13 June, 2017
In the moments during and immediately after birth, the delivery room medical staff is alert to the possibility of hypoxia in the newborn. This condition, caused by a lack of oxygen to the brain, can be extremely dangerous for the baby and requires a rapid medical response to detect and prevent complications that could occur. A thorough assessment of the known risk factors prior to birth can help doctors and pregnant women prepare in advance for the possibility of hypoxia and take steps to prevent it.
Hypoxia in a newborn involves any condition that reduces the supply of oxygen to the brain. A common cause is a problem with the baby's respiratory system that prevents the newborn from getting enough oxygen. If the newborn does not take a breath soon after being born, hypoxia can develop rapidly. A baby born with his umbilical cord wrapped around his neck can also develop hypoxia as a result of the cord choking off blood supply to the brain. In other cases, an underlying medical problem causes hypoxia that develops more slowly, and the infant's blood levels of oxygen decline over the course of a few hours or days until the situation is urgent. If not treated, hypoxia can lead to brain damage or death.
Hypoxia in a newborn is considered a medical emergency. After birth, the delivery room doctor or nurse assesses the newborn for typical responses, behavior and physical condition. If the baby displays signs of hypoxia, such as abnormal coloring or behavioral problems, the immediate response is to attempt to restore oxygen flow to the brain and prevent any further brain damage. This can only be done if the reason for the hypoxia is clear, so the medical staff might have to subject the baby to a range of tests, including blood tests, ultrasounds, blood pressure and heartbeat monitoring and X-rays to determine the source of the problem so that it can be corrected as soon as possible.
Babies who are born under conditions that might lead to hypoxia are watched closely and preventative actions are taken when needed. During birth, the doctor or midwife typically checks the umbilical cord for any signs of knots or looping around the neck and may physically try to adjust it as the baby is being born to prevent problems. Clearing the airway after birth is another way to prevent hypoxia, especially if there is a possibility that the baby inhaled meconium, contents of the digestive tract that some babies release into their amniotic fluid shortly before birth. Fetal heart rate monitoring before birth can also help prevent hypoxia since it can indicate the need for an immediate Cesarean section.
If the newborn is immediately treated after birth and the lack of oxygen is corrected quickly, the baby may be able to make a full recovery. The longer the period of time the brain is without oxygen, the more complications will result. Damage caused by hypoxia is irreversible, so a baby who develops brain damage in this way is likely to experience lifelong effects. Potential complications include cerebral palsy, learning disabilities and mental retardation.
- National Institute of Neurological Disorders and Stroke; NINDS Cerebral Hypoxia Information Page; October 2010
- "Journal of Clinical Pathology Supplement"; Hypoxia in the Newborn Infant; E. O. Reynolds; 1977
- Lippincott's Nursing Center; Hypoxia in the Term Newborn; A. J. Rohan and S. G. Golombek; March 2009
- Laeknabladid; Birth Asphyxia and Hypoxic Ischemic Encephalopathy, Incidence and Obstetric Risk Factors; September 2007
- "The New England Journal of Medicine"; Whole-body Hypothermia for Neonates with Hypoxic-Ischemic Encephalopathy; S. Shankaran, et al.; October 2005
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