Asphyxia occurs due to insufficient oxygen and blood supply to the brain. Asphyxia can occur in utero or during or immediately after birth. The reasons for birth asphyxia may be as follows:
- Low oxygen levels in the mother’s blood due to respiratory or cardiac problems
- High blood pressure in the mother that may lead to poor placental flow
- Failure in uterus relaxation during labour which impacts oxygen circulation to the placenta.
- Early separation of the placenta from the uterus
- Problems of the umbilical cord that decreases blood flow
- Foetal anaemia
- Low amniotic fluid
Due to the lack of oxygen, the organs are unable to perform their functions. The extent of damage depends on how long the oxygen is unavailable to the brain. In case of delayed treatment, birth asphyxia may lead Hypoxic Ischemic Encephalopathy (HIE), acute renal failure and may lead to short term and long term morbidity.
Symptoms of Birth Asphyxia:
The symptoms of birth asphyxia in babies are as follows:
- No crying after birth/ delayed crying at birth
- Babies with abnormal heart rate or abnormal muscle tone
- Abnormal breathing
- Neonatal seizures
- Multiorgan dysfunction
Babies that show mild symptoms of birth asphyxia, recover from it as soon as the oxygen and blood supply is restored. However, if the symptoms are severe, early treatment is vital to prevent permanent damage to body organs.
Diagnosis of Birth Asphyxia:
Medical history and physical examination play a major role in diagnosing birth asphyxia:
- High acid levels in blood — pH less than 7.00
- Low APGAR score
- Low blood pressure
- Respiratory distress
- Low heart rate
Treatment of Birth Asphyxia:
Immediate treatment is critical to avoid any short-term or long-term effects on the baby. For treatment of birth asphyxia:
- All high risk deliveries should be referred to a centre equipped with good neonatal care
- All such deliveries should be attended by a paediatrician or neonatologist
- Standard Neonatal Resuscitation Program (NRP) guidelines should be followed in resuscitating the babies
- Assisted ventilation
- Medications to support the baby’s breathing and regulate blood pressure
Appropriate antiepileptics are initiated to control seizures if any.
The treatment advancements for birth asphyxia are cerebral function monitoring and therapeutic hypothermia (cooling therapy).