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Birth Asphyxia 
Ibra Cham 
USR
Definition* 
• Combination? 
 lack of oxygen (hypoxia) & perfusion (ischemia) 
• ICD 
 Apgar score at 1 min of 0–3 sever...
#s 
• 4 million births w/ asphyxia per year 
• 1 million die 
• ~ 1 million develop serious long term 
neurological sequel...
Causes* 
• acute interruption of umbilical blood flow (during 
cord compression) 
• premature placental separation 
• mate...
Increase Risk 
• maternal diabetes and hypertension 
• third-trimester bleeding, and prolonged rupture of 
membranes 
• fe...
Phases of Asphyxia 
• Primary Apnea (30-60s) 
 short series of respiratory efforts 
 convulsion or a series of clonic mo...
So To Prevent 
• 1st 
 almost any physical or chemical stimulus causes the neonate to breathe 
• 2nd & 3rd 
 resuscitati...
Fate 
• the circulatory response to hypoxia is to redistribute blood flow to critical 
organs 
• thus, brain injury means ...
The Acute Sequelae Of Asphyxia
Identification of Infants at Highest 
Risk of Evolving Brain Injury
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Birth asphyxia

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Neonatal Hypoxic-Ischemia

Publicada em: Saúde e medicina
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Birth asphyxia

  1. 1. Birth Asphyxia Ibra Cham USR
  2. 2. Definition* • Combination?  lack of oxygen (hypoxia) & perfusion (ischemia) • ICD  Apgar score at 1 min of 0–3 severe  Apgar score of 4–7 moderate & mild • New terms  birth depression (Apgar score & abate etiology)  perinatal asphyxia (include etiology)
  3. 3. #s • 4 million births w/ asphyxia per year • 1 million die • ~ 1 million develop serious long term neurological sequelae !!!!
  4. 4. Causes* • acute interruption of umbilical blood flow (during cord compression) • premature placental separation • maternal hypotension or hypoxia • any of the above superimposed on chronic uteroplacental insufficiency • failure to execute a proper resuscitation • anesthetics and analgesics • maternal health and prematurity ????
  5. 5. Increase Risk • maternal diabetes and hypertension • third-trimester bleeding, and prolonged rupture of membranes • fetal conditions, such as prematurity, multiple births, growth restriction, fetal anomalies, and rhesus isoimmunization • conditions related to labor and delivery, including fetal distress, meconium staining, breech presentation, and administration of anesthetics and analgesics ????
  6. 6. Phases of Asphyxia • Primary Apnea (30-60s)  short series of respiratory efforts  convulsion or a series of clonic movements  abrupt fall in heart rate  then no muscle tone  skin cyanotic and then blotchy • Gasping (8m)  3-6/minute  heart rate and blood pressure continue to fall • Secondary/Terminal Apnea
  7. 7. So To Prevent • 1st  almost any physical or chemical stimulus causes the neonate to breathe • 2nd & 3rd  resuscitation
  8. 8. Fate • the circulatory response to hypoxia is to redistribute blood flow to critical organs • thus, brain injury means other organ dysfunction
  9. 9. The Acute Sequelae Of Asphyxia
  10. 10. Identification of Infants at Highest Risk of Evolving Brain Injury

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