Etiology, Clinical Features, and Management of Birth Asphyxia

Definition and Pathophysiology

Birth asphyxia, also known as perinatal asphyxia, is a condition where a newborn fails to breathe spontaneously and effectively after delivery. This results in inadequate oxygen supply to vital organs, leading to potential complications.

Etiology

• Maternal factors such as hypertension, diabetes, or infections.
• Placental complications like placental abruption or previa.
• Umbilical cord accidents such as cord prolapse or knots.
• Intrapartum conditions including prolonged labor or fetal distress.

Clinical Features

The presentation of birth asphyxia varies in severity:

• Respiratory distress or absence of breathing.
• Poor muscle tone and reflexes.
• Altered heart rate (bradycardia or tachycardia).
• Metabolic acidosis due to prolonged hypoxia.
• Neurological signs such as seizures or altered consciousness.

Management and Treatment

Immediate intervention is crucial to improve outcomes. Key management strategies include:

Initial Resuscitation

• Clearing airway obstruction using suction.
• Providing positive pressure ventilation (PPV) if breathing is inadequate.
• Chest compressions in case of significant bradycardia.
• Administering medications such as epinephrine if required.

Supportive Care

• Hypothermia therapy to reduce neurological injury.
• Fluid and electrolyte management.
• Seizure control using appropriate anticonvulsants.
• Long-term neurodevelopmental monitoring and rehabilitation.

Prognosis

Outcomes depend on the severity and duration of asphyxia. Early intervention and adequate supportive care significantly reduce complications and improve survival rates.