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What is Asphyxia Neonatorum?

Asphyxia is the lack of oxygen (hypoxia) or increase in carbon dioxide (hypercapnia) within the body
due to problems with breathing.
Asphyxia neonatorum (sometimes referred to as birth asphyxia) is the hypoxia and/or hypercapnia that
occurs in newborns. This may be categorized into perinatal asphyxia or neonatal asphyxia.
The chances of asphyxia neonatorum is significantly higher in high risk pregnancies, premature births,
multiple births (twins, triplets or more), severe maternal bleeding or toxemia.
Perinatal Asphyxia
Perinatal asphyxia or fetal asphyxia is the asphyxia that results in the baby before or during labor. A
rapid delivery is essential to secure the airways and ensure spontaneous breathing is possible. Perinatal
asphyxia may occur as a result of :
• Umbilical cord compression
• Abruptio placentae which is the premature detachment of the placenta from the wall of the
uterus thereby cutting off vital oxygen rich blood from the mother to the baby.
• Uterine tetany which is the continuous or prolonged uterine contractions that may occur as a
result of complications in labor or certain drugs like oxytocin.
• Maternal hypotension (low blood pressure) which hampers the delivery of sufficient oxygen to
the fetus.
• Uteroplacental insufficiency which prevents adequate gas exchange between the fetus and
mother due to problems.
• Fetal exsanguination which is the loss of blood from the fetus.
Neonatal Asphyxia
Neonatal asphyxia (newborn asphyxiation) is the asphyxia that results after the baby is delivered.
Asphyxia neonatorum may occur as a result of :
• Perinatal asphyxiation
• Drugs – anesthetic or analgesics administered to the mother or the use of narcotics (‘crack
mothers’)
• Malformation of the lungs or breathing muscles.
• Airway obstruction due to meconium, blood or fluids.

Treatment of Neonatal Asphyxiation


The immediate priority of the attending physician is to secure integrity of the airway by clearing any
secretions, fluid or blood. This is often done by suctioning with a soft catheter. In newborns who are well
oxygenated but slightly limp due to the use of analgesics or anesthetics, the attending physician may
gently slap the feet of the baby before commencing with suctioning.
After clearing the airway, ventilation with oxygen is usually necessary in asphyxia neonatorum. The
attending physician may commence resuscitation with a neonatal bag mask with positive pressure
ventilation. Efforts to stimulate the circulation may follow if positive pressure ventilation does not assist
with suitable oxygenation noted by a pink color of the extremities. The newborn’s body temperature must
be maintained during ventilation and efforts to stimulate circulation and this is usually done through
heaters rather than just blankets.
Once the newborn baby is stabilized, he or she will usually be placed into an incubator to ensure positive
pressure ventilation as well as suitable temperature regulation. This is often conducted in a neonatal ICU
(intensive care unit) where close observation by trained staff will ensure that there are no other episodes
of hypoxia.
Newborn Procedures: Eye Ointment May Not
Be Necessary
NaturalNews) A myriad of procedures is done to newborn babies usually immediately after birth. These include a
shot of vitamin K, a hepatitis vaccine, a test for PKU, administration of eye ointment and others.

The eye ointment is administered to prevent conjunctivitis resulting from a gonorrheal or Chlamydial infection in
the mother. This type of conjunctivitis can lead to blindness. Some women are asymptomatic for gonorrhea and
since false positives are possible, prenatal screening of the mother is thought insufficient as a diagnostic tool.

The ointments used are usually silver nitrate or an antibiotic such as erythromycin or povidone-iodine. Silver nitrate
reduces the incidence of conjunctivitis in newborns, but it can cause irritation. Ironically, this irritation itself
sometimes leads to conjunctivitis in the infant!

In 1992 a study of 4,544 babies, born between 1989 and 1991 received one of five treatments so that the efficacy of
the ointments could be tested. Three groups were given antibiotic eye drops: either erythromycin, two doses of
erythromycin or tetracycline. A fourth group received silver nitrate drops and a fifth serving as a control group
received no drops. Surprisingly, no significant differences were found in the incidence of newborn conjunctivitis
among these groups. The drops of antibiotic and silver nitrate made no difference whatsoever. A small 2007 study of
138 infants confirmed these results: no significant difference was found in infection rate for babies receiving saline
drops, erythromycin drops or no drops.

A 1995 study including 3117 infants tested an additional antibiotic called povidone-iodine or betadine. This
antibiotic did reduce the incidence of newborn conjunctivitis relative to erythromycin or silver nitrate. However, this
study did not include a control group against which to measure the effects of these treatments! Nevertheless,
povidone-iodine does appear to have an effect. A fourth study, performed in 2007 examined the effects of povidone-
iodine, erythromycin and no treatment on a total of 330 infants. Those receiving povidone-iodine had fewer eye
infections than those receiving erythromycin or neither.

Additionally, the infection is rather ugly and impossible to be missed by barely competent parents; there is still
plenty of time for treatment when the eye infection starts to look so obvious and antibiotics clear it up.

The indiscriminate use of antibiotics in newborns has the potential to increase the rates of diaper rash, thrush,
digestive problems and antibiotic resistance in some. Anecdotally, some mothers claim that their babies who
received eye ointment didn't gaze at them or their surroundings as soon as their babies who did not receive eye
ointment did.

Results of studies like those described above are not always available to the public. Parents are generally not
counseled on the efficacy or indications for newborn procedures; instead, hospital staff routinely undertakes their
administration unless explicitly asked otherwise. In some cases parents have no choice or are led to believe they
have no choice.