One of the most dangerous conditions that can occur during pregnancy and childbirth - fetal hypoxia and asphyxia. The frequency of children born in asphyxia 4-6%.
hypoxia (Anoxia) fetal - a condition which occurs when insufficient flow of oxygen (over 4 weeks). asphyxia - lack of gas exchange in the lungs of the baby after birth. In other words, the inability to breathe.
Hypoxia occurs during fetal development, birth asphyxia - an acute condition that occurs before birth or during them. All the body's organs need a continuous supply of oxygen, so when his lack of run damage processes, the degree of which depends on the severity of the disease and timely delivery of the first help. Unfortunately, sometimes the degree of damage can be so strong that it leads to irreversible consequences. Brain, heart, liver, kidneys and adrenal glands of the newborn - the most sensitive organs to hypoxia, as a result, they can detect hemorrhage and edema.
Why is this happening?
Among the causes of neonatal asphyxia, doctors call:
• Lack of blood flow through the umbilical cord (umbilical cord entanglement tight around the neck, the cord knots);
• poor blood oxygen saturation mother (anemia, cardiovascular diseases);
• violation of gas exchange through the placenta (abruptio placenta previa);
• birth trauma intracranial newborn;
• poor circulation maternal side of the placenta (if highly active contractions, preeclampsia);
• meconium aspiration;
• suppression of the respiratory effort of the newborn due to the effects of drug therapy in the mother (anesthesia);
• intrauterine fetal brain injury, congenital lung development.
The highest risk of birth asphyxia in preterm and post-term newborns with intrauterine growth retardation.
If there is a suspicion of fetal hypoxia and asphyxia at birth, at birth in the delivery room necessary is a neonatologist or resuscitation of the newborn intensive care unit, which evaluates the need for resuscitation events.
First of all, there is evaluation of the newborn Apgar. Evaluation of normal is 8-10 points, the state of asphyxia newborn with mild estimated 6-7 points, with an average severity - 4-5, with severe asphyxia in a grade 0-3.
The main feature of asphyxia newborn - breathing disorder (his complete lack of or inadequate), resulting in a reduction in the frequency heart rate (normally not less than 100 beats per minute) and disturbance of blood circulation, thereby reducing the muscle tone and fade reflexes.
The degree of asphyxia newborns
Asphyxia mild: Within the first minute of the child makes the first independent breath, but breathing while the child remains weak muscle tone is reduced, there is cyanosis of nasolabial triangle. Reflexes are normal or slightly reduced. At this rate the baby stays with the mother in the rooming.
Asphyxia moderate: Spontaneous breathing, but very relaxed, irregular, weak cry (baby moans), tachycardia. Muscle tone and reflexes were markedly reduced, there is cyanosis of the hands, feet and face. Meconium is usually departs before birth or during the birth due to hypoxia, there is a relaxation of the sphincter. The state of the baby in the event of adequate therapy quickly improves to 4-5-th day of life.
Severe asphyxia: There are irregular breathing movements or not breathing at all. The child is not screaming, it decreased heart rate (at least 60 beats per minute requires indirect cardiac massage), muscle tone and reflexes are absent, pale skin (due to spasm of blood vessels). When such symptoms is carried out with full resuscitation stabilization in the delivery room and further transportation to the emergency department. Such a child held mechanical ventilation, symptomatic therapy. Also addressed the issue of the application of the new method - therapeutic hypothermia, the meaning of which is the general cooling of the body of the child up to 33-35 degrees for 72 hours. Cooling brain processes slow destruction of cells.
Is there salvation?
For timely diagnosis and prevention of fetal hypoxia, the constant need to careful monitoring of the condition of women throughout pregnancy with the mandatory monitoring of the state of the fetus and placental.
