Perinatal asphyxia is a lack of blood flow or gas exchange to or from the fetus in the period immediately before, during, or after the birth

Birth asphyxia, defined as the failure to establish breathing at birth, accounts for an estimated 900,000 deaths each year and is one of the primary causes of early neonatal mortality. The most common cause of perinatal asphyxia is complications during childbirth

1. BIRTH ASPHYXIA PRESENTED BY: SIDRA 19030 PRESENTED TO:MAM FIRDOS

2. OBJECTIVES At the end of this presentation learner will be able to: Define Birthasphyxia. Elaborate its etiological Factors. Describe it’s pathophysiology. Enlist the clinical features of Birthasphyxia. Discuss the management of Birthasphyxia.

3. BIRTH ASPHYXIA Birth asphyxia is the nonestablishment of satisfactory pulmonary respiration at birth. It is the failure of initiation and maintenance of spontaneous respiration with hypoventilation,anaerobic glycolysis and lactic acidosis. It leads to progressive hypoxia,hypercapnia,hypoperfusion and metabolic acidosis.

4. BIRTH ASPHYXIA Historically categorized into two grades : Asphyxia livida (blue asphyxia) - blue appearance of the newborn. Muscle tone is good and the infant is responsive to stimuli. Asphyxia pallida (white/pale asphyxia) more severe, baby is pale, flaccid and unresponsive to stimuli.

5. BIRTH ASPHYXIA Currently, birth asphyxia is graded into 3 categories (mild, moderate and severe) using the APGAR SCORE . According to the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics, a neonate is labelled to be asphyxiated if the following conditions are satisfied Umbilical cord arterial pH <7 Apgar score of 0–3 for longer than 5 min

6. BIRTH ASPHYXIA Neonatal neurological manifestations (e.g. seizures, coma or hypotonia); Multisystem organ dysfunction, e.g. cardiovascular, gastrointestinal, haematological, pulmonary or renal system.

7. ETIOLOGICAL FACTORS

8. PATHOPHYSIOLOGY

9. CLINICAL FEATURES Acidaemia, leading to an abnormal heart rate or rhythm Pallor Cyanosis Decreased tones and reflexes Poor or absent cry Gasping or poor respiratory effort

10. CLINICAL FEATURES Hypotonia Hyporeflexia Meconium stained liquor Ocular manifestation (fixed dilated pupils, nystagmus) Stupor Comma

11. CLINICAL FEATURES Another indicator is a  low Apgar score . Apgar is a rating system that healthcare professionals use to measure the health of a newborn. Apgar stands for: A ppearance P ulse G rimace A ctivity R espiration

12. CLINICAL FEATURES Healthcare professionals will give a baby a rating from 0 to 10, depending on the health of their: skin tone heart rate muscle tone reflexes breathing A low Apgar score (between 0 and 3) that lasts for  more than 5 minutes  can indicate birth asphyxia.

13. Short-term Complications The short-term effects of birth asphyxia can include: acidosis , which is when too much acid builds up in the blood respiratory distress high blood pressure blood clotting problems kidney problems

14. Long-term Complications Long-term effects may include: hyperactivity autism spectrum disorder attention deficits low intelligence quotient score schizophrenia psychotic disorders  in adulthood

15. Long-term Complications Severe asphyxia can cause: intellectual disability cerebral palsy epilepsy sight or hearing impairment

16. MANAGEMENT The type of treatment will depend on the severity and cause of the birth asphyxia. Immediate treatments include: providing extra oxygen to the pregnant person if birth asphyxia happens before delivery emergency or  cesarean  delivery suctioning fluid away from the airways in the case of meconium aspiration syndrome putting the newborn on a respirator

17. MANAGEMENT For severe cases of birth asphyxia, treatment may include: placing the baby in a  hyperbaric oxygen tank , which supplies  100% oxygen  to the baby induced hypothermia to cool the body and help  prevent brain damage medication to regulate blood pressure dialysis  to support the kidneys and remove excess waste from the body

18. MANAGEMENT 5. medication to help control seizures 6. intravenous (IV) nutrition 7. a breathing tube to supply nitric oxide 8.life support with a heart and lung pump

19. PREVENTION Preventing birth asphyxia can be difficult because the condition can happen suddenly and without warning. P roper care and monitoring before and after every birth are vital, particularly in settings where fewer resources are available. 

20. PREVENTION Steps may include: effective resuscitation controlling body temperature ensuring that the correct equipment is available having properly trained and skilled healthcare providers present for every birth

21. PREVENTION 5. pretreatment with certain medications, such as  barbiturates , to  reduce the risk  of brain. injury 6. treatments, such as body cooling, to prevent secondary complications from asphyxia due to damaged cells releasing toxins.

22. THANK YOU