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BIRTH ASPHYXIA
Mrs. Malarkodi.S
Assistant Professor
CON, AIIMS, Rishikesh
Introduction
Birth asphyxia is a leading cause of neonatal mortality
&
morbidity .It is also important cause of developmental
delay &
Neurological problems both term & preterm newborn.
Approximately 5 t0 10% neonates experience
asphyxia a t birth.
Meaning
Birth asphyxia, also called asphyxia neonatorum, is the
inability of an infant to establish regular respiration
Following birth.
Definition
Birth asphyxia is the non establishment of satisfactory
pulmonary respiration at birth.
It is failure of initiation & maintenance of spontaneous
respiration with hypoxia, hypoventilation ,
hypercapnia, hypo perfusion, & metabolic acidosis.
Etiological factor
Approximately 90% of asphyxia events occur as a result of
placental insufficiency due to ante partum & intrapartum
factors. Postnatal factors account for the remaining.
 Ante partum
 Intrapartum
Postpartum
Ante partum
placental insufficiency due to
 Pre-eclampsia
 Hypertension
 Anemia
 Diabetes Mellitus
 Post maturity
Other factor include
 ante partum hemorrhage
 mal presentation
 Multifetal pregnancy
poor fetal growth
 maternal systemic
diseases
 maternal drug therapy
(eg. lithum)
 poly or oligohydramnios
 placental malformation
 vascular anomalies of
the cord
 congenital anomalies of
the fetus.
Intra partum
Emergency CS
Instrumental delivery
Abnormal position
Premature labour
Precipitous labour
Prolonged rupture of
membranes
Prolonged labour > 24 hrs
Prolonged 2nd stage of
labour
Foetal bradycardia
Non-reassuring foetal heart
rate pattern
General anaesthesia
Narcotics administered
within 4 hours of delivery
Meconium stained liquor
Prolapsed cord
Abruptio placenta
Placenta Previa
POST NATAL FACTOR
 pulmonary, cardio
vascular & neurological
abnormalities of the
neonate
 Aspiration
CLINICAL FEATURES
Clinical manifestations depends upon the etiology,
intensity, duration of oxygen lack, plasma carbon
dioxide level & acidosis. There are 2 stages
 Asphyxia livida or stage of cyanosis, primarily due to
respiratory failure with Apgar score 4 to 6.
 Asphyxia pallida or stage of shock due to combined
respiratory & vasomotor failure with Apgar score 0- 3.
MANAGEMENT
COMPLICATION
BRAIN:
 hypoxic- ischemic encephalopathy
 intracranial hemorrhage
 convulsion
HEART:
 hypoxic cardiomyopathy
 cardiac dysrhythmias
 congestive cardiac failure.
 shock
LUNGS:
 meconium aspiration syndrome
 hyaline membrane disease
 pulmonary hemorrhage
 pneumonia
KIDNEYS:
 Hematuria
 renal failure
 renal vein thrombosis
GASTR0 INTESTINAL:
 necrotizing enterocolitis
 paralytic ileus & obstruction
HEMATOLOGIC :
 DIC, hyperbilirubinemia and sepsis
ENDOCRINE:
 Adrenal hemorrhage
IMMUNOLOGIC:
 septicemia
PROGNOSIS
It is depends upon associated factors, maturity of the
baby, duration & intensity of hypoxia & acidosis &
initiation of resuscitative measures in the delivery
room. Subsequent competent care & available
facilities
also influence the out come following birth asphyxia
NURSING DIAGNOSIS
 Ineffective Airway Clearance R/T Aspiration Meconium
& mucus
 Impaired breathing pattern r/t immaturity of the lungs
 Impaired thermoregulation (hypothermia) r/t immature
thermoregulatory state of neonates
 Risk for complication r/t loss of oxygen supply to the
vital organ
PREVENTIVE MEASURES
 Intensive antenatal care
Intra natal assessment of fetal hypoxia
Careful use & intelligent use of anesthetic agents &
depressant drugs in labor
 Care of neonates at birth
 Special attention to avoidance of preterm delivery
Care of pre term & low birth wt baby
Summary
• As we discussed post sequelae of birth asphyxia
is traumatic both physically and psychological
hence it is important for every neonatal nurse to
anticipate the problem and intervene in the right
manner.
References
• Assuma Beevi (2009). Concise Textbook of Pediatric
Nursing. 2nd Edition. Elsevier Publication
• OP Ghai (2013) Essentials of Pediatrics. 8th Edition.
CBS Publishers and distributors.
• Datta Parul (2010). Paediatric Nursing. 3rd Edition.
JAYPEE publication

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Birth Asphyxia.pptx

  • 1. BIRTH ASPHYXIA Mrs. Malarkodi.S Assistant Professor CON, AIIMS, Rishikesh
  • 2. Introduction Birth asphyxia is a leading cause of neonatal mortality & morbidity .It is also important cause of developmental delay & Neurological problems both term & preterm newborn. Approximately 5 t0 10% neonates experience asphyxia a t birth.
  • 3. Meaning Birth asphyxia, also called asphyxia neonatorum, is the inability of an infant to establish regular respiration Following birth.
  • 4. Definition Birth asphyxia is the non establishment of satisfactory pulmonary respiration at birth. It is failure of initiation & maintenance of spontaneous respiration with hypoxia, hypoventilation , hypercapnia, hypo perfusion, & metabolic acidosis.
  • 5. Etiological factor Approximately 90% of asphyxia events occur as a result of placental insufficiency due to ante partum & intrapartum factors. Postnatal factors account for the remaining.  Ante partum  Intrapartum Postpartum
  • 6. Ante partum placental insufficiency due to  Pre-eclampsia  Hypertension  Anemia  Diabetes Mellitus  Post maturity Other factor include  ante partum hemorrhage  mal presentation  Multifetal pregnancy
  • 7. poor fetal growth  maternal systemic diseases  maternal drug therapy (eg. lithum)  poly or oligohydramnios  placental malformation  vascular anomalies of the cord  congenital anomalies of the fetus.
  • 8. Intra partum Emergency CS Instrumental delivery Abnormal position Premature labour Precipitous labour Prolonged rupture of membranes Prolonged labour > 24 hrs Prolonged 2nd stage of labour
  • 9. Foetal bradycardia Non-reassuring foetal heart rate pattern General anaesthesia Narcotics administered within 4 hours of delivery Meconium stained liquor Prolapsed cord Abruptio placenta Placenta Previa
  • 10. POST NATAL FACTOR  pulmonary, cardio vascular & neurological abnormalities of the neonate  Aspiration
  • 11. CLINICAL FEATURES Clinical manifestations depends upon the etiology, intensity, duration of oxygen lack, plasma carbon dioxide level & acidosis. There are 2 stages  Asphyxia livida or stage of cyanosis, primarily due to respiratory failure with Apgar score 4 to 6.  Asphyxia pallida or stage of shock due to combined respiratory & vasomotor failure with Apgar score 0- 3.
  • 13. COMPLICATION BRAIN:  hypoxic- ischemic encephalopathy  intracranial hemorrhage  convulsion HEART:  hypoxic cardiomyopathy  cardiac dysrhythmias  congestive cardiac failure.  shock
  • 14. LUNGS:  meconium aspiration syndrome  hyaline membrane disease  pulmonary hemorrhage  pneumonia KIDNEYS:  Hematuria  renal failure  renal vein thrombosis
  • 15. GASTR0 INTESTINAL:  necrotizing enterocolitis  paralytic ileus & obstruction HEMATOLOGIC :  DIC, hyperbilirubinemia and sepsis ENDOCRINE:  Adrenal hemorrhage IMMUNOLOGIC:  septicemia
  • 16. PROGNOSIS It is depends upon associated factors, maturity of the baby, duration & intensity of hypoxia & acidosis & initiation of resuscitative measures in the delivery room. Subsequent competent care & available facilities also influence the out come following birth asphyxia
  • 17. NURSING DIAGNOSIS  Ineffective Airway Clearance R/T Aspiration Meconium & mucus  Impaired breathing pattern r/t immaturity of the lungs  Impaired thermoregulation (hypothermia) r/t immature thermoregulatory state of neonates  Risk for complication r/t loss of oxygen supply to the vital organ
  • 18. PREVENTIVE MEASURES  Intensive antenatal care Intra natal assessment of fetal hypoxia Careful use & intelligent use of anesthetic agents & depressant drugs in labor  Care of neonates at birth  Special attention to avoidance of preterm delivery Care of pre term & low birth wt baby
  • 19. Summary • As we discussed post sequelae of birth asphyxia is traumatic both physically and psychological hence it is important for every neonatal nurse to anticipate the problem and intervene in the right manner.
  • 20. References • Assuma Beevi (2009). Concise Textbook of Pediatric Nursing. 2nd Edition. Elsevier Publication • OP Ghai (2013) Essentials of Pediatrics. 8th Edition. CBS Publishers and distributors. • Datta Parul (2010). Paediatric Nursing. 3rd Edition. JAYPEE publication