Definition

Perinatal asphyxia is a condition in which a baby’s brain does not receive enough oxygen during or after birth. This results in cardiorespiratory or brain damage.

Asphyxia can be fatal. Brain cells can begin dying within as little as five minutes without oxygen. The disease can also cause long-term damage, including intellectual disability, delayed development, seizures, and cerebral palsy.

Causes

Asphyxia may be caused by:

    
  • The placenta separating from the uterine wall too early
  • Pressure on the umbilical cord
  • Certain medications
  • Infection
  • Breathing in meconium from the amniotic fluid
  • Birth trauma
  • Risk Factors

    Factors that increase your baby’s risk of perinatal asphyxia include:

        
  • Previous still birth
  • Fetal heart rate abnormalities
  • Water breaking more than 12 hours before delivery
  • Meconium in the fluid surrounding the baby before birth
  • Hemorrhage occurring prior to childbirth
  • Fever in the mother
  • Prolonged first and second stages of labor
  • Pre-term or post-term labor
  • Delivery with forceps or a vacuum device
  • Symptoms

    Mild asphyxia may cause:

        
  • Poor muscle tone
  • Irritability
  • Extreme drowsiness
  • Feeding difficulties, including poor suck
  • Severe asphyxia may cause:

        
  • Seizures
  • Poor arousal
  • Blue-colored skin or lips
  • Difficulty breathing
  • Diagnosis

    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:

        
  • Ultrasound
  • CT scan
  • MRI scan
  • Echocardiogram
  • Your baby’s heart and brain activity may also be tested. This can be done with:

        
  • Electrocardiogram (ECG)
  • Electroencephalogram (EEG)
  • Evoked potential test for hearing and, rarely, vision
  • Treatment

    Life-sustaining Treatment

    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 stooped as your baby recovers.

    Medications

    Medication may be needed to support heart function until your baby recovers. Medication and general anesthesia may also be given to control seizures.

    Lowering Body Temperature

    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.

    Prevention

    In most cases, asphyxia is sudden and cannot be prevented.