Asphyxia Neonatorum
The failure of an infant to breathe at birth.
Babies who are born asphyxiated do not breathe or cry when they are delivered. In mild cases of asphyxia the infant's color is bluish and the limbs may feel stiff. In more severe cases, the skin is gray, and the baby is limp and immobile. Asphyxia neonatorum has been linked to low birth weight, late deliveries, and flattening or twisting of the umbilical cord during labor. Smoking during pregnancy is also considered a risk factor for asphyxia because it tends to produce low birth-weight babies.
Asphyxia requires emergency treatment, preferably in a hospital. Brain damage can result if the infant doesn't start breathing within about five minutes. Death can result if the asphyxiation lasts over 10 minutes. Asphyxia can also lead to seizures, especially if the baby requires intubation and has a low Apgar score five minutes after birth, and if the blood from the cutting ofthe umbilical cord has a high acid content. In older preterm infants (32-36 weeks), asphyxia has been linked to lung and kidney damage as well as brain damage. The first step in treating asphyxia is to remove any liquids blocking the baby's airway. In the hospital, this is done with a special tube, after which the infant is supplied with oxygen. In mild cases of asphyxia, the initial gasp of oxygen is enough to initiate breathing. In severe cases, artificial respiration must be performed. If there is brain damage or if the brain is not yet fully developed, the baby may be put on a ventilator for periods of up to several weeks. If asphyxia occurs outside the hospital, a finger should be used to clear any mucus from the baby's throat and gentle mouth-to-mouth resuscitation should be performed.
Identifying infants at risk for asphyxia either before or during labor can prevent the problem or lessen its severity. Obstetricians can identify babies at risk for asphyxia late in pregnancy and advise their patients to deliver in hospitals that have neonatal intensive care units. If an inadequate supply of oxygen from the placenta is detected during labor, the infant is at risk for asphyxia, and an emergency delivery may be attempted either using forceps or by caesarian section.
Today an infant's risk of asphyxia is lower than in the past due to improved prenatal care and awareness of the harmful effects of smoking during pregnancy. However if asphyxia does occur, prompt treatment can assure that the condition will cause no lasting damage.
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