All future parents are looking forward to the birththeir baby, worry about him. And, alas, sometimes these excuses are justified. One of the fairly common pathologies is asphyxia of newborns. Hearing this diagnosis, almost all parents get scared and panic. Of course, asphyxia is a cause for concern, but often the anxiety of parents is often too strong. And most often this happens due to a lack of understanding of what happens to the child with asphyxia. Asphyxia of newborns is a condition of newborns in which, due to a violation of the breathing process, oxygen deficiency develops. There are two types of asphyxia: primary, occurring at the moment of birth, and secondary - developing in the first day after birth.
Causes of asphyxia of newborns
Of course, without any good reason.asphyxia in a newborn child will not occur. As a rule, the causes of asphyxia are either acute or chronic intrauterine hypoxia. In addition, the cause of asphyxia may be:
- Birth intracranial injury of a newborn.
- Immunological incompatibility of mother and fetus.
- The obstruction of the respiratory tract of a newborn child is complete or partial, either by amniotic fluid or mucus.
- Malformations of the fetus, causing difficulty in the process of breathing.
In addition to health problems of the newborn child, asphyxia can also be caused by such problems as the presence of extragenital diseases of pregnant women. For example, such as:
- Diseases of the cardiovascular system, especially those in the acute stage.
- A pronounced iron deficiency anemia, especially in the last trimester of pregnancy.
- Diabetes mellitus, especially insulin-dependent form.
- Later toxicosis - gestosis, accompanied by edema of the legs and increased pressure.
Very often the pathological course of pregnancyalso leads to the occurrence of asphyxia of newborns. Pathology of the structure of the umbilical cord, placenta and fetal membranes, premature detachment of the placenta, premature rupture of amniotic fluid and a long anhydrous period are all factors of increased risk. Also, very often asphyxia of newborns occurs if there are any anomalies of labor, incorrect cutting of the fetal head, pathologically narrow pelvis of the mother in labor, etc. The causes of secondary asphyxia can be such health problems in the child as congenital pneumonia, cerebrovascular accidents, ingress of vomit into the respiratory tract, some types of dysfunction of the central nervous system of a newborn child.
What happens at the moment of asphyxiation?
What happens in the body of a newborn?crumbs at the moment of asphyxia? Regardless of what exactly caused asphyxia, the child begins to immediately change metabolic processes, blood microcirculation, and hemodynamics. How strongly these changes will be expressed depends on the duration of asphyxia and its intensity. During acute hypoxia, the child's total blood volume increases significantly. This happens because the volume of circulating red blood cells in the blood increases. If acute asphyxia develops against the background of preceding chronic fetal hypoxia, hypovolemia develops. Hypovolemia is a change in blood consistency: it thickens, its viscosity increases, and red blood cells and platelets acquire increased aggregation capacity. Edema and hemorrhage, which occur as a result of tissue hypoxia, can be detected in the internal vital organs of a newborn child - in the liver, kidneys and adrenal glands, in the heart and brain. Due to the decrease in peripheral and central hemodynamics, the number of heartbeats decreases and arterial pressure drops. Due to the disruption of the normal metabolic process, the urinary function of the kidneys is disrupted.
Symptoms of neonatal asphyxia
The most important sign of the presence ofnewborn asphyxia is a violation of the respiratory process, which leads to a change in the rhythm of cardiac activity, as well as a pathological change in the functioning of the nervous system: a violation of neuromuscular conduction and the extinction of reflexes. In the first seconds after birth, neonatologists carefully examine the child and assess his condition. The child's condition is assessed using a special Apgar scale:
- Light form of asphyxia
In the event that asphyxia is not clearly expressed, butthe child's body has not suffered much, the child's condition on the Apgar scale will be 6 - 7 points. A child born with a mild form of asphyxia takes his first breath within the first minute after birth. However, despite this, the baby's breathing is weakened, there is a decrease in muscle tone and cyanosis (blueness) of the nasolabial triangle.
- The average severity of asphyxia
In the same case, if the baby is diagnosedaverage degree of hypoxia, the score will be 4-5 points. If the child was born with moderate asphyxia, he will also take his first breath within a minute after birth, but breathing is very weak, may be irregular, the baby's cry is very weak. The baby may also have tachycardia, bradycardia, decreased muscle tone and all reflexes. The skin in the area of the hands and feet, as well as the face, have a pronounced bluish tint. The umbilical cord of such a baby is characterized by intense pulsation.
- Severe form of hypoxia
In severe cases of asphyxia, doctorsThe child's condition is assessed at 1–3 points. In severe asphyxia, breathing is irregular (separate breaths) or absent, the child does not cry, sometimes groans, the heartbeat is slow, in some cases it is replaced by single irregular contractions of the heart, muscle hypotonia or atony is observed, reflexes are absent, the skin is pale as a result of spasm of the peripheral vessels, the umbilical cord does not pulsate; adrenal insufficiency often develops.
- Clinical death
In the event that the overall Apgar scoreequals 0, the child is in a state of clinical death. In this case, in order to save the child's life, resuscitators immediately begin to carry out a set of resuscitation measures.
Treatment of acute asphyxia of newborns
Strictly speaking, all children without exception,born in a state of asphyxia, require immediate intensive care. The effectiveness of all medical procedures depends on how quickly after birth they begin. All intensive care measures begin immediately after the birth of the child, right in the delivery room. During resuscitation measures, the child's condition is continuously monitored for all the main parameters of its vital functions:
- Heart rate.
- Hematocrit.
- Frequency of respiratory movements and their depth.
Based on these indications, doctors havethe ability to monitor the effectiveness of your actions and, if necessary, adjust them. Immediately after the fetus's head is born, the doctor inserts a soft probe into the mouth and nose of the newborn and, using electric suction, removes all the contents of the upper respiratory tract: the remains of amniotic fluid, mucus. After this, the baby's umbilical cord is cut, and the baby is placed on a special resuscitation table, under the rays of a special lamp. After this, repeated aspiration of the contents of the nasopharynx, as well as the contents of the stomach, is performed. After the baby's cardiac and respiratory activity is restored and its condition is stabilized, the baby will be transferred to the intensive care unit. All further medical measures will be aimed at preventing or eliminating existing cerebral edema, normalizing metabolic processes, restoring kidney function and the hemodynamic process.
Rules for caring for a child who has undergone asphyxiation
In order for the child to grow as quickly as possiblerecovered from the effects of asphyxia, it is very important to provide him with proper medical care. The child should be completely at rest, and his head should be in an elevated position. Intensive oxygen therapy is very important for all babies who have suffered asphyxia without exception. Children born with a mild form of asphyxia are placed in a special oxygen tent. This tent is a kind of dome with an increased oxygen content inside. The child spends there from several hours to several days, depending on his health. In the same case, if the child suffered from asphyxia in a moderate or severe form, he should be placed in an incubator. Oxygen is supplied to the incubator, its concentration inside should be approximately 40%. In the same case, if for some reason the maternity hospital does not have the necessary equipment, oxygen can be supplied through a special nasal cannula or through a breathing mask. Very often, a newborn child needs repeated suction of the contents, usually mucus, from the baby's upper respiratory tract. Careful monitoring of such indicators as bowel function, diuresis, and body temperature is also necessary. The first feeding of a child who has suffered mild and moderate asphyxia is done approximately 16 hours after birth. The same children who were born in a state of severe asphyxia are fed for the first time after 24 hours, using a special tube. But the question of when the baby can be put to the breast is decided individually in each case, depending on the child's condition.
After discharge from the maternity hospital
After the baby is discharged home, heshould be under the regular medical supervision of specialists such as a pediatrician and a neurologist. This is necessary to prevent possible complications from the central nervous system. The subsequent prognosis depends on several factors, in particular on the severity of asphyxia, the timeliness of the start of treatment measures and their adequacy. If the child was born with primary asphyxia, the prognosis depends on the secondary assessment of the condition on the Apgar scale (made 5 minutes after birth). If the second assessment is higher than the first, then the prognosis for the child's life is quite favorable. If the child was born in a state of asphyxia, the following complications may be observed during the first years of life. Asphyxia of newborns, consequences:
- Hyper and hypoexcitability.
- Hydrocephalic syndrome.
- Convulsive syndrome.
- Diencephalic disorders.
They occur especially often ifsevere asphyxia of newborns occurred. It is precisely in order to reduce the risk of developing such complications and to begin treatment in a timely manner that dispensary observation by specialists of the relevant profiles is necessary.
Prevention of asphyxia of newborns
To avoid all those problems,which neonatal asphyxia entails, it is necessary to take the necessary preventive measures. Of course, unfortunately, preventive measures cannot always prevent asphyxia, but they should not be neglected. In approximately 40% of cases, preventive measures give a positive result. So:
- Prevention of intrauterine hypoxia
In order to avoid the development of intrauterinefetal hypoxia, constant monitoring of the pregnancy is necessary. During pregnancy, all risk factors should be promptly identified, such as:
- Somatic and infectious diseases, for example, colds, flu, acute respiratory diseases.
- Disorders of the endocrine system and the hormonal background of a pregnant woman.
- The presence of severe stressful situations in the life of a pregnant woman.
- The age of a pregnant woman - the older she is, the higher the risk.
- The presence of such harmful habits, such as smoking and drinking alcohol-containing beverages.
Besides this, it is very important to carry outintrauterine monitoring of the fetus and placenta. For example, the condition of the placenta can clearly indicate possible oxygen starvation of the fetus, and the presence of meconium in the amniotic fluid is a danger signal. As soon as the first alarming signals are noticed, it is necessary to immediately begin the necessary therapy. All of the above once again confirms the need for constant medical supervision of the expectant mother. In no case should you ignore visits to a doctor - a gynecologist during pregnancy - because by doing so you are endangering the health of your baby, and perhaps even his life. In addition, in the prevention of hypoxia, a healthy lifestyle of a pregnant woman plays an important role. To do this, the expectant mother must follow several simple rules:
And be sure to maintain peace of mind and a positive attitude. It is not for nothing that they say that faith in success is about half the success! We recommend reading:
