Birth asphyxia

Birth asphyxia Hypothermia Meconium or amniotic fluid aspiration Necrotizing enterocolitis Respiratory distress syndrome Shock Obstetrics Abortion... 

The relation between maternal morphine administration during labor and the Apgar score of the baby at birth has been studied (SED-11, 137) (96). The authors concluded that morphine alone did not seem to cause asphyxia at birth, but that morphine together with other fetal and/or obstetric factors would definitely be a cause for concern with regard to birth asphyxia. 

Tejavej A, Siripoonya P, Saungsomboon A, Chiewsilp D. Morphine and birth asphyxia. J Med Assoc Thai 1984 67(Suppl 2) 73-9. 

Hemolytic uremic syndrome Minor hemolysis Massive transfusion Newborn Birth asphyxia Hypothermia... 

Fio. 22. The percentage of babies with abnormal GST Bj, GST B2, and ALT levels with 24 and 72 hr of birth asphyxia. Fourteen babies were studied. 

B21. Beckett, G. J., Hussey, A. J., Laing, I., Howie, A. F., Hayes, J. D., Strange, R. C, Faulder, C. G., and Hume, R., Measurements of glutathione S-transferase B, in plasma after birth asphyxia An early indication of hepatocellular damage. Clin. Chem. (Winston-Salem, N.C.) 35,995-999... 

Birth asphyxia (loss of fetal oxygen during delivery) accounts for only a minority of cases of cerebral palsy. 

Neonatal Brain, Birth Asphyxia, and Energy Metabolism... 

In infants who have suffered perinatal hypoxic-ischaemic brain injury (birth asphyxia), P spectra obtained within a few hours of birth show no abnormalities. However, in many cases a delayed secondary energy failure (SEP) develops within 24 h. The Pi signal increases, accompanied by reduced PCr and, in severe cases, low NTP. Furthermore, in contrast to the profound acidosis seen during acute hypoxia-ischemia, an intracellular alkalosis may be detected. Additionally, localized spectroscopy shows elevated lactate levels for several weeks following SEE. Both PCr/Pi and lactate/N-acetylaspartate (Lac/NAA) ratios have proved to be extremely useful indices of the severity of hypoxic-ischaemic injury, with strong prognostic capabilities. 

It is common practice to assess hepatic function in neonates who have suffered transient asphyxia at birth by measuring the plasma activities of ALT or AST. We have investigated the changes in plasma B, and B2 subunits that occur in babies following a normal delivery and 14 infants who suffered transient asphyxia during birth results were compared with the changes found in ALT (B21). 

A good example of the prognostic and diagnostic utility of both H and P MRS is their use in perinatal asphyxia. A significantly increased Lac/Naa peak-area ratio and/or reduced PCr/Pi in the first few days after birth is associated with impaired neurological development with disability at age 1 year. 

Failure of adequate progression of labor due to cephalopelvic disproportion with imminent fetal asphyxia is the most common reason to perform secondary cesarean section. Arrest is typically caused by a combination of a large infant, an abnormal birth mechanism, and a narrow maternal pelvis. Detectable abnormal narrowing with an absolute disproportion occurs in 0.5%-l% of all deliveries today (Fig. 14.1). The incidence of borderline pelvic findings in which the size of the child and the birth mechanism together decide whether spontaneous delivery will be possible is much higher (Table 14.1). 

R.E. (m), with thymine-uraciluria, is the third child of healthy parents. The first child is healthy but the second one died of perinatal asphyxia. A few hours after birth the patient developed cyanosis with a mild respiratory distress. On the third day he developed also a pneumothorax. Furthermore there was a hyperbilirubinemia. Treatment was successful and at 3h weeks he was discharged. Psycho-motor development was normal until the age of Ih years. Then he de/eloped petit mal seizures which were treated. After one month treatment could be discontinued. The parents noticed that behavioural changes occurred after the onset of the seizures. Speech did not develop and his behaviour became solitary. At admission for evaluation of his developmental problems no physical abnormalities were seen. Psychological investigations revealed a normal intelligence with autistic features and the absence of auditory defects. 

During parturition, the fetus is squeezed through the birth canal and delivered to a cold extrauterine environment, which is associated with an increase in the oxygen level. Many studies have documented the severity and the duration of asphyxia associated with delivery (22,23). However, newborn mammals are more resistant than the adult to hypoxia/asphyxia (24,25). This transition is associated with major... 

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