Birth Asphyxia

Signs and Symptoms

The following are the most common symptoms of birth asphyxia. However, each baby may experience symptoms differently.

Before delivery, symptoms may include:

• Abnormal heart rate or rhythm
• An increased acid level in a baby's blood

At birth, symptoms may include:

• Bluish or pale skin color
• Low heart rate
• Weak muscle tone and reflexes
• Weak cry
• Gasping or weak breathing
• Meconium -- the first stool passed by the baby, in the amniotic fluid -- can block small airways and prevent a baby from breathing properly, causing respiratory distress

Diagnosis

The following are used to diagnose birth asphyxia:

• Severe acid levels -- pH less that 7.00 -- in the arterial blood of the umbilical cord

• Apgar score of 0 to 3 for longer than five minutes. The Apgar test is used just after birth to evaluate a newborn's color, heartbeat, reflexes, muscle tone and respiration.

• Neurological problems, such as seizures, coma and poor muscle tone.

• Respiratory distress, low blood pressure, or other signs of low blood flow to the kidneys or intestines. Problems with a baby's circulatory, digestive and respiratory systems may also suggest that a baby has birth asphyxia.

Treatment

Birth asphyxia is a complex condition that can be difficult to predict or prevent. Prompt treatment is important to minimize the damaging effects of decreased oxygen to the baby. Specific treatment for birth asphyxia is based on:

• Your baby's age, overall health and medical history
• Severity of your baby's condition
• Your baby's tolerance for specific medications, procedures or therapies
• Expectations for the course of the condition

Treatment may include:

• Giving the mother extra amounts of oxygen before delivery
• Emergency delivery or Caesarean section
• Assisted ventilation and medications to support your baby's breathing and blood pressure
• Extracorporeal membrane oxygenation (ECMO)

Extracorporeal Membrane Oxygenation

In addition, an extracorporeal membrane oxygenation (ECMO) machine may be used for patients who are experiencing serious heart or lung failure. It delivers oxygen to your baby's brain and body as temporary support. ECMO is a technique similar to a heart-lung bypass machine, which assists your baby's heart and lung functions with an external pump and oxygenator. Blood is drained from the patient to an artificial lung where oxygen is added and carbon dioxide is removed and then the blood is pumped back into your child.

At UCSF Children's Hospital, we treat over 20 patients each year with ECMO and our success outcomes are among the highest in the country. Our team of experts is specially trained in ECMO and includes a neonatologist, surgeon, respiratory therapists and nurses with special training in the management of ECMO.

In addition to ECMO, we also offer a wide range of other types of mechanical ventilation and respiratory therapy, including high frequency oscillatory ventilation and inhaled nitric oxide.