Perinatal Asphyxia Clinical Forms

Perinatal Asphyxia

    * Introduction
    * Clinical Forms
    Antepartum diagnosis *
    * Changes postpartum laboratory
    * Positive Diagnosis
    * Postasfixic Syndrome
    * Treatment
    * Evolution and prognosis
back Clinical Forms
Clinical expression depends on the severity and duration of asphyxia and the combination of hypoxia and hypoxia with metabolic acidosis hipercarbie. Classical Literature fit forms of asphyxia based on Apgar score: - Mild asphyxia (Apgar score 6-7), which only require tactile stimulation to restore breath; - Average Asphyxia (Apgar score 4-5) in which it was necessary to resume breathing with positive pressure ventilation and mask balloon 100% O2; - Severe asphyxia (Apgar score 0-3) in which positive pressure ventilation with mask balloon was necessary to resume breathing medication administration and improved tissue perfusion.
PRIMARY apnea is the lack of oxygenation to the fetus or newborn in the first phase leading to the appearance of irregular breathing, rapid, full stop followed by gasping and breathing for a period of about 1 minute accompanied by a decrease in heart rate around 100 beats per minute. Infant is cyanotic, with this pulsation in the umbilical cord with the presence of spontaneous movements in the lips and eyelids, with normal or slightly elevated blood pressure. A simple suction probe stimulus by introducing and / or tactile stimulation can produce gaspuri or resume breathing.
SECONDARY apnea is a result of continuous hypoxia, appear gaspuri deep breaths become increasingly weak, child has one last gasp and fall in secondary apnea. During this period the heart rate decreases even to 0, as well as blood pressure, the infant shows skin pale gray, marked hypotonia, weak pulses in the umbilical cord or absent, unresponsive to stimuli and positive pressure ventilation should be initiated with balloon and mask with 100% O2 and managing medications is sometimes necessary to improve tissue perfusion. The duration of secondary apnea directly correlates with the severity of hypoxic ischemic brain damage in neurological damage generators. Fetal Hypoxia apnea can produce both primary and secondary apnea at birth not being able to make a clinical distinction between apnea net primary and secondary apnea. In both cases the baby not breathing and heart rate is low. So, an infant apnea at birth must always be considered in secondary apnea and resuscitation initiated by this depending on postasfixice complications. Perinatal asphyxia can be detected both prenatal and postpartum enter or: Fetus, fetal distress is by highlighting: changing the baby's heartbeat, increased amount of meconium in amniotic fluid, abnormal fetal acid-base balance. Perinatal asphyxia refers to perinatal risk factors. Postnatal asphyxia at birth apneii includes highlighting the first installation absence of breathing and low Apgar score, and mental status evaluation of the newborn - can vary from hyper, to dizziness, lethargy, stupor and coma. Pointing disturbance in other organs and systems in the kidney include: oligoanurie, changing urea, creatinine, non-protein nitrogen. In the cardiovascular system may: miocardopatie posthipoxica with different clinical manifestations to heart failure. The liver may appear altered liver enzymes.