Oxygen deficiency around birth
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Babies who have been deprived of oxygen in the abdomen or during delivery may develop problems after birth. The brain is very vulnerable to a lack of oxygen. Symptoms that may indicate a birth problem include difficulty breathing, dull or pale skin, and a slow heart rate. Babies are floppy and react poorly to outside stimuli.
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Babies who have been deprived of oxygen in the abdomen or during delivery may develop problems after birth. The brain is very vulnerable to a lack of oxygen. Symptoms that may indicate a birth problem include difficulty breathing, dull or pale skin and a slow heart rate. Babies are floppy and react poorly to outside stimuli.
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There are situations where babies deteriorate very quickly during labor. This is due, for example, to a prolapsed umbilical cord, a knot in the umbilical cord or if the placenta suddenly separates from the uterus.
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There are situations where babies deteriorate very quickly during delivery. This is due, for example, to a prolapsed umbilical cord, a knot in the umbilical cord or if the placenta suddenly separates from the uterus.
Causes
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Oxygen deficiency at birth (perinatal asphyxia) can be the result of events before and after birth. Before birth, the baby is completely dependent on the uterine system, the placenta and the umbilical cord. Disruptions in this system slowly or directly endanger the baby. The more drastic and acute the situation, the faster it has to be responded to. Factors that play a role in oxygen deprivation around birth include: A malfunctioning placenta A placenta that is partially detached High blood pressure of the mother A prolapsed umbilical cord An umbilical cord that fits tightly around the baby's neck Press the baby's head Not progressing the delivery, where, for example, shoulders hang behind the pubic bone of the mother (shoulder dystocia) Amniotic fluid containing meconium Immaturity of the lungs A collapsed lung (pneumothorax)
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Oxygen deficiency at birth (perinatal asphyxia) can be the result of events before and after birth. Before birth, the baby is completely dependent on the uterine system, the placenta and the umbilical cord. Disruptions in this system slowly or directly endanger the baby. The more drastic and acute the situation, the faster it has to be responded to. Factors that play a role in oxygen deprivation at birth include: A malfunctioning placenta A placenta that is partially detached High blood pressure of the mother A prolapsed umbilical cord An umbilical cord that fits tightly around the baby's neck Press the baby's head Not progressing the delivery, where, for example, shoulders hang behind the pubic bone of the mother (shoulder dystocia) Meconium-containing amniotic fluid Immaturity of the lungs A collapsed lung (pneumothorax)
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Diagnosis
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The physical condition of the baby is recorded immediately after birth by means of the Apgar score. Babies with oxygen deficiency will score lower. Indications that damage may have occurred: Spontaneous breathing starts late There is - for a long time - low muscle tone The reflexes (Moro / suction / search / grasp reflex) are long low or even absent The pupils are narrow Your baby reacts irritably during care Your baby will have convulsions If a baby does not get enough oxygen and can lose carbon dioxide through the umbilical cord (before birth) or through the lungs (after birth), acidification occurs. Hereby the acidity in the blood rises and the content of lactic acid also rises. This can be measured in the blood. The degree of oxygen deficiency in the baby is indicated by the level of the lactic acid content. It is standard that the blood in the umbilical cord is examined for acidity and lactic acid (lactate). This happens after birth. The blood results are reasonably consistent with the degree of oxygen deficiency. However, doctors cannot fully rely on this: it can happen that the values are very good, but there is nevertheless a serious form of oxygen deficiency (and vice versa).
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The physical condition of the baby is recorded immediately after birth by means of the Apgar score. Babies with oxygen deficiency will score lower. Indications that damage may have occurred: Spontaneous breathing starts late There is - for a long time - low muscle tone The reflexes (Moro / suction / search / grasp reflex) are long low or even absent The pupils are narrow Your baby reacts irritably during care Your baby will have convulsions If a baby does not get enough oxygen and can lose carbon dioxide through the umbilical cord (before birth) or through the lungs (after birth), acidification occurs. This increases the acidity in the blood and the content of lactic acid also rises. This can be measured in the blood. The degree of oxygen deficiency in the baby is indicated by the level of the lactic acid content. It is standard that the blood in the umbilical cord is examined for acidity and lactic acid (lactate). This happens after birth. The blood results are reasonably consistent with the degree of oxygen deficiency. However, doctors cannot fully rely on this: it can happen that the values are very good, but there is nevertheless a serious form of oxygen deficiency (and vice versa).
Treatment
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The treatment is aimed at quickly supplying sufficient oxygen. This is done, for example, by giving oxygen to the baby through a cap or by breathing with a hose or tube in the trachea. Care is taken that the baby does not cool down. When breathing has started properly, the baby is placed in an incubator for observation. Babies with severe oxygen deficiency are artificially kept at a temperature of 33 degrees a few days after birth. This can limit further injuries after damage to the cells.
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The treatment is aimed at quickly supplying sufficient oxygen. This is done, for example, by giving oxygen to the baby through a cap or by means of respiration with a hose or tube in the trachea. Care is taken that the baby does not cool down. When breathing has started properly, the baby is placed in an incubator for observation. Babies with severe oxygen deficiency are artificially kept at a temperature of 33 degrees a few days after birth. This can limit further injuries after damage to the cells.
Forecast A lack of oxygen around birth increases the risk of brain damage. It is not the case that damage always occurs. Some children - despite certain factors that have gone through - do not suffer from anything later. Brain damage due to oxygen deficiency causes abnormal muscle tension in (parts of) the body. In old age, a child with oxygen deficiency can suffer from spasticity and / or developmental delay. Not all children with oxygen deficiency develop spasticity or problems later on, and not all children with spasticity have suffered from oxygen deficiency around birth. Unfavorable factors were probably (partly) responsible for its birth. This article has been approved by Dr. J.M. de Bont, pediatrician-pediatric neurologist at UMC Utrecht. Last revised October 12, 2018 Don't miss anything anymore?
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