Friday, July 15, 2016

Birth Asphyxia and its manifestations

Definition: Birth asphyxia Birth asphyxia is defined as a reduction of oxygen delivery and an accumulation of carbon dioxide owing to cessation of blood supply to the fetus around the time of birth.

Although , APGAR score is retrospective scoring , it has been used to assess the severity of Asphyxia.
Apgar score 8~10: no asphyxia
Apgar score 4~8: mild
Apgar score 0~3: severe



Clinic manifestations
Complications:
CNS: HIE, ICH
Respiratory system: MAS, RDS, pulmonary hemorrhage
CVS: heart failure, cardiogenic shock
Gastrointestinal system: NEC, stress gastric ulcer
Others: hypoglycemia, hypocalcemia, hyponatremia

Diagnosis
American Academy of Pediatrics (AAP) and the American College of Obstetrics and Gynecology (ACOG) suggest that all of the following must be present for the designation of perinatal asphyxia severe enough to result in HIE:
  1. Profound metabolic or mixed acidemia (pH < 7) in an umbilical artery blood sample, if obtained
  2. Persistence of an Apgar score of 0-3 for longer than 5 minutes
  3. Neonatal neurologic sequelae (eg, seizures, coma, hypotonia)
  4. Multiple organ involvement (eg, kidney, lungs, liver, heart, intestines)
Suggested reading: Thompson Scoring for HIE

Here is the details for MBBS students on HIE- A CNS manifestation of Asphyxia




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