What is asphyxia? Asphyxia is when there is less than normal oxygen delivered to the body or an organ and there is build up of carbon dioxide in the body or tissue. Not enough blood flow to an organ can cause asphyxia.
When does asphyxia occur? It can happen any time--a long time before birth, shortly before birth, during delivery or after birth.
What happens with asphyxia? If the period of asphyxia is short, the body may recover without damage. If the time is longer there may be injury that is reversible, not permanent. If the period is very long there may be permanent injury to one or more organs of the body.
How does someone know if there is asphyxia? Before birth, asphyxia may occur without people knowing. If the pregnancy is high risk, the obstetrician may monitor the baby before birth looking for heart rate patterns, activity, and amount of amniotic fluid. If a baby is not doing well in the womb the heart rate pattern may become abnormal and/or the baby may stop moving. After birth, doctors can observe more directly the baby's heart rate, color, breathing and activity. Sick babies often have their heart rate, breathing rate, blood pressure, and oxygen monitored all the time.
How is asphyxia treated? The goals of treatment are to:
prevent further asphyxia by trying to make oxygen, carbon dioxide and blood pressure normal. Support the baby so the body can repair the damage that it is possible to repair
Your baby may need:
medicine for seizures medicine to keep blood pressure normal to be feed by vein to be on a breathing machine If your baby has seizures, s/he will probably have an EEG - electroencephalogram or brain wave test. In addition, your baby's doctors may choose to do other tests ( Head ultrasound, CT scan or MRI) if they think they are needed.
Source: University of Wisconsin and The Center For Perinatal Care at Meriter Hospital Madison, Wisconsin
What is Hypoxic-Ischemic Encephalopathy (HIE)? Hypoxic means too little oxygen. Ischemic means not enough blood flow. Encephalopathy means abnormal brain function. HIE means that for a period of time there was too little oxygen and blood flow to the brain. This causes the brain to act abnormal.
How does a baby with HIE act?
The baby will have abnormal activity, either very irritable and tense or very low tone and little or no activity
The baby may have seizures or abnormal movements
The baby may not breathe normally or have apnea, a period of no breathing
The baby may show signs of damage to other organs
Kidney - too little or too much urine, blood in the urine, proteins in the urine, abnormal tests of kidney function (BUN and Creatinine)
Liver- abnormal tests of liver function
Blood - difficulty clotting blood
Intestines - blood in the stool or necrotizing enterocolitis
When will I know if there is permanent brain damage? Those caring for your baby will be best able to answer this question. Often the answer is known only over time. Babies are most like to have severe problems if they
had abnormal EEG's in addition to the seizures on it
take over two weeks to act like a normal baby or learn to feed normally
continue to have very low tone
What kinds of long term problems are possible if there is permanent damage? Serious abnormalities appear gradually. These may include:
motor (movement) problems
tight or stiff muscles
holding legs straight and crossed most of the time
difficulty sitting
slow to crawl, stand, or walk or inability to do these
abnormal crawling, toe walking
frequent arching of the back (not just when angry or at play)
one side weaker than the other
slow mental development does not listen to your voice by age 3-4 months after hospital discharge does not make different sounds by 8-9 months after discharge doesn't seem to understand or say any words by one year after discharge
seizures poor hearing or deafness poor vision
Less serious problems appear more slowly, are more difficult to detect, and may not be obvious until preschool or grade school. These can include:
poor coordination or balance
specific learning disabilities (math or reading)
very short attention span
behavioral problems
difficulty with activities that require coordination of the eyes and hands; for example, catching a ball or copying a simple drawing
It is very important for babies who have HIE to receive close follow-up of their development. If your baby has HIE, s/he may be eligible for a developmental intervention program, see Family Village. Anytime in the future if you are concerned about something that you think might be abnormal, have it checked out by your baby's doctor.
Source: University of Wisconsin and The Center For Perinatal Care at Meriter Hospital Madison, Wisconsin
Last Updated ( Friday, 19 January 2007 )
Videos
Written by Yasiph
Tuesday, 13 March 2007
NOTE: NOT FOR FAINT HEARTED
These Videos here are taken via a digital camera and it might not be very clear at times. For your ease of use I have a picture, followed by its description, date and file size. In description you see time in seconds followed by its Intensity(L=Low,M=Medium,H=High and HH=High high) I have used the term "Convulsion" assuming sudden uncontrollable jerky movements of the body caused by contraction of muscles. This is what I think is happening here but please do see the videos because a trained eye can point out many unseen clues from me because I am not a doctor myself.
Age this Video taken : 2 year 7 months 3 days. This is a 20 sec clip. Notable seconds 00:00 to 00:09HH, 00:10,00:11 On the 00:12 We realised the intensity of this convulsion only when we took a look at the video. This is a HH convulsion. http://www.youtube.com/watch?v=gGNPw6sSYE4
Age this Video taken : 2 year 4 month 11 days. This is a 01 min 15 sec clip. Notable seconds 00:01L,00:14M,00:24L,00:30L,00:36L,00:42L,00:52M Some times he opens mouth or smiles after a convulsion. http://www.youtube.com/watch?v=iHiCwHxLa-Q
Age this Video taken : 2 year 4 month 11 days. This is a 01 min 15 sec clip. Notable seconds 00:01L,00:14M,00:24L,00:30L,00:36L,00:42L,00:52M Some times he opens mouth or smiles after a convulsion. http://www.youtube.com/watch?v=9rnU_ZP7e4Y
Medicines Early months Phenobarbitone: birth to 6 months
until 23rd August 2005 Clonazepam(Rivotril): 1tab bd Sodium Valproate(Valparin 200mg): 2.5ml bd
Now (13 Mar 2007) Clonazepam(Rivotril 0.5mg): 1tab od Baclofen(Lioresal 10mg): 1/4th tab od Sodium Valproate(Valparin 200mg): 3.5ml bd (12 Dec 2006)
Note: What at first diagnosed as colic was later described as a convulsion. It started early as a small twitch has been changing its form day by day. As of June 2005 the convulsions were longer at times, about 4 seconds. Also there was always the 1st Jan 2004 type of jerk when he is trying to sleep. When the convulsion intensity is high he does not give an unvoluntary smile(see video with an involuntary smile 23rd Mar 2004-6) later, he cries with a lot of pain(24 Mar 2005, 07 August 2005 ). A lot has been described by physicians about the type; salaam attacks, infantile spasm, west syndrome, fit, seizure but I have refered as a convulsion throughout this page.
Stopped!
Since 4:30am of 12th Nov 2005, We did not observe any form of the above convulsions! There was no change in the medication or food. Updated: 24 Aug 2006
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