As a result of the interview in which Dani’s mother explained to us that her son suffered from cerebral palsy due to lack of oxygen during childbirth , we discovered the interest that this topic arouses among parents.
Hence, we contacted a specialist to explain when neonatal hypoxia occurs , the name given to oxygen deficiency in tissues before, during and after delivery. But also, how doctors act when it occurs and how it can affect the health of the baby.
We spoke with Dr. Jackie Calleja, gynecologist and director of Bmum, a comprehensive care clinic for women and babies.
The importance of oxygen for the baby
Oxygen is essential for vital functions. Its decrease results in a reduction in the metabolism of glucose, an element that helps cells produce energy. By not receiving the necessary glucose, the cell cannot maintain itself and ends up dying.
Hypoxia or oxygen reduction causes the body of the fetus to react by redirecting the little oxygen it receives to the brain and heart, two vital organs. But if the deficit lasts a long time, cell death is more extensive and affects the brain and heart.
For this reason, to avoid irreparable injuries, medical personnel act as quickly as possible in the event of complicated deliveries or warning on monitors of loss of fetal well-being, accelerating delivery or performing an emergency cesarean section, in order to avoid serious consequences for the health of the baby. baby.
According to the Spanish Association of Pediatrics, the lack of oxygen during birth is one of the main causes of perinatal death, since almost a million children die each year in the world from perinatal asphyxia and another million are left with permanent disabilities.
Causes of hypoxia
Among the situations that compromise oxygen reaching the baby’s bloodstream are:
- Maternal cardiopulmonary disease or anemia.
- Premature detachment of the placenta or placental insufficiency.
- Maternal hypotension or abnormal uterine contraction.
- Compressed umbilical cord.
- Fetal problems: fetal anemia and heart abnormalities (such as arrhythmias).
- Small baby size or premature birth.
- Very long labor, with pushing too often, that does not give time to recover.
Consequences
Lack of oxygen affects all organs and systems to varying degrees: renal, respiratory, digestive, metabolic, cardiovascular and cerebral. The damage depends, above all, on the level of alteration in the delivery of oxygen to the tissues.
Depending on how long the baby has been deprived of oxygen and how much of it, the affectation in the child will be more or less mild.
If the deficit has been mild, the child recovers quickly and the alterations in his body are transitory 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 neurological repercussions such as seizures and cerebral palsy. Keep in mind that the brain is especially vulnerable, as it is still developing.
But there are more causes of the vulnerability of the Central Nervous System (CNS), such as its poor regeneration capacity, since damaged cells are not repaired and the consequences are irreversible.
The most characteristic clinical manifestation has been included under the term hypoxic-ischemic encephalopathy (HIE), and it is considered the most frequent known cause of neonatal brain injury.
HIE is defined as the disorder caused by reduced oxygen supply combined with reduced blood flow to the brain of the newborn. Its most frequent symptoms are:
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Respiratory problems
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Feeding difficulties
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Depressed reflexes
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Low or high muscle tone
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Seizures
Diagnosis of EHI
When it is suspected that the baby may have suffered an oxygen deficiency during delivery, he is immediately transferred to the neonatal ICU. Suspicions arise after traumatic or complicated labor and delivery, which are reflected in the monitors.
Medical staff provide 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 carried out, making a small painless incision in his scalp. A drop of blood is removed to check your degree of metabolic acidosis and therefore the effect that your brain may have.
Once the case is evaluated (even with an imaging diagnosis), a treatment called hypothermia therapy can be performed before six hours of life. The baby’s brain or body is cooled for 72 hours below normal temperatures to slow down the baby’s metabolism (minimal consumption of resources), stabilize brain cells and prevent (or slow down) inflammation.
After an oxygen deprivation injury, rapid oxygenation can cause increased inflammation and the release of certain compounds that can further damage cells.
Unfortunately, despite testing, in some cases the related brain damage will not be palpable until the child shows poor motor control or developmental delay.
In addition, because of contacts we have had with parents of children with serious consequences due to lack of oxygen during childbirth, talking with other parents who are going through the same thing helps a lot , because they say that sharing your child’s day-to-day life With people who know what you are talking about and in specialized centers, it makes children achieve goals that, when they give you the diagnosis, seem unattainable.
Cerebral palsy is one of the most common consequences and there are associations of affected people throughout Spain that offer resources, advice and therapies.
More information | The IHE Help Center. This US agency provides, in its own words, “educational material to families of children with IHE to help them navigate the diagnosis .”
The ASPACE Confederation. It gathers 80 entities, and it can be a good starting point, although there are more possibilities.
Photos | iStock
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