Definition

Perinatal asphyxia is a condition in which a baby’s brain does not receive enough oxygen during or after birth. This results in cardiorespiratory or brain damage.

Asphyxia can be fatal. Brain cells can begin dying within as little as 5 minutes without oxygen. The disease can also cause long-term damage, including intellectual disability, delayed development, seizures, and cerebral palsy.

Causes

Asphyxia may be caused by:

• The placenta separating too early from the uterine wall
• Pressure on the umbilical cord
• Certain medications
• Infection
• Breathing in meconium from the amniotic fluid
• Birth trauma

Risk Factors

Factors that increase your baby’s chance of perinatal asphyxia include:

• Previous still birth
• Fetal heart rate abnormalities
• Water breaking more than 12 hours before delivery
• Meconium in the fluid surrounding the baby before birth
• Hemorrhage occurring prior to childbirth
• Fever in the mother
• Prolonged first and second stages of labor
• Pre- or post-term labor
• Delivery with forceps or a vacuum device

Symptoms

Mild asphyxia may cause:

• Poor muscle tone
• Irritability
• Extreme drowsiness
• Feeding difficulties, including poor suck

Severe asphyxia may cause:

• Seizures
• Poor arousal
• Blue-colored skin or lips
• Difficulty breathing

Diagnosis

A physical exam will be done. Typically, the history is the most important factor in making the diagnosis.

Your baby’s bodily fluids may be tested. This can be done with blood tests.

Images may need to be taken of your baby’s bodily structures. This can be done with:

• Ultrasound
• CT scan
• MRI scan
• Echocardiogram

Your baby’s heart and brain activity may also be tested. This can be done with:

• Electrocardiogram (EKG)
• Electroencephalogram (EEG)
• Evoked potential test for hearing and, rarely, vision

Treatment

Prevention

In most cases, asphyxia is sudden and cannot be prevented.

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