Birth Asphyxia.pptx

birth asphyxia

1. BIRTH ASPHYXIA Mrs. Malarkodi .S Assistant Professor CON, AIIMS, Rishikesh

2. Introduction Birth asphyxia is a leading cause of neonatal mortality & morbidity .It is also important cause of developmental delay & Neurological problems both term & preterm newborn. Approximately 5 t0 10% neonates experience asphyxia a t birth.

3. Meaning Birth asphyxia, also called asphyxia neonatorum, is the inability of an infant to establish regular respiration Following birth.

4. Definition Birth asphyxia is the non establishment of satisfactory pulmonary respiration at birth. It is failure of initiation & maintenance of spontaneous respiration with hypoxia, hypoventilation , hypercapnia, hypo perfusion, & metabolic acidosis.

5. Etiological factor Approximately 90% of asphyxia events occur as a result of placental insufficiency due to ante partum & intrapartum factors. Postnatal factors account for the remaining. Ante partum Intrapartum Postpartum

6. Ante partum placental insufficiency due to Pre-eclampsia Hypertension Anemia Diabetes Mellitus Post maturity Other factor include ante partum hemorrhage mal presentation Multifetal pregnancy

7. poor fetal growth maternal systemic diseases maternal drug therapy ( eg . lithum ) poly or oligohydramnios placental malformation vascular anomalies of the cord congenital anomalies of the fetus.

8. Intra partum Emergency CS Instrumental delivery Abnormal position Premature labour Precipitous labour Prolonged rupture of membranes Prolonged labour > 24 hrs Prolonged 2 nd stage of labour

9. Foetal bradycardia Non-reassuring foetal heart rate pattern General anaesthesia Narcotics administered within 4 hours of delivery Meconium stained liquor Prolapsed cord Abruptio placenta Placenta Previa

10. POST NATAL FACTOR pulmonary, cardio vascular & neurological abnormalities of the neonate Aspiration

11. CLINICAL FEATURES Clinical manifestations depends upon the etiology, intensity, duration of oxygen lack, plasma carbon dioxide level & acidosis. There are 2 stages Asphyxia livida or stage of cyanosis, primarily due to respiratory failure with Apgar score 4 to 6. Asphyxia pallida or stage of shock due to combined respiratory & vasomotor failure with Apgar score 0- 3.

12. MANAGEMENT

13. COMPLICATION BRAIN: hypoxic- ischemic encephalopathy intracranial hemorrhage convulsion HEART: hypoxic cardiomyopathy cardiac dysrhythmias congestive cardiac failure. shock

14. LUNGS: meconium aspiration syndrome hyaline membrane disease pulmonary hemorrhage pneumonia KIDNEYS: Hematuria renal failure renal vein thrombosis

15. GASTR0 INTESTINAL: necrotizing enterocolitis paralytic ileus & obstruction HEMATOLOGIC : DIC, hyperbilirubinemia and sepsis ENDOCRINE: Adrenal hemorrhage IMMUNOLOGIC: septicemia

16. PROGNOSIS It is depends upon associated factors, maturity of the baby, duration & intensity of hypoxia & acidosis & initiation of resuscitative measures in the delivery room. Subsequent competent care & available facilities also influence the out come following birth asphyxia

17. NURSING DIAGNOSIS Ineffective Airway Clearance R/T Aspiration Meconium & mucus Impaired breathing pattern r/t immaturity of the lungs Impaired thermoregulation (hypothermia) r/t immature thermoregulatory state of neonates Risk for complication r/t loss of oxygen supply to the vital organ

18. PREVENTIVE MEASURES Intensive antenatal care Intra natal assessment of fetal hypoxia Careful use & intelligent use of anesthetic agents & depressant drugs in labor Care of neonates at birth Special attention to avoidance of preterm delivery Care of pre term & low birth wt baby

19. Summary As we discussed post sequelae of birth asphyxia is traumatic both physically and psychological hence it is important for every neonatal nurse to anticipate the problem and intervene in the right manner.

20. References Assuma Beevi (2009). Concise Textbook of Pediatric Nursing. 2 nd Edition. Elsevier Publication OP Ghai (2013) Essentials of Pediatrics. 8 th Edition. CBS Publishers and distributors. Datta Parul (2010). Paediatric Nursing. 3 rd Edition. JAYPEE publication