Perinatal Asphyxia: Everything You Need to Know

Perinatal asphyxia is the condition in which a newborn infant suffers due to inadequate oxygen supply during childbirth, which can cause physical harm, including damage to the infant's brain. This situation arises when the spontaneous respiratory process of the child is interrupted, leading to mortality and morbidity. Perinatal asphyxia is a severe condition that requires immediate medical attention. This condition can occur when there is inadequate oxygen supply from the 28th week of gestation until the last seven days of childbirth.

Perinatal asphyxia can lead to hypoxic damage to the child's organs, such as the heart, lungs, liver, and kidney. One of the leading concerns related to this condition is brain damage, which is highly unlikely to be healed completely. Perinatal Asphyxia is one of the leading clinical concerns during childbirth, as the consequences are usually very devastating if not detected in the earlier stages. WHO has presented relevant data, which states that 6–10 newborns out of every 1000 suffer from perinatal asphyxia.

Symptoms of Perinatal Asphyxia

With early detection, the condition can be quickly brought under control. The signs to look out for indicating that the child may be suffering from a lack of oxygen or blood flow are as follows:

• Abnormality in skin tone
• Unusually quiet baby
• Low heart rate
• Weak muscular tone
• Unsteady and weak reflexes
• Difficulty in breathing
• Staining of amniotic fluid with meconium
• Frequent seizures
• Poor blood circulation
• Baby turns limp
• Low blood pressure
• Blood clotting

Causes of Perinatal Asphyxia

These are some of the factors that can lead to perinatal asphyxia:

1. Umbilical cord prolapse
2. Compressed umbilical cord
3. Meconium aspiration syndrome, where the baby sometimes inhales the mixture of the amniotic fluid and their very first faeces
4. Premature birth is when the baby is unable to breathe properly due to underdeveloped lungs.
5. Amniotic fluid embolism, which occurs when the amniotic fluid accidentally enters the bloodstream of the pregnant mother
6. Uterine rupture
7. Separation of the placenta from the uterus
8. Prolonged labour
9. High levels of blood pressure
10. Anaemia
11. Insufficient oxygen in the pregnant mother's blood

Who Are at Risk?

1. Pregnant mothers belonging to the age groups of 20-25
2. Multiple births involving the delivery of twins or triplet babies
3. Not receiving enough prenatal care
4. The low weight of pregnant mothers
5. Abnormality in the position of the foetus during childbirth
6. Preeclampsia or Eclampsia
7. Previous case of perinatal asphyxia

Possible Complications 

Perinatal asphyxia often causes hypoxic ischaemic organ damage in newborn babies, leading to fatal and long-lasting pathologies. If the condition is severe, perinatal asphyxia can give rise to neurodegenerative diseases and sometimes mental retardation and epilepsies. Perinatal Asphyxia can lead to brain disorders which can cause schizophrenia and psychotic syndromes in adults. The development of neurodegenerative pathologies, such as type 2 diabetes and cancer, can also be caused if the child has suffered from perinatal asphyxia.

Prevention of Perinatal Asphyxia

The most effective way of preventing perinatal asphyxia would be to carefully monitor the foetus. Also, better prevention can be provided when obstetricians are properly trained to interpret cardiotocography. In some cases, when the mother is diabetic or hypertensive, the pregnancy is complicated, and better care must be provided.  Antenatal screening of mothers suffering from hypertension and preeclampsia is an excellent way to identify pregnancies with a high risk of developing PA.

When Should I See a Doctor?

At birth, the doctor usually checks the baby's vitals and condition, If the score is very low, the child can develop perinatal asphyxia and the child is treated accordingly. The mothers can also get a medical consultation done if they feel their baby is at high risk of perinatal asphyxia.

Treatment of Perinatal Asphyxia

1. Providing the pregnant mother with extra oxygen before the delivery
2. Emergency delivery via caesarean section
3. Providing ventilation, support, and medication to the baby
4. Extracorporeal membrane oxygenation (ECMO)
5. Body cooling
6. Continuous dialysis

Conclusion

Birth asphyxia develops when a newborn does not get enough oxygen, which could make breathing difficult for them. It may occur soon after, before, during, or following the respective birth. However, with prompt care, infants with mild to moderate birth asphyxia may fully recover. Proper prenatal care and postpartum observation may help lower the risk of birth asphyxia.

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