the back of the mouth, with a soft catheter. When stimulation and a clear airway do not result in adequate respiration, the physician may give 100 percent oxygen via a face mask. If the infant is still not breathing, some form of artificial ventilation is then required. The usual method is to use mask ventilation with a resuscitator. The mask is applied tightly to the infant's face. If this procedure fails, the infant can be intubated with a endotracheal tube to which the resuscitator can then be connected. The more severe the fetal asphyxia, the longer it will take before the infant starts to breathe spontaneously. If the infant does not breathe despite adequate ventilation, or if the heart rate remains below 80 beats per minute, the physician can give an external cardiac massage using two fingers to depress the lower sternum at approximately 100 times a minute while continuing with respiratory assistance. Adrenaline may also be administered to increase cardiac output. Once the infant starts breathing, he or she is transferred to a nursery for observation and further assessment. Temperature, pulse and respiratory rate, color, and activity are recorded, and blood glucose levels checked for at least four hours.
Treatment may also include the following:
- giving the mother extra amounts of oxygen before delivery
- medications to support the baby's breathing and sustain blood pressure
- extracorporeal membrane oxygenation (ECMO)
ECMO is a technique similar to a heart-lung bypass machine, which assists the infant's heart and lung functions with use of an external pump and oxygenator.
If an inadequate supply of oxygen from the placenta is detected during labor, the infant is at high risk for asphyxia, and an emergency delivery may be attempted either using forceps or by cesarean section.
The prognosis for asphyxia neonatorum depends on how long the new born is unable to breathe. For example, clinical studies show that the outcome of babies with low five-minute Apgar scores is significantly better than those with the same scores at 10 minutes. With prolonged asphyxia, brain, heart, kidney, and lung damage can result and also death, if the asphyxiation lasts longer than 10 minutes.
Anticipation is the key to preventing asphyxia neonatorum. It is important to identify fetuses that are likely to be at risk of asphyxia and to closely monitor such high-risk pregnancies. High-risk mothers should always give birth in hospitals with neonatal intensive care units where appropriate facilities are available to treat asphyxia neonatorum. During labor, the medical team must be ready to intervene appropriately and to be adequately prepared for resuscitation.
Adrenaline —Another name for epinephrine, the hormone released by the adrenal glands in response to stress. It is the principal blood-pressure raising hormone and a bronchial and intestinal smooth muscles relaxant.
Anemia —A condition in which there is an abnormally low number of red blood cells in the bloodstream. It may be due to loss of blood, an increase in red blood cell destruction, or a decrease in red blood cell production. Major symptoms are paleness, shortness of breath, unusually fast or strong heart beats, and tiredness.
Anesthesia —Treatment with medicine that causes a loss of feeling, especially pain. Local anesthesia numbs only part of the body; general anesthesia causes loss of consciousness.
Apgar score —The results of an evaluation of a newborn's physical status, including heart rate, respiratory effort, muscle tone, response to stimulation, and color of skin.
Asphyxia —Lack of oxygen.
Asphyxia neonatorum —Respiratory failure in the newborn.
Bradycardia —A slow heart rate, usually under 60 beats per minute.
Cyanosis —A bluish tinge to the skin that can occur when the blood oxygen level drops too low.
Hemoglobin —An iron-containing pigment of red blood cells composed of four amino acid chains (alpha, beta, gamma, delta) that delivers oxygen from the lungs to the cells of the body and carries carbon dioxide from the cells to the lungs.
Hypotonia —Having reduced or dimini