31 years
Slt dr quelles sont les risque d un asphyxie au cours de l accouchement et a ce que il ya des nouveau méthode de tratemetn
Aug 17, 2014
Birth asphyxia is lack of oxygen to the baby’s organs before, during, or immediately after birth. It can go unnoticed.
Some causes of birth asphyxia may include:
- The mother's blood does not have enough oxygen before or during birth: this could be due to maternal illness such as an infection, especially if it's complicated by a very low blood pressure; maternal smoking
-Problems with the placenta separating from the uterus too soon
-Very long (> 18 hours) or difficult delivery
-Problems with the umbilical cord during delivery: it twists around the baby's neck
-A serious infection in the mother or baby
-High or low blood pressure in the mother
-Baby's lungs are not well formed
-Baby's airway is blocked
-Anemia in the baby so his/her red blood cells cannot carry enough oxygen.
So frequent close follow up with your obstetrician and maintaining a healthy pregnancy, in addition to anticipation (in case the mother or the baby has known risk factors that were identified during pregnancy), prompt identification and treatment of birth asphyxia (baby’s color is blue, baby not breathing well, baby's movements are not vigorous, baby's not crying, baby’s heart rate is low, there's meconium - baby's 1st stools- in the amniotic fluid) are key in preventing birth asphyxia.
The frequency of birth asphyxia is about four of every 1,000 full-term births, more common in premature delivery.
The extent of damage to the newborn depends on the duration and severity of asphyxia, and the time frame between asphyxia and initiation of treatment.
Two stages of injury can happen with birth asphyxia:
-The first stage: happens within minutes of absence of oxygen. Cell damage occurs with the initial lack of blood flow and oxygen.
-The second stage: known as “reperfusion injury” and can last for days to weeks. This happens after normal blood flow and oxygen are re-established in the brain, and is due to toxins released from the damaged cells.
Babies with mild or moderate asphyxia are expected to have full recovery. Babies who have suffered asphyxia for a longer time may have permanent injury to their brain, heart, lungs, kidneys, bowels or other organs.
When a baby born prematurely has asphyxia, the damage may lead to cerebral palsy, developmental disabilities, attention deficit hyperactivity disorder or impaired sight. In the most severe cases, asphyxia can lead to organ failure and death.
Treatment options include:
-Mild asphyxia at birth: breathing support (through nasal prongs) until they can breathe well enough on their own.
- Severe asphyxia: mechanical ventilation (a breathing machine), respiratory therapy, fluid, and drugs to control blood pressure and prevent seizures. oral feeds may be delayed to allow the baby’s bowel to recover.
-When needed, inhaled nitric oxide (NO) is used to treat high blood pressure in the lungs (pulmonary hypertension). NO is given directly through a breathing tube into the windpipe. This helps the lungs’ blood vessels open (dilate) so they can carry oxygenated blood into the body.
-Hypothermia: cooling the baby's internal body temperature to 33.5C for up to 72 hours can help protect the baby's brain from damage during the second stage of asphyxia, the “reperfusion" stage, when normal blood flow and oxygen are restored to the brain. The optimal time to give this type of treatment is within six hours after birth. The baby must be at least 36 weeks' gestation (not more than four weeks early) to qualify for this treatment.
Some causes of birth asphyxia may include:
- The mother's blood does not have enough oxygen before or during birth: this could be due to maternal illness such as an infection, especially if it's complicated by a very low blood pressure; maternal smoking
-Problems with the placenta separating from the uterus too soon
-Very long (> 18 hours) or difficult delivery
-Problems with the umbilical cord during delivery: it twists around the baby's neck
-A serious infection in the mother or baby
-High or low blood pressure in the mother
-Baby's lungs are not well formed
-Baby's airway is blocked
-Anemia in the baby so his/her red blood cells cannot carry enough oxygen.
So frequent close follow up with your obstetrician and maintaining a healthy pregnancy, in addition to anticipation (in case the mother or the baby has known risk factors that were identified during pregnancy), prompt identification and treatment of birth asphyxia (baby’s color is blue, baby not breathing well, baby's movements are not vigorous, baby's not crying, baby’s heart rate is low, there's meconium - baby's 1st stools- in the amniotic fluid) are key in preventing birth asphyxia.
The frequency of birth asphyxia is about four of every 1,000 full-term births, more common in premature delivery.
The extent of damage to the newborn depends on the duration and severity of asphyxia, and the time frame between asphyxia and initiation of treatment.
Two stages of injury can happen with birth asphyxia:
-The first stage: happens within minutes of absence of oxygen. Cell damage occurs with the initial lack of blood flow and oxygen.
-The second stage: known as “reperfusion injury” and can last for days to weeks. This happens after normal blood flow and oxygen are re-established in the brain, and is due to toxins released from the damaged cells.
Babies with mild or moderate asphyxia are expected to have full recovery. Babies who have suffered asphyxia for a longer time may have permanent injury to their brain, heart, lungs, kidneys, bowels or other organs.
When a baby born prematurely has asphyxia, the damage may lead to cerebral palsy, developmental disabilities, attention deficit hyperactivity disorder or impaired sight. In the most severe cases, asphyxia can lead to organ failure and death.
Treatment options include:
-Mild asphyxia at birth: breathing support (through nasal prongs) until they can breathe well enough on their own.
- Severe asphyxia: mechanical ventilation (a breathing machine), respiratory therapy, fluid, and drugs to control blood pressure and prevent seizures. oral feeds may be delayed to allow the baby’s bowel to recover.
-When needed, inhaled nitric oxide (NO) is used to treat high blood pressure in the lungs (pulmonary hypertension). NO is given directly through a breathing tube into the windpipe. This helps the lungs’ blood vessels open (dilate) so they can carry oxygenated blood into the body.
-Hypothermia: cooling the baby's internal body temperature to 33.5C for up to 72 hours can help protect the baby's brain from damage during the second stage of asphyxia, the “reperfusion" stage, when normal blood flow and oxygen are restored to the brain. The optimal time to give this type of treatment is within six hours after birth. The baby must be at least 36 weeks' gestation (not more than four weeks early) to qualify for this treatment.
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