Birth Asphyxia
Birth asphyxia happens when a baby’s brain and other organs do not get enough oxygen and nutrients before, during or right after birth. This can happen without anyone knowing. Without oxygen and nutrients, cells cannot work properly. Waste products (acids) build up in the cells and cause damage.
In severe cases, it can cause serious complications and even be life threatening. Immediate treatment is necessary to ensure that the baby receives enough oxygen.
Other names for birth asphyxia include perinatal asphyxia and neonatal asphyxia.
Sign & Symptoms –
Each baby may experience symptoms of birth asphyxia differently. However, the following are the most common symptoms.
Before delivery, symptoms may include:
• Abnormal heart rate or rhythm
• An increased acid level in a baby’s blood
At birth, symptoms may include:
• Bluish or pale skin color
• Low heart rate
• Weak muscle tone and reflexes
• Weak cry
• Gasping or weak breathing
• Meconium — the first stool passed by the baby — in the amniotic fluid, which can block small airways and interfere with breathing
Causes –
A variety of factors can cause birth asphyxia. These can relate to the pregnant person or the fetus, and they include:
• Umbilical cord prolapse: This birth complication occurs when the umbilical cord leaves the cervix before the baby.
• Compression of the umbilical cord
• Meconium aspiration syndrome: This syndrome occurs when a baby inhales a mixture of amniotic fluid and meconium, their first feces.
• Premature birth: If a baby is born before 37 weeks, their lungs may not yet be fully developed, and they may be unable to breathe properly.
• Amniotic fluid embolism: Although rare, this complication — in which amniotic fluid enters the pregnant person’s bloodstream and causes an allergic reaction — is very serious.
• Uterine rupture: It has shown a significant association between tears in the muscular wall of the uterus and birth asphyxia.
• The placenta separates from the uterus: This separation can happen before the birth.
• Infection during labor
• Prolonged or difficult labor
• High or low blood pressure in pregnancy
• Anemia: In a baby with anemia, the blood cells are not carrying enough oxygen.
• Not enough oxygen in the pregnant person’s blood: The level of oxygen may be insufficient before or during birth.
Risk Factors –
Risk factors for birth asphyxia include –
• the pregnant person being between the ages of 20 and 25 years
• multiple births, such as delivering twins or triplets
• not attending prenatal care
• low birth weight
• abnormal position of the fetus during delivery
• preeclampsia or eclampsia
• history of birth asphyxia in a previous birth
Diagnosis –
Your baby will receive an Apgar score about 1 to 5 minutes after birth. The scoring system has five factors:
• breathing
• pulse
• appearance
• response to stimulus
• muscle tone
Each factor gets a score of 0, 1, or 2. The highest score possible is 10. A baby with a lower Apgar score after 5 minutes has a higher risk for birth asphyxia. A score lower than 7 can indicate that a baby doesn’t have enough oxygen. The doctor may suspect your baby has birth asphyxia if they have an Apgar score of 3 or lower for more than 5 minutes.
Treatment –
The type of treatment will depend on the severity and cause of the birth asphyxia. Immediate treatments include:
• providing extra oxygen to the pregnant person if birth asphyxia happens before delivery
• emergency or cesarean delivery
• suctioning fluid away from the airways in the case of meconium aspiration syndrome
• putting the newborn on a respirator
For severe cases of birth asphyxia, treatment may include:
• placing the baby in a hyperbaric oxygen tank, which supplies 100% oxygen to the baby
• induced hypothermia to cool the body and help prevent brain damage
• medication to regulate blood pressure
• dialysis to support the kidneys and remove excess waste from the body
• medication to help control seizures
• intravenous (IV) nutrition
• a breathing tube to supply nitric oxide
• life support with a heart and lung pump
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