the time when something begins (especially life); "they divorced after the birth of the child"; "his election signaled the birth of a new age"
the event of being born; "they celebrated the birth of their first child" (同)nativity, nascency, nascence
a baby born; an offspring; "the overall rate of incidence of Downs syndrome is one in every 800 births"
a condition in which insufficient or no oxygen and carbon dioxide are exchanged on a ventilatory basis; caused by choking or drowning or electric shock or poison gas
"Neonatal asphyxia" redirects here. For the more general term covering inadequate oxygen supply to the fetus, see intrauterine hypoxia.
Perinatal asphyxia
Specialty
Pediatrics, Obstetrics
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. Hypoxic damage can occur 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.
It 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 perfusion, 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.[1] WHO estimates that 4 million neonatal deaths occur yearly due to birth asphyxia, representing 38% of deaths of children under 5 years of age.[2]
Perinatal asphyxia can be the cause of hypoxic ischemic encephalopathy or intraventricular hemorrhage, especially in preterm births. An infant suffering severe perinatal asphyxia usually has poor color (cyanosis), perfusion, responsiveness, muscle tone, and respiratory effort, as reflected in a low 5 minute Apgar score. 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.
There has long been a scientific debate over whether newborn infants with asphyxia should be resuscitated with 100% oxygen or normal air.[3] It has been demonstrated that high concentrations of oxygen lead to generation of oxygen free radicals, which have a role in reperfusion injury after asphyxia.[4] Research by Ola Didrik Saugstad and others led to new international guidelines on newborn resuscitation in 2010, recommending the use of normal air instead of 100% oxygen.[5][6]
There is considerable controversy over the diagnosis of birth asphyxia due to medicolegal reasons.[7][8] Because of its lack of precision, the term is eschewed in modern obstetrics.[9]
Contents
1Cause
2Risk Factors
3Treatment
4Epidemiology
5Medicolegal Aspects
6References
7External links
Cause
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 oxytocin
Premature separation of placenta
Placental insufficiency
Knotting of umbilical cord around the neck of infant
Risk Factors
Elderly or young mothers
Prolonged rupture of membranes
Meconium-stained fluid
Multiple births
Lack of antenatal care
Low birth weight infants
Malpresentation
Augmentation of labour with oxytocin
Antepartum hemorrhage
Severe eclampsia and pre-eclampsia
Antepartum and intrapartum anemia[10]
Treatment
A= Establish open airway: Suctioning, if necessary endotracheal intubation
B= Breathing: Through tactile stimulation, PPV, bag and mask, or through endotracheal tube
C= Circulation: Through chest compressions and medications if needed
D= Drugs: Adrenaline .01 of .1 solution
Hypothermia treatment to reduce the extent of brain injury
Epinephrine 1:10000 (0.1-0.3ml/kg) IV
Saline solution for hypovolemia
Epidemiology
Disability-adjusted life year for birth asphyxia and birth trauma per 100,000 inhabitants in 2002
A 2008 bulletin from the World Health Organization estimates that 900,000 total infants die each year from birth asphyxia, making it a leading cause of death for newborns.[11]
In the United States, intrauterine hypoxia and birth asphyxia was listed as the tenth leading cause of neonatal death.[12]
Medicolegal Aspects
There is current controversy regarding the medicolegal definitions and impacts of birth asphyxia. Plaintiff's attorneys often take the position that birth asphyxia is often preventable, and is often due to substandard care and human error.[13] They have utilized some studies in their favor that have demonstrated that, "...although other potential causes exist, asphyxia and hypoxic-ihy affect a substantial number of babies, and they are preventable causes of cerebral palsy."[14][15][16] The American Congress of Obstetricians and Gynecologists disputes that conditions such as cerebral palsy are usually attributable to preventable causes, instead associating them with circumstances arising prior to birth and delivery.[17]
References
^Truwit, C. L.; Barkovich, A. J. (November 1990). "Brain damage from perinatal asphyxia: correlation of MR findings with gestational age -- Barkovich and Truwit 11 (6): 1087 -- American Journal of Neuroradiology". American Journal of Neuroradiology. 11 (6): 1087–1096. Retrieved 2008-03-27.
^Aslam, Hafiz Muhammad; Saleem, Shafaq; Afzal, Rafia; Iqbal, Umair; Saleem, Sehrish Muhammad; Shaikh, Muhammad Waqas Abid; Shahid, Nazish (2014-12-20). "Risk factors of birth asphyxia". Italian Journal of Pediatrics. 40: 94. doi:10.1186/s13052-014-0094-2. ISSN 1824-7288. PMC 4300075. PMID 25526846.
^Davis, PG; Tan, A; O'Donnell, CPF; Schulze, A (2004). "Resuscitation of newborn infants with 100% oxygen or air: a systematic review and meta-analysis". The Lancet. 364 (9442): 1329–1333. doi:10.1016/S0140-6736(04)17189-4. PMID 15474135.
^Kutzsche, S; Ilves, P; Kirkeby, OJ; Saugstad, OD (2001). "Hydrogen peroxide production in leukocytes during cerebral hypoxia and reoxygenation with 100% or 21% oxygen in newborn piglets". Pediatric Research. 49 (6): 834–842. doi:10.1203/00006450-200106000-00020. PMID 11385146.
^ILCOR Neonatal Resuscitation Guidelines 2010
^Norwegian paediatrician honoured by University of Athens, Norway.gr
^Blumenthal, I (2001). "Cerebral palsy—medicolegal aspects". Journal of the Royal Society of Medicine. 94 (12): 624–7. PMC 1282294. PMID 11733588.
^Dhar, KK; Ray, SN; Dhall, GI (1995). "Significance of nuchal cord". Journal of the Indian Medical Association. 93 (12): 451–3. PMID 8773129.
^ACOG. "Committee Opinion, Number 326, December 2005: Inappropriate Use of the Terms Fetal Distress and Birth Asphyxia". Retrieved June 9, 2010.[permanent dead link]
^Kaye, D. (2003-03-01). "Antenatal and intrapartum risk factors for birth asphyxia among emergency obstetric referrals in Mulago Hospital, Kampala, Uganda". East African Medical Journal. 80 (3): 140–143. doi:10.4314/eamj.v80i3.8683. ISSN 0012-835X. PMID 12762429.
^Spector J, Daga S. "Preventing those so-called stillbirths". WHO. Retrieved 13 December 2013.
^National Center for Health Statistics
^Andreasen, Stine (2014). "Acta Obstetricia et Gynecologica". Acta Obstetricia et Gynecologica Scandinavica. 93 (2): 152–158. doi:10.1111/aogs.12276. PMID 24237480.
^"APFEL Handout: Birth Asphyxia & Cerebral Palsy" (PDF). Colorado Bar Association. Archived from the original (PDF) on April 16, 2016. Retrieved April 8, 2016.
^Cohen, Frances M. (2003). "Origin and Timing of Brain Lesions in Term Infants with Neonatal Encephalopathy". The Lancet. 361 (9359): 736–42. doi:10.1016/S0140-6736(03)12658-X. PMID 12620738.
^Becher, J-C; Stenson, Bj; Lyon, Aj (2007-11-01). "Is intrapartum asphyxia preventable?". BJOG: An International Journal of Obstetrics & Gynaecology. 114 (11): 1442–1444. doi:10.1111/j.1471-0528.2007.01487.x. ISSN 1471-0528. PMID 17877776.
^Van Eerden, Peter. "Summary of the Publication, "Neonatal Encephalopathy and Cerebral Palsy: Defining the Pathogenesis and Pathophysiology," by the ACOG Task Force on Neonatal Encephalopathy and Cerebral Palsy". Medscape. Retrieved April 8, 2016.
External links
Classification
D
ICD-10: P21
ICD-9-CM: 768
MeSH: D001238
DiseasesDB: 1416
External resources
eMedicine: ped/149
v
t
e
Certain conditions originating in the perinatal period / fetal disease (P, 760–779)
Maternal factors and complications of pregnancy, labour and delivery
placenta:
Placenta praevia
Placental insufficiency
Twin-to-twin transfusion syndrome
chorion/amnion:
Chorioamnionitis
umbilical cord:
Umbilical cord prolapse
Nuchal cord
Single umbilical artery
Length of gestation and fetal growth
Small for gestational age/Large for gestational age
Preterm birth/Postmature birth
Intrauterine growth restriction
Birth trauma
scalp
Cephalhematoma
Chignon
Caput succedaneum
Subgaleal hemorrhage
Brachial plexus lesion
Erb's palsy
Klumpke paralysis
By system
Respiratory
Intrauterine hypoxia
Infant respiratory distress syndrome
Transient tachypnea of the newborn
Meconium aspiration syndrome
pleural disease
Pneumothorax
Pneumomediastinum
Wilson–Mikity syndrome
Bronchopulmonary dysplasia
Cardiovascular
Pneumopericardium
Persistent fetal circulation
Haemorrhagic and hematologic disease
Vitamin K deficiency
Haemorrhagic disease of the newborn
HDN
ABO
Anti-Kell
Rh c
Rh D
Rh E
Hydrops fetalis
Hyperbilirubinemia
Kernicterus
Neonatal jaundice
Velamentous cord insertion
Intraventricular hemorrhage
Germinal matrix hemorrhage
Anemia of prematurity
Digestive
Ileus
Necrotizing enterocolitis
Meconium peritonitis
Integument and thermoregulation
Erythema toxicum
Sclerema neonatorum
Nervous system
Perinatal asphyxia
Periventricular leukomalacia
Musculoskeletal
Gray baby syndrome
muscle tone
Congenital hypertonia
Congenital hypotonia
Infectious
Vertically transmitted infection
Neonatal infection
Congenital rubella syndrome
Neonatal herpes simplex
Mycoplasma hominis infection
Ureaplasma urealyticum infection
Omphalitis
Neonatal sepsis
Group B streptococcal infection
Neonatal conjunctivitis
Other
Miscarriage
Perinatal mortality
Stillbirth
Infant mortality
Neonatal withdrawal
UpToDate Contents
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1. 周産期仮死の全身への影響 systemic effects of perinatal asphyxia
2. 新生児脳症の臨床的特徴、診断、および治療 clinical features diagnosis and treatment of neonatal encephalopathy
3. 新生児脳症の病因および発症機序 etiology and pathogenesis of neonatal encephalopathy
Neonatal complications among 596 infants delivered by vacuum extraction (in relation to characteristics of the extraction).
Ekéus C1, Wrangsell K2, Penttinen S3, Åberg K1.
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.J Matern Fetal Neonatal Med.2018 Sep;31(18):2402-2408. doi: 10.1080/14767058.2017.1344631. Epub 2017 Jul 10.
Clinical significance of primary symptoms in women with placental abruption.
Mei Y1, Lin Y1.
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.J Matern Fetal Neonatal Med.2018 Sep;31(18):2446-2449. doi: 10.1080/14767058.2017.1344830. Epub 2017 Jul 6.
Impacts of therapeutic hypothermia on cardiovascular hemodynamics in newborns with hypoxic-ischemic encephalopathy: a case control study using echocardiography.
Yoon JH1, Lee EJ1, Yum SK1, Moon CJ1, Youn YA1, Kwun YJ1, Lee JY1, Sung IK1.
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.J Matern Fetal Neonatal Med.2018 Aug;31(16):2175-2182. doi: 10.1080/14767058.2017.1338256. Epub 2017 Jul 7.
A Case of Meconium Aspiration Syndrome in a Bottlenose Dolphin (Tursiops truncatus) Calf
, , , , , ,
Journal of Veterinary Medical Science 76(1), 81-84, 2014
… Here, we report a case of meconium aspiration syndrome (MAS) in a male neonate of bottlenose dolphin (Tursiops truncates) who died immediately after birth. … MAS due to perinatal asphyxia should be taken into account as a possible cause of neonatal mortality and stillbirth of dolphin calves. …
BIRTH ASPHYXIA. 332 likes · 2 talking about this. NEW ALBUM OUT NOW !! ... NEXT SHOW Birth Asphyxia & Gorevent ダブルレコ発 10月20日（土） 新大久保EARTHDOMにてBirth AsphyxiaとGoreventのダブルレコ発を行います。
