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Neonatal Asphyxia
GH.R Walizadeh
Iranian Journal of Pediatrics , 1986,
Abstract: Neonatal Asphyxia may impose a major risk on the life and well-being of the newborn infant. The recognition of the four phases of Asphyxia at birth, I.e., primary hyperpnea, primary apnea secondary hyperpnea and secondary apnea, is of importance in employment of the appropriate treatment. The causes of Asphyxia may be operative intrauterine, natally or postnatally. Apgar score is a practical means of estimating the grade of severity of neonatal Asphyxia and its outcome. The treatment should employ mechanical ventilation, medical suppression of the convulsions and correction of the acidosis.
The Professional Medical Journal , 2004,
Abstract: Introduction: Birth asphyxia and the hypoxic-ischemicencephalopathy are one of the very common neonatal problems in our country. It is commonest causeof hospital admission of a newborn. Objectives: 1) To determine the incidence of different risk factorsleading to birth asphyxia in babies delivered at Nishtar Hospital, Multan. 2) To find out common clinicalpresentation of birth asphyxia. 3) To suggest measures for the prevention of birth asphyxia and thedisability resulting from it. Material and methods: This study was conducted in the department ofpediatric medicine, Nishtar Hospital, Multan. All babies born at Nishtar Hospital, Multan, presentingwith history of delayed cry ar birth for more than 1 minute and newborns of less than 7 days of age bornat Nishtar Hospital, Multan presenting any complication of birth asphyxia were included in the study.Results: The incidence of birth asphyxia is higher in preterm, intrauterine growth retarded and infantsof diabetic and toxemic mothers. Specific problems and complications of birth asphyxia depend uponinfant’s gestational age (outcome is poorest in preterm), efficiency of resuscitation and severity of thehypoxic – ischemic encephalopathy. About 6% of all live births are estimated to be asphyxiated at birth.Apgar score is widely used criterion for diagnosis of birth asphyxia. Conclusion: Emergency caesareansection was noted as a significant risk factor of birth asphyxia. The common clinical features associatedwith delayed cry, with which asphyxiated babies presented were, grunting, cyanosis, meconium stainingand meconium aspiration. Other risk factors were, prolonged rupture of membranes, antepartumhaemorrhage, pregnancy induced hypertension, eclampsia, polyhydramnios, oilgohydramnios, diabetesmellitus, breech presentation, transverse lie and obstructed labour. Fetal distress was noted in almost twothird of the asphyxiated babies. Birth asphyxia is common in males.
Perinatal Asphyxia
H Shajari
Iranian Journal of Pediatrics , 2000,
Abstract: Asphyxia before, during or after delivery is an important cause of perinatal mortality and neurologic morbidity. The fetus and newborn are equipped with a wide range of adaptive mechanisms to survive an Asphyxia episode, and when these fail, injury can occur. The American academy or pediatrics (AAP) and the American college of obstetrics and gynecology (AcoG) committees on maternal-fetal medicine and fetus and newborn have recently defined certain criteria that must be present: Profound umbilical artery metabolic or mixed academia (PH<700), persistence of an apgar score of 0 to 3 for longer than 5 minutes, neonatal neurologic sequelae (E.g., seizures, coma, hypotonia), and multiorgan system dysfunction (E.g., cardiovascular, gastrointestinal, hematologic, pulmonary or renal). In cases in which such evidence is laking, we cannot conclude that perinatal Asphyxia exists. The staging of the encephalopathy is useful for determination of prognosis. Those with mild encephalopathy do well, those with severe encephalopathy have a poor prognosis. The outcome of these with moderate (Stage II) hypoxic-ischemic encephalopathy is less certain, however, these children are at risk for neurologic disability and future academic failure. Overall tests used to evaluate subtle changes that may relate to perinatal hypoxic-ischemic injury have been inadequate, future studies should include tests of acquisition of new learning, memory, problem solving, and reasoning.

- , 2017,
Abstract: 《周易音义》“窒,张栗反。徐得悉反,又得失反”三切同音,涉及“重音音切”与文字讹误的问题。《经典释文》为“窒”所出之音用字颇不一致,情况较为复杂,根据对“窒”字的全部注音的分析,考订出“得失反”当为“得迭反”之误。今本《经典释文》真正的重音是因后人添加音切造成的,故必两两成对,不存在三切相重的现象;凡有三音相同的重复音注,其中必有因文字讹误造成的“假性重音”。根据反切类型及层次,可以推定《经典释文》“窒”字音注的首音原貌大抵就是“徐得悉反”及“《说文》都节反”之类。
Magnesium for neuroprotection in birth asphyxia  [cached]
Gathwala Geeta,Khera Atul,Singh Jagjit,Balhara Bharti
Journal of Pediatric Neurosciences , 2010,
Abstract: Background : Magnesium ion gates the N-methyl-D-aspartate (NMDA) receptor and may protect the brain from NMDA receptor-mediated asphyxial injury. The present study evaluated the neuroprotective role of magnesium in birth asphyxia. Material and Methods : Forty term neonates with severe birth asphyxia were randomized to either the study group or the control group. Neonates in the study group received magnesium sulfate in a dose of 250 mg/kg initially within half an hour of birth followed by 125 mg/kg at 24 and 48 h of birth. Cranial computed tomography (CT) scan and electroencephalography (EEG) were performed for all the babies. Denver II was used for developmental assessment at the age of 6 months. Results : Two babies in each group died of severe hypoxic ischemic encephalopathy. EEG abnormalities occurred in 43.75% of the cases in the control group compared with 31.25% in the study group. CT scan abnormalities were present in 62.5% of the control group compared with 37.5% of the cases in the study group. The Denver II assessment at 6 months revealed that there were five babies that were either abnormal or suspect in the control group compared with three in the study group. Conclusion : Magnesium is well tolerated and does appear to have beneficial effects in babies with severe asphyxia. More data is however needed and a large multicenter trial should be conducted.
Biochemical Markers in Perinatal Asphyxia  [PDF]
Manisha Naithani,Ashish Kumar Simalti
Journal of Nepal Paediatric Society , 2011, DOI: 10.3126/jnps.v31i2.4155
Abstract: Early assessment of the severity of an acute cerebral lesion secondary to hypoxia-ischemia or other pathologic conditions may provide a very useful basis for preventive or therapeutic decisions in pediatric patients. In the present review, we discuss the diagnostic and prognostic value of a series of biochemical parameters, with special reference to the diagnosis of neonatal HIE. Currently many specific biochemical markers of brain injury are being investigated to assess regional brain damage after perinatal asphyxia in neonates of which serum protein S-100β, brain-specific creatine kinase, neuron-specific enolase, IL6 and urinary uric acid levels appear promising in identifying patients with a risk of developing hypoxic-ischemic encephalopathy. Whether detection of elevated serum concentrations of these proteins reflects long-term neurodevelopmental impairment remains to be investigated. Key words: S-100; Brain specific creatine kinase; neuron specific enolase; IL6; urinary uric acid; hypoxic ischaemic cerebral injury. DOI: 10.3126/jnps.v31i2.4155 J Nep Paedtr Soc 2010;31(2):151-156
Physiopathological Mechanism and Assessment of Fetal Asphyxia  [PDF]
Panagiotis Tsikouras, Anastasia Bothou, Zacharoula Koukouli, Bachar Manav, Constantinos Bouschanetzis, Dorelia Deuteraiou, Xanthi Anthoulaki, Anna Chalkidou, George Iatrakis, Stefanos Zervoudis, George Galazios
Open Journal of Obstetrics and Gynecology (OJOG) , 2017, DOI: 10.4236/ojog.2017.76064
Abstract: Treatment and outcome of childbirth depend on the acidobasic balance of the fetal blood related to the oxygen and carbon dioxide level. Hypoxemia could lead to asphyxia that is why fetal monitoring and biochemical parameters assessment are mandatory. Although there are compensatory mechanisms that temporarily protect the fetus, there are also other factors that interfere with the oxygenation of the fetus and determine the development of the fetus and the newborn. Actually, the level of the oxygen, the carbon dioxide, the acidobasic balance and the pH are the cornerstones of the well-being of the fetus.
Midwives’ adherence to guidelines on the management of birth asphyxia in Malawi  [PDF]
Bertha Chikuse, Ellen Chirwa, Alfred Maluwa, Address Malata, Jon Odland
Open Journal of Nursing (OJN) , 2012, DOI: 10.4236/ojn.2012.24052
Abstract: A study was conducted to determine midwives adherence to guidelines on management of birth asphyxia at Queen Elizabeth Central Hospital in Blantyre district, Malawi. The study design was descriptive cross sectional using quantitative data analysis method on 75 midwives that were working in the maternity unit of the hospital. A structured questionnaire was used to collect data on participant’s demographic characteristics and midwives’ comprehension of birth asphyxia and an observational check list was used to observe midwives’ adherence to WHO resuscitation guidelines. In addition midwives were observed on their adherence to the Integrated Maternal and Neonatal Health guidelines that were developed by the Malawi Ministry of Health. The findings indicate that the midwives had knowledge of birth asphyxia in general. However, there were gaps in their ability to identify warning signs of birth asphyxia through partograph use. In addition the midwives did not adhere to 9 out of the 21 steps of the resuscitation guideline. Generally there was substandard adherence to guidelines on identification of warning signs of birth asphyxia and neonatal resuscitation. On the other hand, the facility did not have adequate resuscitation equipment and supplies. The results are discussed in relation to the importance of adhering to resuscitation guidelines in the management of birth asphyxia for babies that do not breathe at birth. Training of the midwives on partograph use and resuscitation to improve neonatal outcomes is recommended. It is recommended further that the health facility should have adequate resuscitation equipment and supplies.
Neonatal asphyxia: A study of 210 cases  [PDF]
Hülya üzel,Selvi Kelek?i,Celal Devecio?lu,Ali Güne?
Journal of Clinical and Experimental Investigations , 2012,
Abstract: Objectives: Perinatal asphyxia remains an importantcause of neonatal morbidity and mortality. The aim of thisstudy was to investigate antenatal, natal, and postnatalrisk factors of neonatal asphyxia, relationship with knownrisk factors and stage of Sarnat and Sarnat scores, theeffect of risk factors on hospital discharge and survival forneonates with perinatal asphyxia.Materials and methods: In this study, we retrospectivelyanalyzed the hospital records of 210 patients diagnosedas perinatal asphyxia. The patients’ demographic characteristics,antepartum, intrapartum, and postpartum riskfactors and Sarnat and Sarnat clinical staging criteria ofnewborns were analyzed.Results: The risk factors for asphyxia were detectedantepartum period in 67.7% of newborns, intrapartum in91% and potpartum in of 29.5% of neonates. When caseswere examined according to the studied years, perinatalasphyxia ratio was the most frequent in 2007 as 28.1%.With a decline over the years, frequency dropped to %21in 2010. The number of patients with stage 3 and mortalityrate were significantly decreased over the years (p<0.05).Conclusions: Less preventable intrapartum causes ofbirth asphyxia are seen more frequently. Early detectionof risk factors together with appropriate prenatal, nataland postnatal care provision, reduced emergency caesareansections and will decrease considerably decreasefrequency of perinatal asphyxia. We think that followingup neonates who needed intensive care in neonatal unitssufficiently equipped will decrease complications due toasphyxia. J Clin Exp Invest 2012; 3(2): 194-198
Journal of Special Education and Rehabilitation , 2010,
Abstract: Asphyxia is a risk factor that is very often related to neuro-developmental issues in high risk infants and equally affects preterm and term infants, however its outcome on the developed brain differs from the outcome on the preterm brain.In preterm infants, asphyxia usually exerts a hemorrhagic or ischaemic event and periventricular leukomalacia.In term infants, asphyxia leads to cerebral edema and atrophy of the brain, which may later lead to hypoxic ischaemic encephalopathy (HIE).The number of term infants with HIE who have survived is lower than those of preterm infants, while the percentage of term infants with HIE who have neuro-developmental issues is higher. Preemies face more problems in their motor development as a result of the brain damage, while term infants suffer from encephalopathy and their cognitive abilities are more affected.We have conducted a study about the effects that asphyxia has on the developmental outcomes in high risk infants. In our study, we did a longitudinal developmental follow-up of 30 high risk infants and an evaluation of their developmental outcome using the Griffiths Mental Development Scales, from the 4th month of life until the end of the 36th month. First, we found that high risk infants had a much lower developmental outcome than the control group during the trial. Finally, we found that asphyxia makes a difference in the developmental outcome of preterm infants without asphyxia who have a very low birth weight, the preterm infants with asphyxia, and the term infants with HIE-II.
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