Perinatal hypoxia (perinatal hypoxia) is a term used to describe symptoms resulting from inadequate oxygen distribution in the first and / or second stage of labor. Perinatal hypoxia, one of the most common causes of death in the perinatal period, is a serious neonatal problem. What are the causes and consequences of perinatal hypoxia?

Perinatal hypoxia , orperinatal hypoxiais a consequence of two states of affairs. On the one hand, it is the effect of insufficient oxygen in the blood, inadequate to the current demand. The term for this is hypoxemia. It happens that the concentration of oxygen, i.e. resilience is good but there are problems with distribution to all tissues. This in turn is called ischemia in medical terms.

It is worth emphasizing that the organs have different tolerance to hypoxia. The most sensitive brain is the fetus. Therefore, each episode of hypoxia is reflected in the functioning of the nervous system. Of course, as in the case of adults, it is extremely important that the fetal tissues remain without adequate oxygenation. It is assumed that 3 minutes are the most critical. After this time, irreversible changes often occur, which may result in: epilepsy, hearing / vision impairment, cerebral palsy.

Taking into account the hypoxia mechanism, free oxygen radicals are formed, which have a destructive effect on the cells of the nervous system.

Risk factors for perinatal hypoxia

In order to take adequate measures early, you should know the risk factors of perinatal hypoxia, which allows you to select a group of patients who should be given special care. The etiology of hypoxia may result from maternal or fetal diseases or may be related to the perinatal period. On the mother's side, the diseases that increase the probability of the discussed pathology are:

  • hypertension
  • cardiovascular diseases
  • diabetes during pregnancy
  • drug / alcohol addiction

On the part of the fetus:

  • fetal swelling
  • intrauterine infection
  • fetal anemia

Factors directly correlated withdelivery is: prolonged labor, surgical delivery, e.g. forceps delivery, multiple pregnancy. Pathologies within the placenta play an important role in the etiopathogenesis of perinatal hypoxia: fibrosis within the placenta, underdevelopment or premature detachment of the placenta. The fall of the umbilical cord or the wrapping of the umbilical cord around the neck, especially multiple ones, is another reason for improper tissue oxygenation.

Symptoms of perinatal hypoxia

The main symptom of improper tissue oxygenation is all kinds of disorders in the functioning of the nervous system. The extent of abnormality correlates with the time of decreased oxygen distribution. In addition, other symptoms appear, such as respiratory disorders, renal failure, necrotizing enterocolitis or impaired metabolic processes, the main source of which is the liver. It is difficult to give an unequivocal answer with regard to the optimal diagnosis time of hypoxic patients. Some newborns develop symptoms immediately after delivery, others only later during screening. An example of such examinations is the transatrial ultrasound.

Diagnosis of perinatal hypoxia

The diagnosis of perinatal hypoxia is made on the basis of the Apgar score given to newborns. The maximum score in the above-mentioned on the scale is 10. Points are awarded at three points: immediately after delivery, in the 5th minute and 10. Severe hypoxia is indicated by 3 points. Besides, as has been emphasized above, the time of inadequate oxygen pressure is extremely important. Sometimes the symptoms of perinatal hypoxia do not appear until a few months old baby. It can then be recognized by the abnormal, abnormal psychomotor development.

Perinatal hypoxia is also correlated with abnormal umbilical cord blood pH test results. A result below 7, i.e. acidosis, indicates inadequate distribution of oxygen to the body's tissues. Other indicators are: increased levels of creatinine, liver transaminases, low levels of platelets and increased erythrocytes.

Prophylaxis of perinatal hypoxia

There has been a lot of progress in the field of neonatology. This also applies to the care of a newborn with perinatal hypoxia. The most effective method is hypothermia, i.e. operating with a low temperature. Special caps are made, placed on the child's head, which are designed to reduce the brain temperature by about 2-2.5 degrees C. This allows to reduce the production of free radicals, which are the most destructive element that destroys nervous tissue. Besides this form of therapythe use of erythropoietin (EPO) - a hematopoietic hormone that has a protective effect on the brain, works perfectly well. Prevention of perinatal hypoxia really comes down to selecting patients from the high-risk group. This allows you to quickly detect the threat and take appropriate interventions, and above all, it increases the doctor's vigilance.

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Pregnancy