الفهرس | Only 14 pages are availabe for public view |
Abstract Perinatal asphyxia is the medical condition resulting from deprivation of oxygen to a newborn infant that lasts long enough during the birth process to cause physical harm, usually to the brain leading to neonatal encephalopathy. Asphyxia remains a severe condition leading to significant mortality and morbidity. Perinatal asphyxia has an incidence of 1 to 6 per 1,000 live full-term births, and represents the third most common cause of neonatal death. Perinatal asphyxia can arise from a number of antepartum and intrapartum risk factors including severe maternal anaemia or hypertension, traumatic birth and interruption to the umbilical cord circulation during labour which results in cessation of respiratory gas exchange to the fetus. The neonate who is encephalopathic may have an abnormal state of consciousness (eg, hyperalert, irritable, lethargic, diminished spontaneous movements, respiratory or feeding difficulties, poor tone, tremors, jitteriness, seizures, absent primitive reflexes and seizure activity), The infant will often exhibit low Apgar scores and a weak or absent cry and apnea with bradycardia. Guidelines from the American Academy of Pediatrics (AAP) and the American College of Obstetrics and Gynecology (ACOG) for HIE indicate that all of the following must be present for the designation of perinatal asphyxia severe enough to result in acute neurologic injury: 1. Profound metabolic or mixed acidemia (pH <7) in an umbilical artery blood sample, if obtained 2. Persistence of an Apgar score of 0-3 for longer than 5 minutes 3. Neonatal neurologic sequelae (eg, seizures, coma, hypotonia) 4. Multiple organ involvement (eg, kidney, lungs, liver, heart and intestines). |