Perinatal asphyxia

A medical condition in newborns

Perinatal asphyxia is a medical condition characterized by a lack of oxygen (hypoxia) to a newborn infant that occurs during the perinatal period, which is the time immediately before and after birth. This condition can lead to significant neurological damage and is a major cause of neonatal morbidity and mortality.

Pathophysiology

Perinatal asphyxia occurs when there is an interruption in the supply of oxygen to the infant's brain and other vital organs. This can result from various factors, including complications during labor and delivery, such as umbilical cord prolapse, placental abruption, or prolonged labor. The lack of oxygen can lead to metabolic acidosis, where the blood becomes too acidic, and can cause damage to the central nervous system.

Clinical Presentation

Newborns with perinatal asphyxia may present with a variety of symptoms, including poor muscle tone, weak or absent cry, difficulty breathing, and cyanosis (a bluish discoloration of the skin due to lack of oxygen). In severe cases, the infant may experience seizures, coma, or multi-organ failure.

Diagnosis

The diagnosis of perinatal asphyxia is typically based on clinical findings and laboratory tests. Key indicators include low Apgar scores at 1 and 5 minutes after birth, evidence of metabolic acidosis in the umbilical cord blood, and signs of hypoxic-ischemic encephalopathy (HIE) on neurological examination.

Management

The management of perinatal asphyxia involves immediate resuscitation and stabilization of the newborn. This may include providing oxygen therapy, mechanical ventilation, and fluid management. Therapeutic hypothermia is a treatment that has been shown to improve outcomes in infants with moderate to severe HIE by reducing brain injury.

Prognosis

The prognosis for infants with perinatal asphyxia varies depending on the severity of the condition and the timeliness of intervention. Mild cases may result in full recovery, while severe cases can lead to long-term neurological impairments such as cerebral palsy, intellectual disability, or epilepsy.

Prevention

Preventive measures for perinatal asphyxia focus on ensuring optimal maternal and fetal health during pregnancy and delivery. This includes regular prenatal care, monitoring of fetal well-being during labor, and timely intervention in cases of fetal distress.

Related pages

• Hypoxic-ischemic encephalopathy
• Neonatal resuscitation
• Cerebral palsy
• Neonatal intensive care unit