All the parents are eagerly awaiting the birth of their baby, worried about him. And, alas, sometimes these excuses are justified. One fairly common pathology is asphyxia. Hearing the diagnosis, almost all parents are frightened and panic. Of course, asphyxia - a cause for alarm, but often the anxiety of parents is often too strong. And most often it occurs because of the lack of understanding of what is happening with the child during asphyxia.
Asphyxia - is a state of the newborn, in which, due to violations of the process of respiration, oxygen deficiency develops. There are two types of asphyxiation: primary, occurring at birth, and secondary - developing in the first days after birth.
Causes of neonatal asphyxia
Of course, no good reasons asphyxia in a newborn child is not there. As a rule, the reasons that cause asphyxia is either acute or chronic intrauterine hypoxia. In addition, the reason for the occurrence of asphyxia may be:
- Generic intracranial injury newborn.
- Immunological incompatibility of mother and fetus.
- Blockage of the airway of newborn baby - a complete or partial, or amniotic fluid, or mucus.
- Malformations of the fetus, causing difficulty breathing process.
Apart from the health problems of newborn baby apnea can be caused also problems such as the presence of extragenital diseases in pregnant women. For example, such as:
- Cardio - vascular system, especially those in the acute stage.
- Pronounced iron deficiency anemia, especially in the last trimester of pregnancy.
- Diabetes, especially insulin-dependent form.
- Late toxicosis - gestosis accompanied by swelling of the feet and high blood pressure.
Very often the pathological course of pregnancy also leads to the emergence of neonatal asphyxia. Pathology structure of the umbilical cord, placenta and fetal membranes, premature placental abruption, preterm rupture of membranes and a long dry period - all these high-risk factors.
Also, very often asphyxia occurs if there are any - any abnormalities of labor, poor fetal head bumping, pathologically narrow pelvis mother and so on.
The reason may be asphyxia secondary health problems such a child as congenital pneumonia, cerebrovascular accident, getting vomit in the respiratory tract, some types of disorders of the central nervous system of a newborn baby.
What happens at the moment of asphyxia?
What happens in the body of the newborn at the time of the crumbs of asphyxia? No matter what it was caused by asphyxia, the child begins an immediate change in exchange processes, microcirculation hemodynamics. That is, how much will be expressed in these changes depends on the time duration of asphyxia and its degree of intensity.
During acute hypoxia in the child significantly increases total blood volume. This occurs due to the fact that the blood volume increases in circulating erythrocytes. In the event that severe asphyxia develops in the preceding her chronic fetal hypoxia develops hypovolemia. Hypovolaemia - that change blood consistency: it condenses, its viscosity increases, and erythrocytes and platelets acquire increased aggregation ability.
In the internal vital organs of a newborn baby - in the liver, kidneys and adrenal glands, heart and brain - can detect edema and hemorrhage occurring as a consequence of tissue hypoxia. Due to the reduction of the peripheral and central hemodynamic parameters reduces the number of heart rate and blood pressure falls. Because of the disruption of the process of metabolism is a violation of the urinary function of the kidneys.
Signs of neonatal asphyxia
The most important sign of the presence of a newborn baby asphyxia is a violation of the respiratory process, which leads to a change in heart rhythm, as well as the pathological changes in the nervous system: disorders of the nervous - muscle conductivity and fading reflexes. In the first seconds after birth, doctors - neonatologists carefully examine the child and assess his condition. The child's condition is evaluated by a special Apgar:
In the event that asphyxia is not clearly expressed, and the child's body does not hurt much, assessment of the child's Apgar score will be 6 - 7 points. A child born with mild asphyxia, making his first breath within the first minute after birth. However, despite this, the crumbs of a weakened breath, there is a decrease in muscle tone and cyanosis (blue) nasolabial triangle.
- The average severity of asphyxia
In the same case, if a baby is diagnosed an average degree of hypoxia, the score will be 4 - 5 points. In that case, if the child is born with asphyxia moderate, he also made his first breath within minutes after birth, but breathing heavily weakened, can be irregular, crying baby is very relaxed.
Also, the baby may experience tachycardia, bradycardia, decreased muscle tone and reflexes of all. The skin of the hands and feet, as well as individuals have a distinct bluish tint. For the cord of the crumbs characterized by intense throbbing.
When pronounced form of asphyxia doctors assess the condition of the child in the 1 - 3 points.
In severe asphyxia breathing is irregular (individual breaths) or absent, the child does not cry, sometimes groans, heartbeats slowed, in some cases replaced by a single irregular heartbeats observed hypotonia or atony, reflexes are absent, pale skin as a result of spasm of peripheral blood vessels, umbilical cord pulses; often developed adrenal insufficiency.
In that case, if the total Apgar score is 0, the child is in a state of clinical death. In this case, in order to save the child's life, resuscitation immediately embarking on a complex resuscitation.
Treatment of acute asphyxia newborns
Strictly speaking, all children, without exception, were born in a state of asphyxia, need immediate intensive care. Just how effective will all medical procedures, depending on how soon after birth, they began. All events begin intensive care immediately after birth, right in the delivery room.
During resuscitation child's condition is continuously monitored all the basic parameters of life of his body:
- The heart rate.
- Respiratory rate and depth.
Based on these readings doctors are able to monitor the effectiveness of their action and, if necessary, correct them.
Immediately after the head of the fetus is born, the doctor inserts into the mouth and nose of the newborn and soft probe with an electric suction removes all the contents of the upper respiratory tract: the remnants of amniotic fluid, mucus. After that, the umbilical cord is cut the child, and the crumbs are placed in a special resuscitation table, under the rays of a special lamp. After that, the re-aspiration of the contents of the nasopharynx and stomach contents.
After cardiac and respiratory activity of the child will be restored, and his condition is stable, the crumbs are taken to the intensive care unit. All further medical measures are aimed at preventing or the elimination of existing cerebral edema, normalize metabolic processes, recovery of renal function and hemodynamics of the process.
Terms childcare asphyxiated
In order for the child as quickly as possible recovered from the effects of asphyxia, it is very important to provide him with proper medical care. The child must be in full rest, and his head - in the raised position. Very important is intensive oxygen therapy without exception babies asphyxiated.
Children born with mild asphyxia, placed in a special oxygen tent. This tent is a kind of dome, inside which high oxygen content. The child spends several hours to several days, depending on its state of health.
In the same case, if the child suffered asphyxia in moderate or severe, it should be placed in the incubator. The incubator supplied oxygen, its concentration should be within about 40%. In the same case in the nursing home for some - any reason not have the necessary equipment, the supply of oxygen available through a special nasal cannula or through a breathing mask.
It is often necessary to conduct newborn re-extraction content, usually mucus from the upper respiratory tract of the baby. Also, careful monitoring of indicators such as bowel function, diuresis, body temperature.
The first feeding of the child, who suffered mild to moderate asphyxia, produced in about 16 hours after birth. Those children who were born in a state of severe asphyxia, the first time the food within 24 hours, using a special probe. But the question of how. When the crumb can start applying to the chest, solved individually in each case, depending on the child's condition.
After discharge from the hospital
After the baby is discharged home, it should be under medical observation of specialists such as a pediatrician and neurologist. This is necessary in order to prevent possible complications of the central nervous system.
The subsequent prognosis depends on several factors, including the severity of asphyxia, timely start of therapeutic measures and their adequacy. In that case, if the child was born with a primary asphyxia, prognosis depends on secondary assessment of the Apgar score (performed 5 minutes after birth). In the event that the second estimate higher than the first, the forecasts for the child's life are rather favorable.
In that case, if the child is born in a state of asphyxia, during the first years of life can be observed such complications. Asphyxia, the consequences:
- Hyper and gipovozbudimost.
- Hydrocephalic syndrome.
- Spastic syndrome.
- Diencephalic violations.
Most often they arise in the event that there have been severe neonatal asphyxia. It is in order to reduce the risk of such complications and early treatment, and follow-up is necessary to have appropriate expertise.
Prevention of neonatal asphyxia
In order to avoid all the problems that entails asphyxia, need to take the necessary preventive measures. Of course, unfortunately, is not always preventative measures can prevent asphyxia, but to ignore them is not necessary. Approximately 40% of the preventive measures give a positive result. So:
- Prevention of intrauterine hypoxia
In order to avoid the development of fetal hypoxia, need constant monitoring of the pregnancy. During pregnancy should be promptly identified all the risk factors, such as:
- The somatic and infectious diseases, such as colds, flu, acute respiratory diseases.
- Disorders of the endocrine system and hormonal pregnant woman.
- The presence of strong stress in the life of the pregnant woman.
- Age of the pregnant woman - what she is older, the higher the risk.
- The presence of these bad habits, like smoking and use of alcohol-containing drinks.
In addition, it is important to carry out prenatal monitoring of the fetus and placenta. For example, the condition of the placenta can explicitly indicate a possible oxygen starvation of the fetus and the presence of meconium in the amniotic fluid is a danger signal. As soon as will be seen early warning signs, you should immediately begin appropriate therapy.
All this once again confirms the need for ongoing medical monitoring of the future mother. In no case is inadmissible to ignore visiting the doctor - a gynecologist during pregnancy - because thus you expose threats to the health of your baby, and perhaps even his life.
In addition, prevention of hypoxia is not the last role is played the right way of life of the pregnant woman. To do this, the expectant mother should observe a few simple rules:
- Walking. For normal pregnancy expectant mother must spend enough time outdoors. Blood woman is saturated with oxygen, which gets the baby. Oxygen is essential for proper development of his internal organs and growth. Many women believe that walks are only useful if they are out of town. However, walking is ideal and ordinary next to the house Square.
- Daily regime. For pregnant women it is very important to observe the mode of the day. Night gatherings at the computer, waking up early in the morning, the crazy rhythm of the day - all the expectant mother should be left in the past, "doberemennoy" life. A woman should sleep at least 9 hours per night, and at least a couple of hours in the afternoon. Always try to find time to relax.
- Vitamin - mineral complexes. Whatever variety was not food a pregnant woman, especially the quality of today's products are such that to obtain all necessary for the development of the child's vitamins, trace elements and minerals are just impossible. That is why every pregnant woman should take vitamin - mineral complex that will satisfy all the needs of both mother and child. However, it is not necessary to choose one or the other drug - it should be done by your doctor - a gynecologist who knows all the features of your body and pregnancy.
And be sure to keep the peace of mind and a positive attitude. It's no wonder they say that the belief in success - that's about half the work!