Perinatal Asphyxia

Reviews the current knowledge of the definition & diagnosis of acute perinatal asphyxia in term infants in order to develop operational & specific criteria to be tested in new studies. Summarized information currently available on this topic. Contents: scientific basis of brain injury in acute perinatal asphyxia; clinical assessment -- obstetrics; clinical assessment -- neonatal; interventions (conventional management; neuronal rescue & neuronal prohylaxis; glutamate antagonists, calcium channel blockers & Allopurinol); clinical studies of long-term outcome; clinical research. Charts & tables.

The aim of this book is to transmit the message that asphyxia is the major cause of infant mortality in the ne asphyxia-if severe, caus onatal period. The sequelae of ing cerebral palsy; if mild, leading to MBD to seizures are all potential risks. It is important to make young physicians and nurses aware of this complication of the birth period, how to avoid it, and how to treat it. Facilitating such awareness is the chief purpose of this book. Alberto Lacoius-Petruccelli New York 7 Contents 1. Asphyxia: Definitions, History, and Incidence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 2. Occurrence in Utero, at Birth, and after Delivery ................................. 17 3. Physiopathology of Asphyxia and Its Staging .................................. 21 4. Work-up and Treatment in the Newborn: Delivery Room, Nursery, and Perinatal leU 25 5. Mechanical Ventilators .................... 31 6. Prognosis ................................ 37 7. Brain Asphyxia and Hemorrhage ., ........ 51 8. Types and Stages of Fetal Anoxia: Anoxic, Anemic, Stagnant, and Histotoxic ......... 57 9. Embryonic and Fetal Periods .............. 65 10. The Placenta: Origin and Functions ........ 77 9 CONTENTS 10 11. Fetal Circulation 87 12. Placental Insufficiency or Dysfunction ..... .

Obstetricians and pediatricians in daily practice will find here the answersand explanations they need concerning the major problem of perinatal asphyxia. Leading experts in pediatrics, obstetrics and neurophysiology havecome together to produce a single sourcebook covering all aspects of thesubject. Biochemical mechanisms and clinical aspects of perinatal asphyxia, fetal and neonatal assessment, and perinatal management are thoroughly discussed. Neurodevelopmental outcome is another important issue addressed. In light of newer technologies, the prognosis of infants suffering from asphyxia is examined. Many figures and typicalcases are provided, making the book easy to use and providing quick access to solutions. The reader can easily identify a problem in the fetus and its subsequent development. With such knowledge, the improved managementof perinatal asphyxia is made possible.

The Presence Of Asphyxia In The Antenatal Period Has An Effect On Events During Labour And Immediately After That. In This Volume Current And Potential Methods Of Identifying And Assessing Perinatal Asphyxia Are Discussed Along With Doppler Velocimetry, Fetal Heart Rate Monitoring, Pulse Oximetry And Biochemical Measurements. The Problems In Developing Countries And Risk Management Which May Help To Prevent Recurrences Are Also Discussed. (Pb)

The Guest Editors have assembled top experts to provide the most current and clinically relevant articles devoted to Birth Asyphyxia. Articles in this issue are devoted to: Neonatal Transition After Birth; Pathophysiology of Birth Asphyxia; Perinatal Asphyxia from the Obstetrical Standpoint: Diagnosis and Interventions; Stillbirths: U.S. and Global Perspectives; Novel Approaches to Resuscitation and the Impact on Birth Asphyxia; Multiorgan Dysfunction and its Management After Birth Asphyxia; Neonatal Encephalopathy and Update on Therapeutic Hypothermia and Other Novel Therapeutics; Biomarkers in Neonatal Encephalopathy; Imaging and Other Diagnostics in Neonatal Encephalopathy; Asphyxia in the Premature Infant; The role of the NeoNeuro Unit for Birth Asphyxia; Long-term Cognitive Outcomes of Birth Asphyxia and the Contribution of Identified Perinatal Asphyxia to Cerebral Palsy; Global Burden, Epidemiologic Trends, and Prevention of Intrapartum Related Deaths in Low-resource Settings; and Neonatal Resuscitation in Low-resource Settings.

In severe asphyxia, lipid peroxidation occurs. Neonatal lipid concentration may indicate the severity of asphyxia and be a reason for needing cooling therapy. Asphyxia in Neonates describes the results of research into the impact oxygen deficits in neonates. The physiological consequences of asphyxiated newborn infants include changes in the pH of plasma and changes in lipid concentrations. These changes can result in apoptosis, loss of cell membrane integrity, and damage to the brain. Features Reviews pathophysiology of asphyxia Describes the influence of asphyxia on lipids concentrations Summarizes the weight distribution of neonates with asphyxia based on lipid concentration Illustrates the use of lipids as an indicator of prognosis following asphyxia Provides guidance for lipids parameters in cooling therapy

Decision making in modem obstetrics and perinatology is con trolled by a variety of different factors, but there is little doubt that in industrialized countries one of the most powerful single factors is the concern and fear of causing permanent brain damage in the unborn and newborn. The dramatic increase in the rates of abdom inal deliveries in many parts of the world is certainly rooted to a substantial part in the ~bstetrician's concern not so much about possible perinatal death, but more so about permanent brain dam age in surviving children. This trend has been accelerated by the increasing number of litigations in connection with brain damage observed in many societies. This problem itself has many aspects, but it seems evident that litigation - justified or unjustified - is one modem expression of the human and social tragedy inflicted on individuals and families by the birth of a brain-damaged child. The medical, social, and human importance of the problem is in sharp contrast to the relative lack of scientific knowledge avail able. This became very clear when the National Institutes of Health published the excellent review in 1985 on "Prenatal and Perinatal Factors Associated with Brain Disorders" and its editor, J. M.