Asphyxia in newborns, when oxygen supply decreases

Babies need an adequate supply of oxygen during childbirth. If the oxygen supply is lacking, the brain and all organs in the baby's body cannot function properly. It is not impossible, one of the complications of childbirth can occur in newborns known as asphyxia neonatorum.

This condition cannot be taken lightly because it can be fatal. So, what is asphyxia neonatorum or newborn?

For more details, here is a complete review of asphyxia in newborns.

What is asphyxia in newborns?

Asphyxia in newborns is a disease also known as perinatal asphyxia or neonatal asphyxia.

Literally, the meaning of asphyxia is a condition when the oxygen supply decreases or stops.

Perinatal is a condition that includes before, during, and after childbirth, either a normal delivery in any labor position or a cesarean section.

Meanwhile, neonatorum refers to diseases experienced by newborns.

Quoting from Seattle Children's, asphyxia is defined as a condition when the body lacks oxygen and blood flow to the brain.

So, the definition of asphyxia neonatorum or in newborns is a condition when the baby does not get enough oxygen during the labor process.

This automatically makes it difficult for the baby to breathe before, during, and after birth.

This condition of asphyxia in newborns or neonatorum prevents the baby's brain and other organs from getting enough oxygen and nutrition.

So actually not only during childbirth, these birth complications can also be experienced by babies before and after birth.

This condition that occurs in newborns can also be caused by increased levels of carbon dioxide.

This complication during childbirth cannot be underestimated because it can pose a fatal risk to the baby.

This is because without an adequate supply of oxygen for the baby, the cells in the body automatically cannot work properly.

As a result, there is no oxygen supply for the baby causing many waste products such as acid waste to accumulate in the cells.

This condition will later lead to disturbances in the body of the newborn so that it can cause damage to the brain.

This complication of childbirth can be fatal for the baby because without oxygen, the cells in the baby's brain can not function properly.

In fact, this condition can cause long-term problems in babies, such as intellectual disorders, seizures, stunted development, and cerebral palsy.

What are the symptoms of this disease in newborns?

Symptoms of asphyxia in newborns can vary from one another.

In fact, sometimes, the symptoms of this condition can appear immediately, but may not be detected shortly after the baby is born.

One of the signs that usually appears is the baby's heart rate that is too high or low.

In general, the following are various symptoms of perinatal asphyxia before a baby is born according to Benioff Children's Hospital UCSF:

Abnormal heart rate or rhythm.
Increased levels of acid in the baby's bloodstream.

After birth, the symptoms of asphyxia neonatorum or in newborns are as follows:

The skin appears pale or slightly bluish in color.
Difficulty breathing, causing the baby to breathe quickly or gasping, and use the stomach.
Heart rate slows slightly.
Weakened muscles.
The baby looks limp.
Stunted growth.
There is meconium (baby's first stool) in the amniotic fluid, skin, nails, or umbilical cord

In addition, the classification of neonatal asphyxia symptoms can also be divided into mild or moderate and severe.

Classification of symptoms of mild or moderate asphyxia

Symptoms of mild or moderate neonatal asphyxia in newborns are as follows:

Weak muscle strength or poor muscle tone.
Irritable and cranky.
Extreme sleepiness.
It is difficult to eat and breastfeed because you are unable to suck the mother's nipple.

Classification of symptoms of severe asphyxia

While the various symptoms of mild or moderate category of neonatal asphyxia in newborns are as follows:

The baby's body is cramped.
Baby's skin and lips are blue.
It's hard to breathe.

The length of time the baby does not get an adequate supply of oxygen can affect the mild and severe the symptoms of asphyxia neonatorum he experiences.

This means that the longer the baby does not get a sufficient amount of oxygen, the more likely the symptoms of asphyxia will appear.

In some cases, the classification of severe asphyxia symptoms in newborns can cause damage to various organs.

The damage includes the baby's heart, brain, kidneys and lungs.

What causes asphyxia in newborns?

There are various things that can cause asphyxia neonatorum or in newborns.

That is why doctors and medical teams must always monitor the condition of mothers and babies before, during, even after childbirth.

The various causes of neonatal asphyxia in newborns are as follows:

The mother's blood pressure is too high or low during labor.
Insufficient oxygen supply in the mother's blood before or during delivery.
There is a problem with the baby's respiratory tract.
Babies are anemic so that their body's blood cells don't get enough oxygen.
There is an infectious disease that attacks the mother or baby.
Labor that is difficult or takes a long time.
There is a problem with the placenta that wraps around the baby's body.
The placenta is released too quickly during delivery, making it difficult for the baby to breathe.
The prolapsed umbilical cord or cord that comes out earlier than the baby.
A meconium aspiration syndrome occurs, which is the meconium a baby is inhaled before, during, or after delivery.
When the baby is born before 37 weeks (premature babies), the lungs of premature babies experience complications because they have not developed so that it is difficult to breathe.

In more detail, the causes of neonatal asphyxia can be divided into two, namely in premature babies and babies born at term.

Causes of asphyxia in premature babies

The causes of asphyxia in newborn premature babies with symptoms that appear at less than 6 hours of age are:

Pneumonia
Hyaline membrane disease (HMD)
Shock

The causes of asphyxia in preterm newborns with symptoms that appear more than 6 hours old are:

Pneumonia
Congenital heart disease
Lung problems
Hemorrhagic or bleeding

Causes of asphyxia in term babies

The causes of asphyxia in full term babies with symptoms that appear at less than 6 hours are:

Transient tachypnea of the newborn (TTN or TTNB), which is a respiratory disorder that appears in neonates shortly after birth
Meconium aspiration syndrome, which is the entry of amniotic fluid containing the baby's first feces into the respiratory tract
Persistent pulmonary hypertension in newborns

The causes of asphyxia in babies born at term with symptoms that appear more than 6 hours old are:

Pneumonia
Congenital heart disease
Polycythemia

A baby's lack of oxygen supply before, during, or after delivery can occur in two ways.

The first causes immediate interference that occurs for a few minutes after delivery.

Second, disturbances that arise when the body's cells are no longer lacking oxygen.

However, these cells actually release toxins into the baby's body.

Before actually giving birth, usually the mother feels the signs of childbirth such as real labor contractions which need to be distinguished from false contractions.

Not only that, the sign of labor, namely the water breaking and the opening of the birth can also occur.

Because the arrival of the delivery process is difficult to predict, make sure the mother has prepared various labor preparations and essential delivery supplies.

How to diagnose this condition?

The doctor and medical team will conduct a physical examination to look for conditions such as the following:

The baby is not breathing or crying
Decreased muscle tone
Low birth weight (LBW)
Heart rate less than 100 beats per minute
There is meconium mixture in the mother's amniotic fluid or meconium residue in the baby's body

Apart from physical examination, there are also supporting examinations whose results will be checked further in the laboratory.

The purpose of this laboratory examination is to look for possible results of acidosis (high acid levels) in the umbilical cord blood.

Various other supporting tests to diagnose a baby's lack of oxygen supply before, during, or after birth, namely:

Complete peripheral blood count
Blood gas analysis after birth
When blood sugar
Lactate
Ureum creatinine
Blood electrolytes (calcium, sodium, potassium)
Radiological examination or chest X-ray
Radiological examination or three-position abdominal X-ray
Head ultrasound examination
Electroencephalography (EEG) examination
CT scan of the head

This complication of childbirth for babies is easier and faster to handle if the mother gives birth in a hospital instead of giving birth at home.

If the mother has been accompanied by a doula from the time of pregnancy, the duties of this childbirth companion will continue until after delivery.

What is the treatment for neonatal asphyxia?

In general, the treatment of newborns with asphyxia is usually based on the cause.

Treatment is given depending on the severity of the symptoms of asphyxia in the newborn and the time when the baby is diagnosed with asphyxia.

Doctors usually perform resuscitation as a treatment for asphyxia in infants, both for premature babies (preterm infants) and full term babies.

Resuscitation for babies is given while paying attention to several things such as:

Babies are warmed by placing them under an internal radiant warmer
nakedness.
The baby is placed with a slight tilt of the head to make it easier to fit the appliance and the entry of air after resuscitation.
The airway, such as the windpipe (trachea), is cleaned to prevent meconium aspiration syndrome when meconium is found in the amniotic fluid of the baby.

On the other hand, babies can also be given therapy according to their condition, for example artificial surfactant therapy.

The baby may also be given additional oxygen or a ventilator.

Can this condition be cured?

Asphyxia that occurs in newborns that are mild or moderate can recover completely.

It's just that, if the baby's body cells do not get enough oxygen for a long time, it may cause injury.

To make matters worse, asphyxia in newborns that is not treated as soon as possible can have the risk of affecting the condition of the brain, heart, lungs, kidneys, intestines and other organs of the body.

Cooling the body (therapeutic hypothermia) can improve the condition of asphyxia in newborns at full term.

Unfortunately, in severe cases, asphyxia in newborns can lead to organ failure and death.