Perinatal Asphyxia Antepartum diagnosis

Perinatal Asphyxia

    * Introduction
    * Clinical Forms
    Antepartum diagnosis *
    * Changes postpartum laboratory
    * Positive Diagnosis
    * Postasfixic Syndrome
    * Treatment
    * Evolution and prognosis
back Antepartum diagnosis
Electronic fetal heart monitoring cardiotocografie measured indirectly by the central nervous system, fetal oxygenation and acid-base status. Normal fetal heart rate ranges between 110-160 beats per minute. Can be detected: - Tachycardia (160 beats per minute), which is often due to early hypoxia, maternal fever and / or fetal infection; - Bradycardia (less than 100 beats per minute more than 1-2 minutes), which is due to persistent hypoxia, acidosis, direct myocardial depression; - Variability of the normal deceleration rate of early and late expressing either the fetal head compression or cord compression at the level or utero-placental insufficiency; - Non-stress test; - The contraction stress test.
Fetal ultrasound helps: - Estimating gestational age, with an accuracy of + 2 days if ultrasound is performed in the first 20 weeks of gestation and + 3 weeks if ultrasound is performed in the third quarter. - Estimation of fetal weight: delay in intrauterine growth, macrosomia. - Measurement of amniotic fluid volume: too much or too little amniotic fluid interfere with fetal pathology - Determination of structural abnormalities as hydrocephalus, abnormal renal failure.
Doppler studies allow the study of blood flow through the umbilical artery and fetal cerebral flow. Studies velocimetriei component involves the study systolic and diastolic, systolic component reflects cardiac function, diastolic component reflecting the value of peripheral resistance. During pregnancy uterine blood flow is increased, with minimal peripheral resistance to the effects of estrogen on uterine circulation. If peripheral resistance increases much more flow in diastole is reduced, reaching 0. Absence of end diastolic flow is associated with intrauterine growth restriction, intrauterine fetal death, asphyxia at birth.
Direct investigation of the fetus, which can be done either by amniocentesis or by cordonocenteza (the technique has not yet been well set) is used in order to determine: hemoglobin and hematocrit of the umbilical cord blood pH and cord blood gases, fetal white blood cell function, Ig M's, fetal karyotype, biochemical determinations of amniotic fluid reveals the ratio lecithin / sfingomielina, phosphatidylinositol, fosfatidilglicerolul.