Following the interview in which Dani's mother explained to us that her son suffered cerebral palsy because of lack of oxygen during childbirth, we discovered the interest that this topic arouses among parents.
Hence we got in touch with a specialist to explain when neonatal hypoxia occurs, name that receives oxygen deficiency in the tissues before, during and after childbirth. But also, how doctors act when it occurs and how it can affect the health of the baby.
We talked to Dr. Jackie Calleja, gynecologist and director of Bmum, a clinic for comprehensive care for women and babies.
The importance of oxygen for the baby
Oxygen is essential for vital functions. Its decrease results in a reduction in glucose metabolism, an element that helps cells produce energy. By not receiving the necessary glucose, the cell cannot keep and ends up dying.
The hypoxia or reduction of oxygen causes the body of the fetus to react by redirecting the little oxygen it receives to the brain and the heart, two vital organs. But if the deficit lasts a long time, cell death is broader and affects the brain and heart.
For that reason, to avoid irreparable injuries, medical personnel act as quickly as possible before complicated deliveries or warning on monitors of loss of fetal well-being, speeding up the delivery or performing an emergency caesarean section, in order to avoid serious consequences for the baby's health.
In Babies and more Fetal monitoring before delivery, what is it for?According to the Spanish Association of Pediatrics, the lack of oxygen during birth is one of the main causes of perinatal death, because almost one million children die each year in the world due to perinatal asphyxiation and another million are left with permanent disabilities.
Causes of hypoxia
Among the situations that compromise that oxygen reaches the baby's blood flow are:
- Maternal cardiopulmonary diseases or anemia.
- Premature detachment of the placenta or placental insufficiency.
- Maternal hypotension or abnormal uterine contraction.
- Compressed umbilical cord.
- Fetal problems: fetal anemia and cardiac abnormalities (such as arrhythmias).
- Small baby size or premature birth.
- Very long labor, with too many bids that do not allow time to recover.
Consequences
The lack of oxygen affects all organs and systems in varying degrees: renal, respiratory, digestive, metabolic, cardiovascular and cerebral. The damage depends, above all, on the level of alteration of oxygen delivery to the tissues.
Depending on how long the baby has been deprived of oxygen and how much of it, the involvement in the child will be more or less mild.
If the deficit has been mild, the child recovers quickly and alterations in your organism are transient and reversible.
They are more serious if the child has been deprived of oxygen for a longer time (between 5 and 15 minutes, although it cannot be established exactly). In these cases it has repercussions at the neurological level such as seizures and cerebral palsy. You have to keep in mind that The brain is especially vulnerable, as it is still developing.
But there are more causes of vulnerability of the Central Nervous System (CNS), such as its poor capacity for regeneration, since damaged cells are not repaired and the consequences are irreversible.
The most characteristic clinical manifestation has been encompassed under the term hypoxic-ischemic encephalopathy (EHI), and is considered the most common known cause of neonatal brain injury.
EHI is defined as the disorder caused by reduced oxygen supply combined with reduced blood flow to the newborn's brain. Its most frequent symptoms are:
Respiratory problems
Feeding difficulties
Depressed reflexes
Low or high muscle tone
Seizures
In Babies and more Feeling or loss of fetal well-being: what it is, what its symptoms are and what causes itHI diagnosis
When it is sensed that the baby has been able to suffer an oxygen deficit during the birth, He is immediately transferred to the ICU of neonates. Suspicions occur after traumatic and complicated labor and delivery, which are reflected in the monitors.
The medical staff provides all the supportive care that the newborn may need: breathing therapy, controlling and preventing seizures, lowering blood sugar or minimizing inflammation of the brain, among others.
There an analysis of the baby's pH is performed, making a small painless incision in your scalp. A drop of blood is taken to check your degree of metabolic acidosis and therefore the damage that your brain can have.
After assessing the case (even with an imaging diagnosis), a treatment called hypothermia therapy can be performed before six hours of life. The baby's brain or body cools for 72 hours below normal temperatures to slow down the baby's metabolism (minimum consumption of resources), stabilized brain cells and preventing (or slowing down) inflammation.
After an oxygen deprivation injury, rapid oxygenation can cause increased inflammation and the release of certain compounds that can further damage the cells.
Unfortunately, despite the tests performed, in some cases, the related brain damage will not be palpable until the child shows signs of poor motor control or developmental delay.
In addition, for contacts we have had with parents of children with serious consequences due to lack of oxygen during childbirth, talking to other parents who are going through the same help and a lotWell, they say that sharing your child's day-to-day life with people who know what you are talking about and in specialized centers allows children to reach goals that, when they give you the diagnosis, seem unattainable.
Cerebral palsy is one of the most common consequences. and there are associations of those affected throughout Spain that offer resources, advice and therapies.
The ASPACE Confederation. It brings together 80 entities, and it can be a good starting point, although there are more possibilities.
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