2. Introduction
Birth asphyxia is a leading cause of neonatal mortality
&
morbidity .It is also important cause of developmental
delay &
Neurological problems both term & preterm newborn.
Approximately 5 t0 10% neonates experience
asphyxia a t birth.
3. Meaning
Birth asphyxia, also called asphyxia neonatorum, is the
inability of an infant to establish regular respiration
Following birth.
4. Definition
Birth asphyxia is the non establishment of satisfactory
pulmonary respiration at birth.
It is failure of initiation & maintenance of spontaneous
respiration with hypoxia, hypoventilation ,
hypercapnia, hypo perfusion, & metabolic acidosis.
5. Etiological factor
Approximately 90% of asphyxia events occur as a result of
placental insufficiency due to ante partum & intrapartum
factors. Postnatal factors account for the remaining.
Ante partum
Intrapartum
Postpartum
6. Ante partum
placental insufficiency due to
Pre-eclampsia
Hypertension
Anemia
Diabetes Mellitus
Post maturity
Other factor include
ante partum hemorrhage
mal presentation
Multifetal pregnancy
7. poor fetal growth
maternal systemic
diseases
maternal drug therapy
(eg. lithum)
poly or oligohydramnios
placental malformation
vascular anomalies of
the cord
congenital anomalies of
the fetus.
8. Intra partum
Emergency CS
Instrumental delivery
Abnormal position
Premature labour
Precipitous labour
Prolonged rupture of
membranes
Prolonged labour > 24 hrs
Prolonged 2nd stage of
labour
10. POST NATAL FACTOR
pulmonary, cardio
vascular & neurological
abnormalities of the
neonate
Aspiration
11. CLINICAL FEATURES
Clinical manifestations depends upon the etiology,
intensity, duration of oxygen lack, plasma carbon
dioxide level & acidosis. There are 2 stages
Asphyxia livida or stage of cyanosis, primarily due to
respiratory failure with Apgar score 4 to 6.
Asphyxia pallida or stage of shock due to combined
respiratory & vasomotor failure with Apgar score 0- 3.
16. PROGNOSIS
It is depends upon associated factors, maturity of the
baby, duration & intensity of hypoxia & acidosis &
initiation of resuscitative measures in the delivery
room. Subsequent competent care & available
facilities
also influence the out come following birth asphyxia
17. NURSING DIAGNOSIS
Ineffective Airway Clearance R/T Aspiration Meconium
& mucus
Impaired breathing pattern r/t immaturity of the lungs
Impaired thermoregulation (hypothermia) r/t immature
thermoregulatory state of neonates
Risk for complication r/t loss of oxygen supply to the
vital organ
18. PREVENTIVE MEASURES
Intensive antenatal care
Intra natal assessment of fetal hypoxia
Careful use & intelligent use of anesthetic agents &
depressant drugs in labor
Care of neonates at birth
Special attention to avoidance of preterm delivery
Care of pre term & low birth wt baby
19. Summary
• As we discussed post sequelae of birth asphyxia
is traumatic both physically and psychological
hence it is important for every neonatal nurse to
anticipate the problem and intervene in the right
manner.
20. References
• Assuma Beevi (2009). Concise Textbook of Pediatric
Nursing. 2nd Edition. Elsevier Publication
• OP Ghai (2013) Essentials of Pediatrics. 8th Edition.
CBS Publishers and distributors.
• Datta Parul (2010). Paediatric Nursing. 3rd Edition.
JAYPEE publication