Hypoxia in a newborn - consequences for the child

Hypoxia or oxygen starvation is not as rare among newborns as we would like. Almost 10% of all infants experience acute or chronic form of this problem.

Hypoxia is not considered to be an independent disease; this term refers to an unfavorable condition that develops as a result of the pathological course of pregnancy, the birth process or a congenital malformation of the child.

This condition is dangerous primarily because the central nervous system of the newborn suffers. Depending on the severity of hypoxia, oxygen deprivation can lead to disability or death.

Causes of hypoxia

To prevent the disease, you need to know about the reasons that can cause this condition. If the expectant mother can protect herself from them, there is a chance that this trouble will not affect the child. Many factors really depend on a woman’s behavior and health. The first two groups of causes lead to a chronic form of the disease, and it manifests itself during pregnancy. The last group of factors provokes an acute form of hypoxia, which is diagnosed only after childbirth.

Health problems for the expectant mother:

• diseases of the cardiovascular system (heart disease, hypotension, hypertension, vegetative-vascular dystonia);
• bronchopulmonary diseases;
• anemia;
• infectious infection of the genitourinary system;
• age limit below 18 or above 35 years;
• non-compliance with the daily routine and proper lifestyle: frequent stress, lack of sleep, lack of fresh air, poor nutrition;
• bad habits (alcoholism, drug addiction, smoking);
• disturbances in the functioning of the endocrine system.

Pregnancy pathologies:

• pathologies of the placenta (abruption, early aging, presentation);
• toxicosis in the last months of pregnancy;
• umbilical cord pathologists (knots, entanglement);
• early birth;
• post-maturity;
• threat of interruption;
• multiple births;
• oligohydramnios/polyhydramnios;
• pathologies in fetal development.

Problems during childbirth:

• prolonged/difficult labor;
• entanglement of the fetus with the umbilical cord;
• C-section;
• early birth;
• large fruit;
• birth injuries;
• use of various tools (for example, forceps);
• use of medications.

An extensive list of reasons shows that both the mother who did not follow medical instructions for the normal course of pregnancy and the doctors who showed themselves to be unprofessional during childbirth may be to blame for hypoxia in the newborn. In some cases, a confluence of circumstances occurs, where the mother’s painful body cannot cope with such difficult processes as bearing a child and childbirth.

Hypoxia can be detected already during pregnancy (read more about this in the previous article), and appropriate measures must be taken to properly treat the baby. However, very often the diagnosis is made after childbirth. How do you know if your child is developing oxygen deficiency?

What is infant hypoxia?

Literally, the term hypoxia is translated as “little oxygen ,” which accurately describes the essence of this painful condition. Even slight oxygen starvation provokes the death of nerve cells , provoking a variety of neurological disorders. Due to a lack of oxygen, problems arise in the functioning of the heart and respiratory organs, and reflexes become dull.

Hypoxia has acute and chronic forms. The first is characterized by a lack of oxygen during childbirth, while the second is a pathological condition that develops even during pregnancy.

Symptoms and signs

Hypoxia in a newborn most often has pronounced symptoms, which do not present difficulties in making an accurate, correct diagnosis immediately after the birth of the baby. This allows you to start treatment on time and cope with the disease. The main symptoms of hypoxia in newborns are:

• tachycardia (heart contraction occurs at an increased frequency);
• bradycardia (the opposite indicator is a significant decrease in the frequency of contraction of the heart muscle);
• arrhythmia (irregular heartbeat);
• the presence of meconium in the amniotic fluid;
• heart murmurs;
• hypovolemia (low blood volume);
• the formation of blood clots in blood vessels, which lead to tissue hemorrhages.

Doctors distinguish between several degrees of hypoxia using a special Apgar scale. It evaluates how fully the systems of a small organism function:

1. 8–10 points - excellent condition of the newborn, who is not threatened by any hypoxia;
2. 7–6 points —grade 1 hypoxia, mild form of the disease;
3. 5–4 points - hypoxia of the 2nd degree, moderate form;
4. 3–0 points – hypoxia of the 3rd degree, severe form.

A mild degree is characterized by a gradual improvement in the newborn’s condition immediately, within a few minutes. The second degree may require several days to fully restore the normal functions of the small body. The third requires full treatment, which includes measures for primary resuscitation and subsequent care.

Prevention

To avoid oxygen starvation in a newborn, several important preventive rules must be followed:

• Regularly do ultrasounds during pregnancy, monitoring the slightest disturbances in intrauterine development and other pathologies.
• Entrust the organization and conduct of childbirth to a professional.
• Clear the baby's airway immediately after birth.

At the same time, the expectant mother should give up bad habits, spend more time in the fresh air, eat right and follow the instructions of the obstetrician-gynecologist.

Hypoxia in newborns is a fairly common phenomenon, which in most cases has a successful outcome. Therefore, in order to avoid complications and subsequent disability, the baby must be provided with emergency medical care. The recovery process (after hypoxia) can take a long time, since restoration of the functions of the brain and other body systems is not a quick process. During the rehabilitation period, the child will need the attention and care of parents, a balanced diet and developmental classes from a qualified psychologist. Only then does the baby have a chance to fully restore the body without harming its health.

Treatment of hypoxia in infants

The baby’s further recovery will depend on the sequence of medical actions and the professionalism of doctors. Proper treatment of hypoxia in newborns involves the following set of measures:

1. restoration of normal breathing: cleansing the respiratory tract, oral and nasal cavities from mucus;
2. warming the child using heating pads and a special table;
3. the use of drugs to stimulate blood circulation and restore breathing;
4. using an oxygen mask if the baby’s breathing cannot be restored;
5. In case of serious condition, the child is placed in a pressure chamber.

When the symptoms of hypoxia in newborns disappear, they are discharged from the hospital. The recovery period requires constant monitoring not only by the local pediatrician, but also by a neurologist. You will have to protect the baby from the slightest stress, carefully monitor his diet and sleep patterns. Massage therapy, soothing baths and aromatherapy sessions are often prescribed.

In severe forms, treatment of hypoxia in infants involves the prescription of medications: sedatives and stimulants of cardiac and brain activity. If the disease is detected late or not treated in a timely manner, hypoxia can have dire consequences for the baby’s health.

Fetal hypoxia during childbirth: how to avoid complications?

Hypoxia is a violation of the oxygen supply to the fetus.

It can be chronic intrauterine, associated with maternal illness or a violation of the formation of placental vessels.

There is acute hypoxia - this is a condition that occurs during childbirth and requires medical intervention or emergency cesarean section.

Causes of fetal hypoxia during childbirth

The causes of acute hypoxia in a child during childbirth can be different. Many of them can be corrected; complications can be prevented with the right medical approach and the woman’s compliance with all instructions.

A diagnosis of diabetes does not exclude pregnancy, but implies constant monitoring of blood sugar and glucose-lowering therapy.

Tablet drugs are often replaced with insulin, and not every woman finds such a replacement safe. But failure to follow the doctor’s orders will lead to disturbances in the vascular bed of the placenta and an acute process during childbirth.

Hypertension can be chronic, or it can only occur during pregnancy - in any case, the condition requires drug treatment.

And this means the cessation of blood supply to the fetus. Also, hypertension during childbirth is dangerous for the health of the mother.

Smoking and drinking alcohol during pregnancy are known to be harmful to the fetus.

But even if a woman tries to reduce bad habits to a minimum during pregnancy so that they do not affect the baby’s intrauterine development, the system may fail during childbirth.

A woman’s blood vessels, which already have changes due to these abuses, react with a sharp spasm to the increased load during the active period of labor. By this nature saves the mother’s health, but the child suffers.

Therefore, when planning a pregnancy, it is better to give up bad habits in advance and undergo a course of health therapy.

Edema during pregnancy can appear as a result of decreased kidney function or poor diet and water-salt balance.

In swollen tissues, blood flow is disrupted, and therefore the fetus suffers.

Internal swelling is especially dangerous; it may not be visible from the outside (for example, with strong, trained muscles in women actively involved in sports).

Hidden edema is diagnosed by monitoring the pregnant woman’s weight and ultrasound examination.

Edema, especially internal, can not only interfere with normal blood flow, but also mechanically delay labor, preventing the baby from moving freely through the birth canal.

Unfortunately, even a completely healthy woman is not immune from the manifestation of acute conditions during childbirth. A cause for concern will be the entanglement of the fetus with the umbilical cord, due to which the length of the free edge of the umbilical cord is not enough for the birth of a child.

Entanglement is diagnosed by ultrasound.

Sometimes during childbirth, obstetricians are able to eliminate the entanglement during manual examination, but they can also offer operative obstetric care. A woman should not refuse. After all, the health and life of the baby depends on it.

Even more dangerous are knots on the umbilical cord, which can form in the second trimester, while the fetus is still small and moves freely and actively inside the amniotic sac.

Unfortunately, the position of the node may be such that it cannot be seen on ultrasound, and normal blood flow in a node that has not healed does not give cause for concern when performing CTG.

And only during childbirth, when the umbilical cord is stretched, the knot tightens, abruptly interrupting the blood flow. If by this time the baby's head has already appeared, doctors can save the baby, but if the baby is deep in the birth canal, this threatens the death of the fetus.

With timely diagnosis, an emergency cesarean section will help the baby be born. This is why monitoring placental blood flow and fetal heartbeat is so important during pregnancy and throughout the entire period of childbirth.

Consequences of acute fetal hypoxia

The child's brain is the first to suffer from a lack of oxygen. With an acute decrease in blood flow in the uterus, placenta or umbilical cord, a natural protective mechanism is activated: increased cerebral blood flow to the fetus.

This process, seemingly designed to ensure adequate nutrition of the brain cells, also plays a negative role: the weak blood vessels of the newborn cannot withstand the load, and changes similar in physiology to a stroke may occur.

Previously, such lesions were described by neonatologists as “intracranial birth injury” or “cerebrovascular accident” of varying severity.

Later, the terms “hypoxic-ischemic encephalopathy” or “perinatal encephalopathy” were proposed. They describe the problem more accurately, from a medical point of view, since the brain of a newborn is physiologically different from the mature brain of an adult.

That is why such diagnoses made in the first days of life are not always as dangerous and irreversible as strokes in adults.

If hypoxia is diagnosed

In the initial stage of labor, when there are still no frequent contractions, no rupture of water, and the woman feels comfortable, the risk of hypoxia can be assessed by monitoring the fetal heart rate.

The child’s heart must respond adequately to changes in the woman’s blood flow (2-3 simple physical exercises or, conversely, a short breath hold).

If there is a reaction and the child’s heart rate changes along with the mother’s heart rate, there is no danger.

If the baby’s heart beats monotonously, without reacting to the mother’s behavior, this indicates a threat of fetal hypoxia during childbirth. In this case, it is recommended to speed up labor by stimulation or surgery (depending on other related factors).

CTG allows you to monitor the fetal heart rate during the active period of contractions. If there are symptoms of hypoxia, doctors try to restore blood flow by injecting the woman with vasodilators, glucose, calcium gluconate, ascorbic acid, and sometimes insulin and atropine.

Oxygen breathing (through a special mask) is also indicated. Usually these measures allow the birth to be completed safely naturally.

If drug correction does not help, with the consent of the expectant mother, they proceed to surgical delivery.

How to help a newborn?

The condition of the newborn is assessed on a ten-point Apgar scale immediately after birth and after 5 minutes.

A baby who has experienced hypoxia during childbirth is usually pale, weakened, may lack a sucking reflex, and is diagnosed with cardiac arrhythmias.

The child needs the help of neonatologists. The baby may need long-term observation and rehabilitation by neurologists. But measures taken in the first hours of life play a decisive role.

The newborn may be given atropine (sometimes even before labor is completed), and may require mechanical airway clearance, an oxygen mask, or even temporary placement on a ventilator.

Drugs can be used to stimulate cardiac activity or accelerate lung maturation (in case of premature pregnancy or fetal malnutrition).

If you find yourself in a clinic where there is no pediatric intensive care unit, the baby will be transported to a special hospital or perinatal center.

Of course, parting with a newly born child is a huge stress for the mother! But to resist hospitalization of the baby means that he will be deprived of full-fledged assistance, which can further lead to serious developmental disorders, and possibly disability.

When choosing a maternity hospital in advance, ask if there is an intensive care unit for newborns.

Long term prospects

The brain of a newborn child is an immature structure, in which nature itself contains amazing abilities for regeneration and development.

Prevention of acute hypoxia is important.

But if complications cannot be avoided, timely qualified assistance makes it possible to completely get rid of the consequences of oxygen starvation.

During the first year of life, a baby who has experienced hypoxia must be actively treated.

Special massage courses, classes at a rehabilitation center or age-appropriate drug therapy will be required. Water procedures and swimming contribute very well to the restoration of the nervous system.

Your baby has every chance to meet his first birthday completely healthy, not inferior to his peers in either physical or speech development!

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Why is hypoxia dangerous in newborns?

Most often, the consequences of hypoxia in newborns depend on the degree of the disease. The first one passes quickly, without affecting the baby’s health at all. The second will be fraught with temporary slow and depressed reflexes, but these consequences will soon pass, also leaving no mark on the child’s health. In the third degree, the following may be observed:

• anxiety;
• sleep disturbance;
• muscle cramps;
• delay in mental and physical development;
• disturbances in brain function;
• death.

Fatal outcome with today's level of medicine is an exception. Chronic and acute hypoxia today is a very common problem, which doctors cope with quite successfully, completely eliminating or minimizing its consequences.

» Fetal hypoxia

Hypoxia during childbirth and its consequences for the newborn

Hypoxia or oxygen starvation of a child during childbirth is a very common phenomenon. We recommend that expectant mothers familiarize themselves with this topic in depth and in detail in order to avoid hypoxia in the baby during pregnancy and childbirth, and to prevent its dangerous consequences. Knowledge is power! And knowledge combined with maternal love is a special power that can create a miracle. The health and development of your baby depends entirely on your daily actions during pregnancy and in the first three months after birth.

What is hypoxia during childbirth?

The term "hypoxia" refers to a lack of oxygen in tissues. There are two types of hypoxia:

• chronic or perinatal - when the baby does not have enough oxygen supplied with the mother’s blood through the placenta during pregnancy
• acute or labor hypoxia - when the baby experiences pressure during childbirth, the blood vessels are compressed, and blood does not flow to the baby’s organs and tissues.

Doctors distinguish several degrees of hypoxia. Mild hypoxia during childbirth is usually harmless and goes away without consequences. The longer the baby experienced oxygen starvation, the more severe the degree of hypoxia, the more dangerous the possible consequences, the more thorough the rehabilitation should be. Modern children are born with weak, immature connective tissue. This phenomenon is called general dysplasia. Therefore, when the baby experiences pressure during natural childbirth or barotrauma at the time of cesarean section, the immature vessels are compressed too much, blood and oxygen stop flowing through them, and the tissues experience oxygen starvation. Brain cells fall into a “sleepy state.” A child is born with entire areas of dormant cells.

What is the danger of hypoxia during childbirth?

After birth, apoptosis is automatically launched in the child’s body - a genetically programmed process of getting rid of dysfunctional and damaged cells. During the first three months of a child's life, apoptosis permanently destroys dormant cells. But natural developmental care methods awaken dormant cells and restore damaged connections and tissues. A person has enormous potential for recovery from birth trauma. But this potential is different for each child. In addition, the main supply of health and vitality is laid during pregnancy. Therefore, immediately after birth, no doctor will be able to predict the consequences of hypoxia for a particular child. Some babies receive significant birth injuries, of which no trace remains by the age of one year. And there are children who were slightly injured during childbirth, but by the age of one year they receive a diagnosis of cerebral palsy (cerebral palsy) due to intrauterine problems, which were superimposed by hypoxia and lack of rehabilitation in the first 3 months of life. Minimal cerebral dysfunction (MCD) is one of the common consequences of fetal hypoxia during childbirth. This also includes hyperactivity and attention deficit disorder (ADHD), school maladjustment syndrome, etc. These are all mild behavioral and learning disorders that develop as a result of nervous system suffering at an early age. It is difficult to correct these conditions; the help of specialists is required. It is much easier to prevent hypoxia during pregnancy and proper care immediately after childbirth.

Causes of child hypoxia during childbirth

During childbirth, hypoxia in the baby is caused by disturbances in the natural birth process: contractions that are too weak, problems with the mother’s blood pressure. These violations, in turn, can be caused by unreasonable medical interventions that frighten the mother. Therefore, it is very important to fully prepare for childbirth in advance. Prepare organizationally: choose a maternity hospital, think through, prepare and agree on a birth plan with the doctor and midwives. And prepare for the mother herself: train her generic dominant so that during childbirth she can remain focused on her feelings and not pay attention to what is happening around her and may interfere. Childbirth is actually not as traumatic as people think. Osteopaths believe that 99% of problems during childbirth are problems that arose during pregnancy. And damage that the baby may receive during childbirth can be corrected by an experienced osteopath within 3 weeks. But embryonic problems often require attention throughout life. Hypoxia during childbirth also usually occurs as a result of problems during pregnancy. Therefore, the expectant mother needs to do everything to avoid chronic intrauterine hypoxia, as well as everything that improves the elasticity of the baby’s connective tissue. The simplest, most useful and reliable way to prevent hypoxia is to follow the recommendations of the Wellness Program. This means regularly doing osteopathic gymnastics, adaptation gymnastics, and training diaphragmatic breathing. To develop the baby's connective tissue and increase his resistance to hypoxia, relaxation, detoxification, environmental protection, long daily walks, and so on are necessary. In addition, throughout your pregnancy you need to practice synchronous breathing with an assistant during childbirth. Your birth partner will help you remember at the most crucial moment how to breathe correctly in order to provide your baby with enough oxygen. Children whose mothers followed a health program during pregnancy show amazing resilience even during difficult births.

How to find out whether there was hypoxia, whether enhanced developmental care is needed for the child’s rehabilitation?

Regardless of whether the baby is diagnosed with hypoxia or not, pay attention to the main indicator - Apgar scores. If a value of 7 or less is indicated, hypoxia definitely occurred and enhanced rehabilitation with the help of developmental care is required in the first 3 months of the child’s life. If the readings are above 7, congratulations, the baby managed to avoid serious oxygen starvation. In this case, developmental care will help develop the capabilities of the brain and improve the baby’s overall health.

What to do if a child has hypoxia?

If the child received an Apgar score below 7 at birth, we recommend that parents spend the first three months caring for the baby from morning to evening. Such children require strict and regular implementation of all elements of developmental care for the first 100 days of life. Anything done after this period is ten times less effective. But in the first 3 months it is possible to restore damaged brain cells. And for this you will not need medications, complex manipulations or expensive devices. Only minor changes in the usual, traditional child care When a mother correctly carries a newborn baby in her arms, breastfeeds him, engages in nurturing and vestibular gymnastics, the process of “neuroplasty” occurs - that is, awakening “sleeping” brain cells, creating new neural ones connections in the baby’s brain, replacing those damaged due to birth hypoxia. A newborn's neural cells are able to move to the desired part of the brain and learn the necessary functions, restoring the integrity and health of all systems. This amazing property of the human body - the ability to recover - allows loving parents to create a miracle with their own hands. Simple daily actions to care for your baby become powerful rehabilitation and erase the adverse effects of hypoxia. Engage with your baby and help him reach his maximum potential. Let him grow up healthy and happy!

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Hypoxia in newborns

The diagnosis of fetal hypoxia and asphyxia of the newborn is not so uncommon. What kind of disease is this? What are the symptoms and consequences of CNS hypoxia, for example, and how will it be treated?

Hypoxia is a lack of oxygen that can be observed in the fetus during the entire period of gestation, then we are talking about chronic hypoxia in newborns. Hypoxia can also occur directly during the birth process. Ischemic hypoxia in newborns can lead to serious consequences. These are all kinds of diseases of the central nervous system, heart, lungs, kidneys or liver. Death also occurs.

However, everything is not always so sad. Doctors distinguish between several degrees of hypoxia using the Apgar scale:

1. 8–10 points - the newborn is in excellent condition;
2. 7–6 points—grade 1 hypoxia in newborns. This is a mild degree of hypoxia in newborns.
3. 5–4 points – 2nd degree, average form;
4. 3–0 points - 3rd degree, severe form.

It doesn’t matter exactly how the child was born, as a result of surgery or naturally. Hypoxia also occurs after cesarean section.

Signs of hypoxia in newborns

Symptoms of hypoxia in newborns are often pronounced, so this pathology does not present difficulties in making the correct diagnosis after the birth of the child. This makes it possible to begin treatment and defeat the disease. The main signs of hypoxia in infants are:

• bradycardia;
• tachycardia;
• the presence of meconium in the amniotic fluid;
• arrhythmia;
• heart murmurs;
• hypovolemia (insufficient blood volume);
• formation of blood clots in blood vessels.

Doctors distinguish between several degrees of hypoxia, as mentioned above. With a mild degree of hypoxia, the child’s symptoms quickly disappear. Gradual improvement in the baby's condition occurs within a few minutes. The second degree requires several days to restore all functions of the child’s body. Third, it is necessary to seriously treat, providing measures for primary resuscitation and further care.

Causes of hypoxia in newborns

There are several causes of oxygen deficiency in a child:

• Smoking by a pregnant woman can provoke a regular state of hypoxia not only in herself, but also in the child she is carrying.
• Premature maturation of the placenta, in which the baby's place is destroyed long before birth. Sometimes this occurs when drinking alcoholic beverages, certain medications, and also due to various infections.
• All kinds of respiratory diseases of the expectant mother.

But the reasons for the development of hypoxia in a baby can also arise directly during childbirth.

• Incorrect behavior of a woman in labor or illiterate actions of doctors.
• Placental abruption.
• Incorrect position of the umbilical cord and its entanglement around the baby's neck.

Consequences of hypoxia in newborns

Proper treatment of hypoxia will allow the child’s condition to return to normal, but in some cases, the consequences of fetal hypoxia for the child can mean a number of pathologies that can manifest themselves after a considerable time:

• delayed speech development in children, their inability to concentrate, frequent headaches;
• development of progressive pathologies of the central nervous system, in particular, serious hearing impairment;
• persistent central nervous system disorders, such as encephalopathy, epilepsy, other cerebrovascular disorders, including (rarely) cerebral venous thrombosis, ischemic stroke.

Treatment of hypoxia in newborns

Of course, parents, having received such a diagnosis, are first of all interested in how to treat hypoxia in a newborn child. The first thing that needs to be done is to diagnose and establish the causes that led to this disease. When acute hypoxia is diagnosed, the doctor carries out the following measures:

• Frees the airways from mucus and meconium;
• Ensures that a sufficient amount of oxygen enters the baby’s body using special equipment;
• Warms the baby;
• If necessary, administers medications that increase blood pressure;
• If necessary, conducts transfusions of blood or its components;
• Conducts anticonvulsant therapy;
• Prescribes medications that improve blood clotting.

Further treatment is carried out depending on changes in the monitored functions: heartbeat, respiration and blood pressure readings, as well as blood oxygen saturation.

Brain hypoxia in newborns

Brain hypoxia is a dangerous condition that can be fatal. Acute and fulminant hypoxia of the brain usually becomes the cause of death if resuscitation actions are not performed in a timely manner. In other cases, the consequences are determined by the extent and location of brain damage.

Such children develop general cerebral disorders, dizziness, for example, chronic headaches, memory impairment, speech, vision, etc. If the child undergoes rehabilitation, then in the future it is possible to fully restore brain functions, but residual effects of varying degrees of severity often occur.

Therefore, it is especially important to do everything possible to ideally prevent and, if diagnosed, treat this disease in a timely manner.

Varieties

Brain hypoxia in children can develop due to both external and internal factors. There are several types of pathology that are important to identify for further treatment.

Types of hypoxia:

• Respiratory hypoxia . It appears due to the fact that a person’s respiratory system is impaired. Often the disease appears as a side effect of asthma, brain damage and muscle paralysis.
• The disease is hypoxic in nature a. It is determined when the head does not receive enough oxygen from the outside world. A similar situation arises, for example, when climbing to a height.
• Circulatory pathology . It is isolated if a person has diseases of the cardiovascular system. Against this background, there may be a disturbance in blood flow, due to which oxygen does not reach the central nervous system in sufficient quantities. As a result, the person is in a state of shock. Ischemic stroke often occurs due to this condition.
• Tissue pathology . It appears when there are problems with the absorption of oxygen by cells. Fasting occurs due to enzyme blockade. Often, pathology can appear if a person is constantly in contact with poisons or drugs hazardous to health.
• Hemic hypoxia . This disease occurs when there is a problem with oxygen transportation. The vessels lack this element, as well as hemoglobin. The problem occurs when poisoning is caused by poisonous elements, as well as gases.

Regardless of the type of disease, it is important to start treatment in a timely manner to prevent serious complications. First, you will have to undergo diagnostics so that you can be sure of the presence of a specific disease.

Cerebral ischemia in newborns

Cerebral ischemia is a disease characterized by insufficiency (hypoxia) or complete cessation (anoxia) of oxygen supply to the brain.

As for cerebral ischemia in newborns, modern medicine considers this pathology as an extremely serious problem in the field of perinatal neurology. And this is primarily due to the fact that today there are no sufficiently effective methods of treating this disease.

Speaking about the causes of its occurrence, it should be noted that it is a consequence of oxygen deficiency, and this leads to metabolic disorders of varying severity occurring in the brain tissue, including the development of coagulation necrosis and neuronal death in the clinical picture.

Symptoms of cerebral ischemia in newborns

• syndrome of increased excitability (neuro-reflex), which is characterized by decreased or increased muscle tone, shudders, tremor of the chin, legs and arms, increased reflexes, “unreasonable” crying and restless sleep;
• central nervous system depression syndrome, when there is a decrease in the tone of all muscles, reduced motor activity, a significant weakening of sucking and swallowing reflexes, and in some cases even strabismus and facial asymmetry;
• hydrocephalic syndrome, which is characterized by an enlarged head. In this case, the child experiences an enlargement of the fontanelle, which is associated with fluid (cerebrospinal fluid) that accumulates in the spaces of the brain. As a result, the newborn experiences increased intracranial pressure;
• comatose syndrome - an extremely serious condition of a small patient when he is in an unconscious state with a complete lack of coordinating function of the brain;
• convulsive syndrome, which is characterized by paroxysmal twitching of the head and limbs, various episodes of shuddering and other manifestations of seizures.

Degrees of ischemia

Doctors distinguish three degrees of cerebral ischemia. Thus, a mild degree is characterized by excessive depression or, conversely, excitement of the child during the first five to seven days of his life. If the baby experiences convulsions and a much longer period of disturbances, doctors usually diagnose it as moderate. Newborn children suffering from severe cerebral ischemia are placed in the intensive care unit.

At the same time, it must be said that moderate and mild hypoxic brain damage during ischemia is extremely rarely considered the cause of the development of a neurological disorder. But if they do appear, then experts characterize them as functional; it has been proven that they disappear completely if adequate therapy is immediately carried out.

It must be said that the effect of severe (so-called structural) ischemic brain damage in a newborn inevitably leads to organic damage to the central nervous system, and this in turn manifests itself as ataxia, delayed psychomotor development, focal convulsive seizures, impaired hearing and vision, etc.

Treatment

Modern pediatrics can now be proud of significant successes in the treatment and care of children with cerebral ischemia.

The main essence of therapy for such a diagnosis comes down to restoring blood circulation and timely creation of all conditions for the full activity of those parts of the brain that are not damaged.

At the very first stage of this disease, the course of treatment is quite simple - doctors often resort only to ordinary massages, without even using any medications. As for other stages of ischemia, therapy is selected individually, solely according to the indications of the attending physician.

Forecast and consequences

As for prognoses, they are primarily determined directly by the severity of the disease. In addition, the presence of concomitant pathologies and the effectiveness of the ongoing rehabilitation measures prescribed to patients by a pediatric neurologist play a role.

The consequences are often quite severe, which is why treatment should be started as quickly as possible. Ischemia leads to:

• headaches, constant irritability and sleep disturbances;
• to silence, attention deficit, learning difficulties;
• mental retardation and even epilepsy.

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Symptoms of hypoxia in newborns

The main sign of hypoxia in newborns is breathing disorders, which lead to disturbances in cardiac activity, hemodynamics, reflexes and muscle tone.

Immediately after birth and 5 minutes later, in order to identify possible hypoxia and determine its severity, the condition of the newborn is assessed using the Apgar scale. This technique is based on scoring from 0 to 2 points the following indicators:

• breath;
• skin color;
• heartbeat;
• severity of muscle tone;
• reflex excitability.



The author of the article is Sozinova A.V., a practicing obstetrician-gynecologist. More than 12 years of experience in the specialty.

Neonatal hypoxia is not considered a separate disease, but refers only to pathological conditions, that is, it is a manifestation of some congenital/acquired pathology or unfavorable course of pregnancy and childbirth.

Hypoxia necessarily accompanies respiratory distress syndrome, which often develops in premature infants. Moreover, the shorter the gestational age, the more severe this syndrome manifests itself.

So, hypoxia of the newborn is called oxygen starvation of the brain, which leads to its dysfunction, as well as other systemic disorders. Brain hypoxia poses a huge danger to a newborn and can lead to disability and even death.

The factors that provoke the development of hypoxia in the newborn are very numerous. Conventionally, they can be divided into 4 large groups:

Antenatal causes (acting during pregnancy)

These include:

• severe somatic diseases of the mother (cardiovascular, respiratory, endocrine pathology),
• chronic intoxication of a pregnant woman (smoking, drinking alcohol, using drugs, occupational hazards, disturbed ecology).

This list also includes:

• premature and post-term pregnancy,
• gestosis,
• severe pronounced anemia,
• bleeding during pregnancy (previa, placental abruption),
• intrauterine infection of the fetus with chronic maternal infections and acute infection suffered during pregnancy,
• polyhydramnios and oligohydramnios,
• multiple pregnancy.

In addition, hypoxia may be to blame for:

• Rhesus conflict pregnancy and antiphospholipid syndrome,
• permanent threat of miscarriage and development of fetoplacental insufficiency,
• constant stress, unfavorable living conditions, poor nutrition.

Intrapartum causes (complicated labor)

This group includes:

• protracted or, conversely, rapid labor,
• birth injury to the fetus (damage to the brain or spinal cord),
• labor stimulation with oxytocin,
• surgical delivery (application of obstetric forceps, caesarean section).

This group also includes:

• drop in blood pressure during childbirth,
• preeclampsia and eclampsia during childbirth,
• placental abruption during childbirth,
• hypoxia of a woman during general anesthesia,
• uterine ruptures,
• anomalies of labor (discoordination of labor forces).

Pathology from the umbilical cord

• true nodes and their tightening of the umbilical cord,
• rupture of the umbilical vessels,
• umbilical cord entanglement,
• umbilical cord compression.

Fetal causes (from the fetus).

These reasons include:

• hemolytic disease of the fetus and newborn (anemia due to hemolysis of red blood cells),
• fetal malformations (anomalies of the cardiovascular and pulmonary systems),
• infectious intrauterine diseases,
• hemorrhages in the brain, adrenal glands.

Asphyxia of the newborn

Asphyxia, which subsequently turns into hypoxia of the newborn, develops as a result of blockage of the respiratory tract (ingestion of amniotic fluid and meconium by the child, blockage of mucus, tight entanglement of the umbilical cord, prolonged and problematic birth of the head, and others).

Symptoms, causes and consequences of hypoxia in newborns

Details

How dangerous is hypoxia in newborns and what are its consequences?

Moreover, in most cases, parents will never hear clear explanations from the doctor to the questions: “what does this mean?”, “how is hypoxia dangerous for the fetus and newborn?”

I would like to immediately remind parents that it is not in vain that during pregnancy, doctors strongly recommend that you treat the child’s health carefully and responsibly from the moment of conception.

This will help significantly reduce the risk of various pathologies.

When a baby is born, it must take its first breath to allow air to enter its lungs. If the newborn cannot do this on his own, then the first air enters the child’s lungs with the help of doctors.

Due to the fact that the baby cannot breathe for some time, a lack of oxygen occurs - this is hypoxia in newborns.

What is hypoxia and its consequences?

Hypoxia is not a disease, it is a condition in which both the body as a whole and individual organs and tissues experience oxygen starvation.

The central nervous system, heart, lungs, liver and kidneys are primarily affected; depending on the degree of hypoxia, irreversible changes can develop.

Lack of oxygen has a negative impact on the brain, which can lead to neurological diseases. In addition, hypoxia can cause asphyxia (suffocation) in a newborn.

Depending on the child's condition, hypoxia can be mild, moderate or severe.

This is determined by the Apgar scale, which evaluates the child’s condition in the first and fifth minutes after the baby is born:

1. Mild - 6-7 Apgar points in the first minute, 8-10 points by the fifth minute after birth. The baby's breathing is uneven, muscle tone is increased, and motor activity is slightly reduced.

Moderate (moderate severity) - 4-6 points on the Apgar scale by the first minute, by the fifth - 8-10 points. The baby's skin has a bluish, pale color, the child reacts weakly to painful stimuli, reflexes are depressed, the pulse is slow, breathing is impaired, the heart beats weakly, hand tremors and hyperexcitability are possible. Severe - up to 3 Apgar points by the 1st minute, by the fifth - less than 7 points. The general condition of the baby at birth is severe: pale, sometimes sallow skin, inability to breathe independently, low blood pressure, lack of reflexes and reactions to irritation and examination.

This article contains a lot of material about how to boost your child’s immunity.

Causes of the disease

Hypoxia can develop both in utero and during childbirth.

Maternal risk group:

severe intoxication with late toxicosis; complicated medical history (cardiovascular, endocrine, pulmonary diseases); age (women under 20 and over 35 years old); unhealthy lifestyle (poor diet, rare walks in the fresh air, bad habits, stress); Rhesus conflict.

Please note that most of the causes of hypoxia and asphyxia in the newborn can be avoided. That is why a pregnant woman must be attentive to her health and the health of her unborn baby throughout the nine months.

Acquired hypoxia in an infant develops as a result of an immature respiratory system, with entanglement in the umbilical cord, with birth injuries and difficult births (including with weak labor), with premature/post-term or multiple pregnancies.

Symptoms and signs

Symptoms of oxygen starvation of a newborn baby are determined during the initial examination in the maternity hospital.

A baby with hypoxia in the very first minutes of life has a bluish tint of skin, it is difficult for him to breathe, he does not cry at birth, and primary adaptation to the external environment is impaired.

The severity is determined by the Apgar score.

In addition, there are signs of hypoxia that parents themselves can notice when observing their newborn:

• when crying, the baby's chin shakes (tremor of the chin and limbs may also indicate immaturity of the nervous system);

the baby often shudders when his position changes and during sleep; poor sleep, the child often screams in his sleep; anxiety during feeding.

Of course, these signs are not 100% indicative of hypoxia, but if you notice them, be sure to inform the pediatric neurologist about it.

Consequences of acute oxygen deficiency in children

The consequences of hypoxia in newborns can be different. As mentioned above, the baby’s brain suffers the most during oxygen starvation.

Depending on the degree of damage, neurological diseases may develop (for mild injuries, this is perinatal encephalopathy).

The baby may experience irreversible changes in the functioning of internal organs and the central nervous system. With prolonged severe hypoxia of the brain, there is a threat of child disability or even death.

At the end of the monthly acute period, only residual disorders that undergo recovery are identified.

Unfortunately, the consequences of hypoxia may become apparent only after a year, during which your child has been developing successfully.

Speech development delay, restlessness, low concentration of attention are possible.

Consequences of acute hypoxia for children

• Lack of oxygen can lead to a wide variety of disorders. It was already mentioned above that the brain suffers the most. Accordingly, there is a possibility of developing neurological pathologies, and their occurrence is also associated with the stage of hypoxia, for example, with mild disorders of brain function, perinatal encephalopathy can occur.
• In addition, irreversible pathological changes in the functioning of internal organs and the central nervous system may be observed.
• With severe hypoxia, which lasted for a long time, there is a high probability of disability and even death.
• After the end of the monthly acute period, only residual disorders are detected that can be restored. However, unfortunately, the consequences of the pathology can occur after a long time during which the baby has successfully developed.
• In the future, developmental disorders, speech disorders, restlessness, poor concentration, etc. may be observed.