Subject: Midwifery III (Theory)
Asphyxia Neonatorum is described as the ability to initiate and maintain spontaneous respiration within one minute of birth. Asphyxia neonatrum is a clinical term that refers to the failure to establish sufficient lung breathing during birth. The heartbeat remains, but the fetus does not make a meaningful attempt to breathe. Asphyxia is classified into mild, moderate, and severe forms. The APGAR score is a very effective indicator of a baby's respiratory and circulatory condition. The clinical aspects are determined by the cause, degree, and duration of the oxygen deficiency. Newborns with intrapartum indications of considerable fetal impairment, babies delivering before 35 weeks gestation, babies delivering vaginally by the breach, maternal infection, and multiple pregnancies are more likely to require resuscitation or transition care.
Asphyxia Neonatorum is defined as the failure to initiate and sustain spontaneous breathing within one minute of delivery. Asphyxia neonatrum is a clinical term that refers to the failure to establish adequate lung breathing during birth. The heartbeat persists, but the fetus does not attempt to breathe adequately.
The clinical aspects are determined by the cause, severity, and duration of oxygen deficiency. The clinical picture is characterized by concurrent fetal shock as a result of birth trauma. They were originally classed as asphyxia livida and asphyxia Pallotta based on the intensity of clinical symptoms.
This is a means of examining, analyzing, and documenting the baby's status by watching vital indicators such as appearance, pulse, grimace or response to stimuli, activity or muscular tone, and respiratory effort. The baby is given 2, 1 or 0 points for each vital sign, depending on their status, and the points are totaled. The APGAR score is an excellent indicator of a baby's respiratory and circulatory condition.
The examination is performed one minute and five minutes following birth. The most significant observations are the heartbeat and breathing effort. Few APGAR scores are common in high-risk pregnancy and lengthy labor.
Signs |
O |
1 |
2 |
1. Color |
Blue, pale |
Body pink, extremities blue |
Complete pink |
2. Pulse |
Absent |
Slow ( below 100) |
Over 100 |
3. Grimace |
No response |
Grimace |
Cry |
4. Activity |
Flaccid |
Flexion of extremities |
Active body movements |
5. Respiratory effort |
Absent |
Slow, irregular |
Good crying. |
Management
Newborns with intrapartum indications of considerable fetal impairment, babies delivering before 35 weeks gestation, babies delivering vaginally via the breech, maternal infection, and multiple pregnancies are more likely to require resuscitation or transition care.
Furthermore, cesarean delivery is related to an increased risk of issues with the respiratory transition at birth, which necessitates medical intervention, particularly for deliveries before 39 weeks gestation.
Step 1: Position the Baby
Step 2: Clear the Airway
Step 3: Ventilate
Ventilate once or twice, keeping an eye on the baby's chest to see if it rises. If the chest does not rise with each breath, check the baby's position, reposition the baby, your mouth, or the mask, and repeat until the chest rises with each breath. Repeat suctioning as necessary;
When the baby's breathing is normal, discontinue ventilation and continue to constantly observe the baby. Stop ventilation if there is no breathing or gasping after 20 minutes. The infant has passed away.
Step 4: Monitor
Therapeutic hypothermia
Therapeutic hypothermia should be used in term or near-term newborns with moderate to severe hypoxic-ischemic encephalopathy. Both whole-body cooling and selective head cooling are viable options. Cooling should be commenced and carried out in accordance with clearly established protocols, with treatment in neonatal critical care units and the ability to provide multidisciplinary care.
Glucose
Infants who are premature or require substantial resuscitation should be examined and treated to keep blood glucose levels within the normal range. An infusion of 10% glucose, rather than multiple boluses, is usually the most effective at treating low blood glucose levels and maintaining glucose levels in the normal range.
Resuscitation or stabilisation
Most term infants do not require resuscitation and can generally stabilize themselves fairly well during the shift from placental to pulmonary breathing.
Intervention is rarely required if care is taken to limit heat loss (and avoid over-warming) and a little patience is displayed before cutting the umbilical cord. Some infants, however, would have been subjected to stress or insults during labor. Help may then be necessary, which is characterized by interventions meant to save a sick or critically ill infant, and this process is appropriately referred to as resuscitation.
Umbilical cord clamping
Delaying cord clamping for at least one minute, or until the cord stops pulsing, after delivery increases iron status through early infancy in healthy term newborns. Delaying cord clamping for up to 3 minutes for preterm infants in good health at birth leads to improved blood pressure during stabilization, a decreased incidence of intraventricular hemorrhage, and fewer blood transfusions.
Maintaining normal temperature (between 36.5°C and 37.5°C)
In an environment that is comfortably warm for humans, naked, damp newborn infants cannot regulate their body temperature. Infants with impaired immune systems are more prone to the effects of cold stress, which can reduce arterial oxygen tension and exacerbate metabolic acidosis. To avoid hypothermia, active steps must be taken, especially in the preterm infant, where a team approach and a combination of methods may be required.
Define Asphyxia Neonatorum .
Failure to begin and maintain spontaneous breathing within a minute of birth is known as asphyxia neonatorum. Asphyxia neonatrum, as used in clinical terminology, refers to the lack of an adequate pulmonary ventilation during birth. The fetus does not adequately attempt to breathe, but the heartbeat continues.
What are the causes of asphyxia neonatorum ?
What are the Classification of asphyxia ?
Classification of asphyxia
What are the Steps of doing newborn resuscitation ?
Babies who have intrapartum evidence of significant fetal compromise, babies who deliver before 35 weeks gestation, babies who deliver vaginally by the breech, maternal infection, and multiple pregnancies are more likely to require resuscitation or support of transition. Furthermore, caesarean delivery increases the risk of respiratory transition issues at birth that necessitate medical attention, especially for deliveries that occur before 39 weeks of gestation.
Steps of doing newborn resuscitation
Step 1: Position the baby
Step 2 : Clear the airway
Step 3 : Ventilate
Once or again, ventilate while keeping an eye out to see if the baby's chest rises. If the chest does not rise with each breath, check the baby's positioning, move the infant, your mouth, or the mask, and try again. Repeat the suctioning if necessary;
Step 4 : Monitor
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