Perinatal Asphyxia Changes postpartum laboratory

Perinatal Asphyxia

    * Introduction
    * Clinical Forms
    Antepartum diagnosis *
    * Changes postpartum laboratory
    * Positive Diagnosis
    * Postasfixic Syndrome
    * Treatment
    * Evolution and prognosis
back Changes postpartum laboratory
Changing acid-base balance in cord blood: - Low pH below 7 - metabolic acidosis with base excess over -11 carbonates fell below 18 mmol / l (beware, the bicarbonate is stabilized after 24-48 hours!) - Oxygen tension (PaO2) decreased (hypoxia of different degrees); - Carbon dioxide pressure (PaCO2) can be increased (hipercarbie). Subsequent determinations of acid-base balance in arterial blood or blood capillary, arterializat "(by heating the place of harvest) can determine the gravity of asphyxia.
Transcutaneous blood gas monitoring plays an important role. Hemoglobin saturation, which must be maintained between 92-98% (89% prematurely accepted values) is also very useful. Monitoring blood pressure should not be neglected. Record the normal term infant 60-90 mmHg, and the premature infant between 40-80 mmHg, medium voltage (MAP) over 30 mmHg regardless of gestational or postnatal age. Can meet frequently Postasfixic hypotension (below 30 mmHg average - a more accurate determination of the definition of hypotension). Determination of glucose shows an increased importance. Generally meet hypoglycemia (below 40 mg% regardless of gestational age and postnatal age), which may increase brain damage. Determination of calcium will show that generally meet hypocalcemia (serum calcium levels below 7 mg% and calcium ion levels below 3 mg%). Ionograma blood may look hipercaliemie, hyponatremia, hyperchloraemic. Determination of urea, creatinine may be elevated and non-protein nitrogen (BUN 15 mg non-protein nitrogen and creatinine over 1%, 50 mg%) showing the suffering renal asphyxia. Blood determinations, such as hemoglobin and hematocrit, can be modified in the Blood postasfixice suffering. Determination of hepatic transaminases may look postasfixica suffering. Other investigations such as cardio-pulmonary radiography may specify the changes characteristic of hyaline membrane disease, meconium aspiration, with enlargement of the heart in cardiac posthipoxice suffering. Electrocardiogram (ECG) repolarization may change due to ischemic cardiac events. EEG is useful only in conditions of existence of a functional specialist in exploration in the newborn, as this category of children and especially premature normal physiological changes during this period can be interpreted as pathological changes. Trans Ultrasound, computed tomography software (CT) and magnetic resonance imaging (MRI) are necessary to detect postasfixice neurological complications (edema, leukomalacia, cerebral infarction, hemorrhage, etc.).