Birth asphyxia and respiratory distress are common conditions in newborns that can lead to neonatal death if not properly managed. Birth asphyxia is caused by a lack of oxygen during delivery and is diagnosed using the Apgar score and umbilical cord blood pH. Respiratory distress in newborns has pulmonary causes like respiratory distress syndrome or nonpulmonary causes like perinatal asphyxia. Management of both conditions involves providing oxygen, monitoring vital signs, treating infections, and supporting respiratory and cardiovascular functions. Timely identification and treatment can improve prognosis.

2. PRESENTED BY
JASNA RANI BEHERA
M.SC.NSG 2nd YEAR
ROLL-1888008
BIRTH ASPHYXIA
&
RESPIRATORY DISTRESS

3. 1. Birth Asphyxia
introduction ,defintion
risk factors,pathophysiology
clinical features,management
2. Respiratory distress
 introduction,causes,clinical features
 diagnostic evaluation and management

4. • To define birth asphyxia and respiratory distress.
• To know causes ,sign and symptoms.
• To apply the knowledge to manage in preventing the
birth asphyxia and respiratory distress in newborn.

5. • Birth asphyxia is also known as Asphyxia neonatorum.
It is one of the most common causes of neonatal
death in lndia.

6. • Asphyxia is derived from a Greek word "as-fikse-ah",
which means " Stopping of Pulse "
• A condition due to lack of oxygen in respired air, resulting
in impending or actual cessation of apparent life".

8. • Perinatal asphyxia is defined by following criteria:
1. Apgar score of 3 or less at 5 min.

10. 2.Umbilical arterial blood pH of <7.0.
3.Clinical evidence of hypoxic ischemic encephalopathy.

11. 4.Evidence of multi-organ system dysfunction.

12. • Placental insufficiency
• Maternal age >35 or <16 years
• Traumatic delivery
• Prolonged / premature labour
• Analgesics
• Sedation or drugs depressing the
respiratory centre

13. birth
oxygen enters into lungs,
pulmonary arterioles
normal breathing
relaxation of arterioles

14. birth
decreased oxygen supply to organs
lungs-primary,secondary apnea
heart- -B.P. low,myocardial infraction ,
brain-death ,others organs dysfunction

15. 1.Asphyxia livida or stage of cyanosis -includes respiration
failure with apgar score (4 - 6).
2.Asphyxia pallida or stage of shock-includes combined and
vasomotor failure with apgar score (0-3)

16. • Immediate Management-neonatal resuscitation
• Post asphyxial Management

17. • pre requisities:
room and environment
equipment
prepartion of staff as well receving of baby after birth

18.  Bag and mask(sizes ‘0’ and ‘1’)
 Suction equipment
 Radiant warmer or other heat surface

19.  2 Warm towels
 Clock with second hand
 Scissors

20.  Oxygen source
 Gloves
 Cord tie/cord clamp
 Stethoscope

21. • Dries baby with dry,warm
towel,removes wet towel and
assess if baby is
crying/breathing.
• If not crying, clamps and cut the
cord immediately
• Place the baby on a warm,firm,
flat surface (radiant warmer)

22. • Position the baby in slight
neck extension

23. • Suctioning of mouth and nose.

24. • Stimulates the baby by gently rubbing .
• Re-positions the head.
• Assesses breathing
• If breathing well-provides observational care with
mother
If not breathing well-
Applies appropriately sized mask correctly
Initiate bag and mask ventilation using room air .

25. • Gives 5 ventilatory breaths using room air and looks for
chest rise.
• If there is no chest rise after 5 breaths ,take corrective
measures(corrects the position/sucks mouth and
nose/checks the seal/gives ventilation with increased
pressure)

26. • If there is adequate chest rise, continues bag and ,mask
ventilation for 30 seconds(Breath -2-3)
• Reassesses the breathing after 30 seconds of
ventilation.
• If still not breathing calls for help. Continues bag and
masks ventilation and asks for trained help .

27. • If heart rate is <100/min and baby is still not breathing
, continue bag and mask ventilation and connects
oxygen.
• If help available- chest compression, intubation and
medication by trained person.
• If not - baby not breathing,
refers to higher centre immediately.

28. • If heart rate is ≥100 and baby is breathing well or at any
point, if baby starts breathing, provides observational care
with mother.

29. Goals of management are:
- To evaluate and monitor injury to various organs
- To prevent secondary brain injury
- To document prognostic indicators

30. • Thermal control: radiant warmer,
(Core temperature 36-37 ℃, skin temperature 36.0 -36.3℃ ).
• Respiratory support: supplemental oxygen,Ventilation
in case of severe encephalopathy.
• Cardiovascular support:-10ml/kg of saline to maintain
CVP-5-8 cm if no response than ionotropes etc..
• Seizure control:-anticonvulasnat drugs
• Cerebral edema management: mannitol,corticosteriods etc..

31. Prognosis
Neonates with multisystem failure often die in neonatal
period.survivours may have long term neurodevelopmental
problems .

33. Respiratory distress in neonates is a common emergency life-
threatening condition. It accounts for significant morbidity and
mortality. It occurs in 4 to 6 percent of neonates.

34. • Pulmonary causes:
• Nonpulmonary causes:

35. • Respiratory distress syndrome (RDS) or hyaline
membrane disease (HMD)
• meconium aspiration syndrome (MAS)
• pleural effusion
• congenital malformations like tracheoesophageal fistula
with esophageal atresia (TEF with EA),

36. :
• Perinatal asphyxia
• metabolic acidosis
• cerebral edema
• neurological disorders

37. • presence of tachypnea (respiration rate more than 60
breaths/ minute),
• chest indrawing (subcostal, substernal, intercostal
retractions)
• expiratory grunting (cyanosis, nasal flaring along with
alteration of air entry )

38. • Antenatal and perinatal history-
 gestational age
 prolonged rupture of membrane more than 24 hours,
 presence of asphyxia
• Examination
 Silverman -Anderson scoring
 Downes score
• Chest X-ray

41. • thermoneutral environment- to keep the baby warm with
normal body temperature.
• clear airway - removal of secretions by suctioning.
• oxygen administration- term neonates- 90 to 93%
preterm neonates -88 to 92%.

42. • Continuous monitoring -general condition, respiratory status
(respiration rate, retractions, grunting, cyanosis, nasal flaring),
heart rate. , body temperature and other parameters.
• IV fluid therapy-
• normal blood glucose and calcium level.

43. • Antibiotic therapy- to treat sepsis, if present.
• Surfactant therapy -preterm , RDS.
• routine care ,infection control measures.

44. Antenatal corticosteroid therapy -Preterm Neonates ,
preterm labor or APH, before 34 weeks of pregnancy
Injection betamethasone -12 mg IM every 24 hours with two
doses
or
injection dexamethasone -6 mg IM every 12 hours with four
doses.

45. • Prognosis of this condition depends upon early
identification of problems, cause of respiratory distress
and the time of initiation of treatment.

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535-540..
• 7.https://www.slideshare.net/aftabasiddiqui18/respiratory-distress-in-newborn-final
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syndrome