baby recovers.
Medication may be needed to support heart function until your baby recovers. Medication and
may also be given to control seizures.
Your baby may be wrapped in cooling blankets within hours of birth. This will lower body temperature and reduce the risk of tissue injury and reduce the risk of long-term problems.
In most cases, asphyxia is sudden and cannot be prevented.
Birth asphyxia. Seattle Children's website. Available at: http://www.seattlechildrens.org/medical-conditions/airway/birth-asphyxia. Accessed April 4, 2016.
Edwards AD. The discovery of hypothermic neural rescue therapy for perinatal hypoxic-ischemic encephalopathy. Semin Pediatr Neurol. 2009;16(4):200-206.
Harrington DJ, Redman CW, Moulden M, Greenwood CE. The long-term outcome in surviving infants with Apgar zero at 10 minutes: a systematic review of the literature and hospital-based cohort. Am J Obstet Gynecol . 2007;196(5):463.e1-e5.
Itoo BA, Al-Hawsawi ZM, et al. Hypoxic ischemic encephalopathy. Incidence and risk factors in North Western Saudi Arabia. Saudi Med J. 2003;24(2):147-153.
Lai MC, Yang SN. Perinatal hypoxic-ischemic encephalopathy. J Biomed Biotechnol. [Epub 2010 Dec 13].
Last reviewed April 2016 by Karli-Rae Kerrschneider, RN
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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