Perinatal asphyxia: literature review
DOI:
https://doi.org/10.69849/2w0rqm46Keywords:
Neonatal asphyxia, intrauterine asphyxia, fetal deathAbstract
The term asphyxia refers to the condition in which there is impaired gas exchange in an individual, causing progressive hypoxia, hypercapnia and acidosis. During the perinatal period, this fetal condition is most often a consequence of impaired placental blood flow, which, in some children, can progress to hypoxic-ischemic brain injury. However, caution should be taken when considering the diagnosis of “asphyxia” in a newborn (NB), as: (1) it lacks a specific biochemical definition; and (2) it is often unjustifiably associated with impaired neurological activity, resulting in costly litigation. In fact, the manifestation of neonatal encephalopathy at birth may be due to asphyxia; however, it may be secondary to other causes, such as congenital metabolic defect, genetic anomalies or intracranial hemorrhage. Before an acute intrapartum hypoxic-ischemic event can be associated with a subsequent diagnosis of cerebral palsy, the Task Force on Neonatal Encephalopathy and Cerebral Palsy of the American Congress of Obstetricians and Gynecologists (ACOG) defines four essential criteria (ACOG, 2005): (1) evidence of metabolic acidosis in umbilical cord arterial blood obtained at the time of birth. parturition (pH < 7 and base deficit ≥ 12 mmol/L); (2) early onset of moderate or severe neonatal encephalopathy in children born at 34 or more weeks of gestation; (3) cerebral palsy of the dyskinetic or spastic quadriplegic type; and (4) exclusion of other identifiable etiologies, such as trauma, coagulation abnormalities, infectious diseases, or genetic abnormalities.
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