birth asphyxia in newborns

1. Birth asphyxia

2. Asphyxia
• asphyxia (as-FIX-ee-uh) means lack of oxygen and blood flow to the
brain. 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.

3. Factors of severity
• The amount of harm depends on:
• How long your baby does not get enough oxygen
• How low the level of oxygen is
• How quickly the right treatment is given

4. Stages
• Two stages of injury can happen with birth asphyxia:
• The first stage happens within minutes if blood flow is low and cells
do not get enough oxygen.
• The second stage is called “reperfusion injury.” It can last for days or
even weeks. This injury happens after the brain starts getting normal
levels of blood and oxygen. Toxins released from the damaged cells
cause this injury.

5. Causes
Some causes of birth asphyxia include:
•Too little oxygen in the mother’s blood before or during
birth
•Problems with the separating from the womb too soon
•Very long or difficult delivery
•Problems with the during delivery
•A serious infection in the mother or baby
•High or low blood pressure in the mother
•Baby’s airway is not formed properly
•Baby’s airway is blocked

6. Symptoms of asphyxia at the time of birth may include:
•Not breathing or very weak breathing
•Skin color that is bluish, gray, or lighter than normal
•Low heart rate
•Poor muscle tone
•Weak reflexes
•Too much acid in the blood (acidosis)
• stained with meconium (first stool)

7. • baby is checked for other signs of a lack of blood flow or oxygen.
These include:
• Abnormal breathing
• Poor blood circulation
• Lack of energy (lethargy)
• Low blood pressure
• Not peeing
• Blood-clotting abnormalities

8. Babies with more serious asphyxia may need:
•Breathing support from a machine that sends small,
• rapid puffs of air into your child’s lungs. ‘
•Some babies may need nitric oxide
•through a breathing tube or a heart-lung pump for life
support.
•Body cooling (hypothermia).
•Medicine to control blood pressure.
•Kidney support with dialysis.
•Medicine to treat seizures.
•Intravenous (IV) nutrition to give their time to recover.

9. • Inhaled nitric oxide is used if your baby has respiratory failure or high
blood pressure in the lungs (pulmonary hypertension). Your baby will get
nitric oxide through a breathing tube into their airway. This helps open
(dilate) the blood vessels in their lungs so the vessels can carry oxygen-rich
blood around the body.
• High-frequency ventilation uses a breathing machine that sends small,
quick puffs of air into your baby’s lungs. It is more gentle than a regular
breathing machine, which sometimes uses high pressure that can damage
fragile newborn lungs.

10. Neonatal sepsis
• Sepsis in newborns, or neonatal sepsis, is a serious medical condition that
occurs when a baby younger than 28 days old has a life-threatening response
to an infection. Bacterial infections are the most common cause of neonatal
sepsis.
• Sepsis in newborns (neonatal sepsis) is a serious medical condition that affects
babies younger than 28 days old. Sepsis occurs when your body has an
extreme response to an infection. A newborn who has an infection and
develops sepsis can have inflammation throughout their body. This
inflammation and blood clotting causes reduced blood flow to your baby’s
limbs and vital organs. It can lead to organ failure and even death.

11. • two categories based on the age of onset:
• Early-onset neonatal sepsis: Most providers use the term “early-onset neonatal
sepsis” to describe sepsis that develops within the first 72 hours of life.
• Late-onset neonatal sepsis: Most providers refer to “late-onset neonatal sepsis”
as sepsis that develops after three days of life.
• Babies born prematurely don’t have antibodies to protect them against certain
bacteria. That’s because they’re born before they can receive the antibodies
from their mother. Neonatal sepsis also more commonly occurs in babies who:
• Have a low birth weight.
• Have a low Apgar score.
• Are male.
• Have a mother with an infection during pregnancy.

12. Symptoms and Causes
• Cold hands and feet.
• Clammy, pale skin.
• Yellow skin and whites of their eyes (jaundice).
• Reduced activity.
• Seizures
• Fever or low temperature.
• Fast or slow heart rate.
• Fast breathing or shortness of breath.
• Vomiting.
• Diarrhea.
• Reduced sucking/difficulty feeding.
• Swollen belly (abdomen)

13. leading cause of neonatal sepsis
• Bacterial infections are the most common cause of sepsis in newborns.
Bacteria such as E. coli, Listeria and Group B streptococcus (GBS) are
common bacteria that can cause infections that lead to sepsis.
• Viruses, fungi and parasites can also lead to the condition. For instance,
the herpes simplex virus (HSV) can cause severe infections in newborns.

14. • Early-onset neonatal sepsis
• Newborns with early-onset neonatal sepsis get an infection from their
mother before or during delivery. These infections occur when your
baby is exposed to certain types of bacteria. These infections happen
more often when:
• Bacteria such as GBS have colonized in your vagina during pregnancy.
• baby is born prematurely.
water breaks early (more than 18 hours before your baby is born).

15. • Late-onset neonatal sepsis
• Newborns with late-onset neonatal sepsis get an infection after delivery. Your
baby can acquire an infection from bacteria in their new environment, rather
than bacteria from your body. Bacteria can spread to your newborn through
medical equipment such as catheters, IVs and tubes. These infections happen
more often when your baby:
• Has a low birth weight.
• Needs a breathing tube.
• Needs antibiotics.
• Has a catheter inserted in a blood vessel or their bladder for a long time.
• Needs treatment for another condition that prolongs their stay at the hospital.

16. Diagnosis
• Blood tests: Complete blood count, blood cultures and
C-reactive protein.
• Urine tests: Urinalysis and urine culture.
• Spinal tap (lumbar puncture): A provider inserts a very small needle
into the space around your baby’s spine to withdraw spinal fluid to
test for infections.
• Imaging tests: Chest X-ray or ultrasound.

17. • Neonatal sepsis treatment needs to begin immediately. Your baby’s healthcare
provider may admit your baby to an intensive care unit (ICU). Treatment for
sepsis in newborns may include:
• Intravenous (IV) fluids.
• IV antibiotics to fight bacterial infections.
• Antiviral medication to fight viral infections.
• Heart and/or blood pressure medications.
• Extra oxygen and other forms of respiratory support, if needed.
• Occasionally, babies may need blood transfusions.

18. • To prevent passing along an infection to your baby, your obstetrician may
recommend you take preventive antibiotics. Your provider will give you IV
antibiotics for several hours before delivery if:
• You have an infection such as chorioamnionitis.
• You have group B strep colonization in your vagina.
• previous baby born with sepsis.
• Practice good hygiene.
• See healthcare provider regularly.
• Get recommended vaccines.
• Know the signs of sepsis.
• Get care fast if you think you or your baby have sepsis.

19. complications
• Extreme sluggishness (lethargy).
• Bulging of the soft spot between their skull bones (fontanelle).
• Hearing loss.
• Developmental delays.
• Cerebral palsy.
• Seizures.
• Coma.