What Are Common Causes Of Perinatal Asphyxia?
Perinatal asphyxia is a decrease in the blood flow to your baby’s tissues or a decrease in the amount of oxygen in your baby’s blood that occurs before, during, or immediately following delivery. Perinatal asphyxia is a serious condition that can have a long-lasting impact on the health of your child.
The common causes of perinatal asphyxia include placental abruption, umbilical cord obstruction, abnormal fetal development, genetic abnormalities, fetal infections, and maternal hemorrhage or illness. In some cases of perinatal asphyxia, the exact cause is never clearly identified.
OVERVIEW OF PLACENTAL ABRUPTION
One of the common causes of perinatal asphyxia is placental abruption. Placental abruption happens when your placenta detaches itself from the wall of your uterus. It usually occurs after week 20 of your pregnancy. In cases where your placenta detaches from your uterine walls too early, your unborn child might not grow as expected. In extreme cases, some babies might not survive at all.
Because your placenta carries vital oxygen and nutrients from you to your baby up until its birth, placental abruption can reduce your baby’s supply of oxygen and nutrients, which could result in brain damage or other birth injuries. Your doctor should be able to diagnose a placental abruption based on observation of your
SYMPTOMS OF PERINATAL ASPHYXIA
No matter which of the common causes of perinatal asphyxia led to your child’s diagnosis, the main symptom will be a newborn who appears pale and lifeless at birth. Newborns with perinatal asphyxia might show signs of injury to one or more of their organs or systems.
- The effects of perinatal asphyxia on your baby’s heart might show up as poor color or low blood pressure.
- When perinatal asphyxia affects your newborn’s lungs, it can cause difficulty breathing and low oxygen levels.
- Perinatal asphyxia that impacts your child’s brain can lead to lethargy, seizures, or coma.
- Your newborn’s kidneys might create a reduced urine output, and his liver might have trouble digesting milk.
- Your new baby’s blood-forming (hematopoietic) system might show low platelet counts and excessive bleeding.
If your newborn suffers from perinatal asphyxia, he might breathe very weakly, fail to breathe at all at birth, or have an extremely slow heart rate.
HOW PERINATAL ASPHYXIA IS TREATED
Your newborn might need to be resuscitated after their delivery. Resuscitation may be done with a resuscitation bag and mask that forces air into your baby’s lungs. It might also be done by inserting a breathing tube into your newborn’s throat. This procedure is called endotracheal intubation.
If perinatal asphyxia resulted from rapid blood loss, your newborn may be in shock and will be given fluids through their veins or a blood transfusion. Your newborn might require drugs to help their heart function. He might also require the use of a ventilator to support breathing. Your child might also need a transfusion of blood cells and plasma to manage problems in the blood-forming system.
THE PROGNOSIS FOR YOUR BABY AFTER A PERINATAL ASPHYXIA DIAGNOSIS
If your newborn’s organs were damaged by perinatal asphyxia, organ recovery can be speedy with the right treatments. Unfortunately, it might lead to brain damage. Some brain damage might be minimal, and you can expect a completely normal prognosis for your child.
Babies who have a minimal injury to their brains may be completely normal intellectually. Babies who have moderate to severe injuries to their brains are more likely to have permanent signs of brain damage. These children will exhibit a range of cognitive disorders ranging from mild learning disorders, developmental delays, or cerebral palsy. Newborns who suffer from the most severe form of perinatal asphyxia might not survive.
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What Are The Effects Of Perinatal Asphyxia?
Perinatal asphyxia can lead to severe brain damage and physical challenges for your child. The effects of perinatal asphyxia will vary according to how severe the resulting damage to your child is. Most newborns with perinatal asphyxia will seem ashen, colorless, or pale at birth and might also appear to be limp, flaccid, or lifeless
BABIES WITH PERINATAL ASPHYXIA CAN BE SERIOUS
Your infant might need life-saving resuscitation to improve a very slow heart rate. If resuscitation is required, a bag and mask might be used to force air into your baby’s lungs. If needed, your infant might be resuscitated by the insertion of a breathing tube into his throat. This procedure is called endotracheal intubation.
When Is Perinatal Asphyxia Most Likely To Be Diagnosed During Pregnancy?
Perinatal asphyxia occurs late in pregnancy, usually during the days and weeks leading up to delivery, during the delivery itself, or in the first hours or days following birth. For this reason, it is usually not diagnosed during pregnancy. Instead, the doctors treating the baby following birth recognize signs of the condition and diagnose the baby.
After birth, babies may experience perinatal asphyxia because:
- Obstructed airway
- Maternal opiate use
- Respiratory depression caused by other problems
Generally, doctors diagnose perinatal asphyxia after seeing signs of a problem and running tests to confirm the diagnosis. This will include having evidence to show:
- A slow respiratory and neurological response; and
- An acute hypoxic compromise with acidaemia
Doctors confirm these conditions when the baby has an Apgar score below 7 at five minutes after birth and an arterial blood pH of less than 7 or base excess greater than 12 mmol/L, respectively. There may also be other tests and signs your doctor used to identify an issue and diagnose your child.
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Are There Different Types Of Perinatal Asphyxia?
Perinatal asphyxia can be either complete, with no oxygen getting to the brain and vital organs, or partial. Partial asphyxia is known as hypoxia, while a total lack of oxygen is anoxia. In addition, perinatal asphyxia can occur either prenatally or immediately after birth.
Prenatal asphyxia may occur because of a problem with the placenta or another cause that leads to a decrease of oxygen reaching the baby. Post-natal asphyxia affects the ability of the pulmonary system–the lungs–to exchange gases and get oxygen to the baby’s organs.
CAUSES AND TREATMENT OF DIFFERENT TYPES OF PERINATAL ASPHYXIA
Prenatal asphyxia and post-natal asphyxia have different causes. According to StatPearls, among the causes of prenatal hypoxia or anoxic injuries include:
- Low maternal blood pressure (hypotension)
- Excess anesthesia
- Placental abruption (the premature separation of the placenta)
- Placental insufficiency
Prenatal hypoxic or anoxic injuries may occur because:
- Excess oxytocin does not allow the uterus to relax properly
- Prolonged and stressful labor and delivery
- Knotting of the umbilical cord around the neck of the infant
- Other birth injuries that reduce the baby’s ability to breathe
When a baby is born with any type of perinatal asphyxia, the immediate concern will focus on ensuring breathing, blood flow, and oxygenation. According to Seattle Children’s Hospital, these babies may also need:
- Nitric oxide treatment
- Respiratory support, including mechanical respiration in some cases
- Body cooling (hypothermia) for full-term infants
- Medication to control blood pressure
- Dialysis if there are kidney issues
- Treatment for seizures
- Intravenous (IV) nutrition if there is damage to the bowels
What Treatment Options Are Available Following A Perinatal Asphyxia Diagnosis?
A diagnosis of perinatal asphyxia can mean a lifetime of specialized care for your newborn. Understanding what treatment options are available following a perinatal asphyxia diagnosis can help you provide the best care for your son or daughter. Available treatment options can range from blood transfusions to resuscitation. Other treatment options might include one or more of the following:
- Perinatal asphyxia can be life-threatening. For this reason, your newborn might be very pale and appear to be lifeless at birth. In fact, your son or daughter might be born breathing very poorly or not breathing at all. They might also have an extremely slow heart rate. If any of these circumstances are present at your child’s birth, they might need to be revived after delivery.
- The treatment options for your newborn can include resuscitation using a resuscitation bag and mask that pushes air into your baby’s lungs. Resuscitation can also be done by the insertion of a breathing tube into your newborn’s throat. This treatment option is called endotracheal intubation.
- If your child’s perinatal asphyxia is the result of sudden or rapid blood loss, he might lapse into a state of shock. If that happens, your son or daughter will immediately be given intravenous fluids. Your newborn might also be given a beneficial blood transfusion.
- Depending on the extent of their birth injury, treatment options are available following a perinatal asphyxia diagnosis. Your newborn might require the use of drugs that will help his heart function correctly. He might also need a mechanical ventilator to support his breathing.
- If your newborn required resuscitation at birth, another treatment option is a specialized treatment that will use a cooling blanket to lower his body temperature for up to 72 hours. At the end of the specified amount of time, your baby’s body temperature will be slowly returned to normal.
- The treatment plan for your newborn might also include blood cell transfusions and plasma transfusions. These treatment options might be deemed necessary by your child’s physician to help manage problems with his blood forming system.
Your child’s physician may consult with other medical specialists or choose other treatment options. They might also create a custom treatment plan specifically for your child. All available treatment options should be discussed with you along with any potential side effects.
Can Surgery be Used to Decrease the Likelihood of Perinatal Asphyxia in Newborns?
Common causes of perinatal asphyxia include placental abruption, obstruction of the umbilical cord blood flow, and maternal hemorrhage. In addition, many birth injuries share a common cause–a difficult delivery because your baby becomes lodged in the birth canal. Because this difficulty is often the cause of birth injuries, one type of surgery that might decrease the likelihood of perinatal asphyxia in newborns is a C-section delivery.
What Is a Cesarean Delivery?
A cesarean delivery, also known as C-section delivery, means your baby will be delivered through two surgical incisions—one in your abdomen and one in your uterus. Your medical team should recommend a C-section delivery when they believe it will prove safer than vaginal delivery for you, your baby, or both of you. Some situations that might lead your doctor to choose a C-section delivery include:
- Labor that progresses too slowly
- Abnormal fetal positioning such as a breech presentation
- An abnormal fetal heart rate that indicates fetal distress
- Excessive vaginal bleeding that indicates placental abruption
A C-section delivery might lead to a longer and more painful recovery from childbirth but could result in a safer delivery of your baby.
What Is Placental Abruption?
Your placenta is normally situated in the upper portion of your uterus and is firmly attached to your uterine wall where it remains until after your baby is safely delivered. A healthy placenta is critical because it carries oxygen and nutrients from you to your unborn child. Your placenta is delivered shortly after your child is delivered.
Placental abruption happens when your placenta prematurely detaches from the wall of your uterus, usually occurring after twenty weeks of pregnancy. When placental abruption happens, your unborn child might be unable to grow as much as needed. Placental abruption might also lead to the loss of your child’s life.
Risk factors for placental abruption include high blood pressure developed during your pregnancy, advanced maternal age, blood vessel disorders, abdominal injuries, and an excessive amount of amniotic fluid.
What Are the Tell-Tale Signs of Perinatal Asphyxia?
During prenatal care visits, labor, and delivery, you or a member of your medical team might notice signs and symptoms of perinatal asphyxia. Symptoms of perinatal asphyxia may not always be immediately apparent, but might include these common symptoms:
- An abnormal fetal heart rate prior to your child’s birth
- Low fetal pH levels that might indicate excessive acid levels
- Poor skin color and a low heart rate at birth
- Decreased muscle tone and poor gasping
- Meconium (stool) stained amniotic fluid
- A poor five-minute Apgar score
- Evidence of neurological disorders
- Respiratory problems
When your physician notices these symptoms, he should perform extensive evaluations and may order additional tests to confirm his diagnosis and prepare a treatment plan to ensure a safe delivery for your unborn child.
How Can Infants Recover From Perinatal Asphyxia?
When you receive the final diagnosis of perinatal asphyxia, your immediate concern is for the health of your new baby. One of the first things you will want to know is how infants recover from perinatal asphyxia and what specific measures can help your child reach a favorable prognosis.
How infants recover from perinatal asphyxia largely depends on their symptoms or a combination of symptoms. Some potential outcomes and their accompanying recovery options include:
- Your newborn might require resuscitation after their birth and then be temporarily connected to medical machinery to regulate their breathing.
- Your child might suffer from organ system dysfunction that can leave them with a variety of uncomfortable symptoms. When the symptoms are treated, most infants with perinatal asphyxia will eventually experience full recovery of their organs.
- If your baby experiences minimal brain damage as the result of their perinatal asphyxia may be able to recover from the brain damage and live a completely normal life.
- If your child’s brain damage ranges from moderate to extensive, your child might be left with permanent brain damage that will lead to delayed cognitive development and mild, moderate, or severe learning disabilities.
- Some children who are afflicted with perinatal asphyxia may eventually be diagnosed with cerebral palsy. Cerebral palsy is a permanent, lifelong disorder that leads to a lack of muscle tone and serious cognitive delays. Your child with cerebral palsy might also suffer from slurred speech and a lack of social skills.
Your child’s pediatrician and other medical specialists will be able to provide you with a specific prognosis for your son or daughter. The treatments your child will be offered and the scope of their prognosis will depend on the severity of their perinatal asphyxia.
Is Perinatal Asphyxia Ever Fatal?
Perinatal asphyxia is a serious birth injury that can have both temporary and permanent effects on the physical and cognitive health of your child. Perinatal asphyxia can be near-fatal at birth and require that your child be resuscitated or revived. Some newborns who are afflicted with perinatal asphyxia will experience severe brain damage that does not support proper bodily function. In these cases, the most severely asphyxiated infants will not survive.
The Causes of Perinatal Asphyxia
Perinatal asphyxia, or decreased blood flow to your baby before, during, and after delivery, can have many causes. Some of the most commonly seen causes of this birth injury include:
- Placental abruption, a condition where your placenta separates from your uterus prior to the delivery of your baby
- An umbilical cord problem that causes an obstructed blood flow to your unborn child
- A genetic abnormality that results in an abnormally developed fetus
- A serious infection in your unborn child
- Severe maternal hemorrhage or illness
In some cases of perinatal asphyxia, an underlying cause can never be fully identified. A medical specialist might be able to identify the cause of your child’s birth injury and the scope of possibilities for his prognosis.
Preventing Perinatal Asphyxia
Infants recover from perinatal asphyxia at varying rates and in varying degrees. As you watch and wait for your child to begin the potentially long recovery process, it is natural to wonder if the initial birth injury could have been avoided altogether.
With regular and proper prenatal care and screenings, the symptoms of perinatal asphyxia can be detected and treated. Some of those symptoms include an abnormal fetal heart rate, low pH levels that indicate an excessive amount of fetal acid, and signs and symptoms of placental abruption.
Placental abruption is the premature detachment of your placenta. This condition occurs only in pregnant women and is diagnosed based on observance of your symptoms and with the use of prenatal ultrasound technology. Like most pregnancy complications, many instances of placental abruption can be treated effectively.
A Birth Injury Lawyer for Perinatal Asphyxia
When a birth injury or medical neglect complicates the birth of your child, you are entitled to answers and explanations. You and your child might also be entitled to financial compensation to help cover the cost of current and ongoing medical care.
Infants recover from perinatal asphyxia. How your child recovers can play a role in their treatment plan and expected prognosis. You are entitled to provide your child with the best medical care that offers the greatest possible outcome. An attorney can help you receive the financial recovery your son or daughter deserves. Call the Birth Injury Lawyers Group at (800) 215-4455 to schedule a free review of the merits of your lawsuit.