The Effects Of Hypoxic Ischemic Encephalopathy On Fetal Or Neonatal Asphyxia

According to the World Health Organization (WHO, 2016), preterm birth are the birth that happened before 37 ended weeks of pregnancy and is one of the number reason of newborn deaths and the second prominent cause of deaths in children below five. The preterm babies have chances of an amplified risk of illness, disability and death. In the first weeks, the complications of premature birth may include: breathing problems, heart problems, brain problems, temperature control problems, gastrointestinal problems, blood problems, metabolism problems, immune system problems. Long-term complications includes cerebral palsy, impaired cognitive skills, vision problem, hearing problems, dental problems, behavioral and psychological problems, chronic health issues.

researchers stated that SIDS babies probably have a defect in the brain neurochemicals that usually operate the protective responses to changes in oxygen and carbon dioxide levels.(IntelliHealth 3)

Neonatal RDS is a condition of increasing respiratory distress commencing at or shortly after birth (BAPM-2006). It’s the single most important cause of morbidity and mortality in preterm infants (Greenough, et al 2004). Typically RDS affects preterm infants with the incidence being inversely proportional to the gestational age (Stewart 2005) Approximately 60% of those born before 28 weeks gestation are affected (Fraser, et al 2004) Incidence also increases in infants of diabetic mothers those born via elective caesarean section (Fraser, et al 2004) and perinatal asphyxia (Rodriguez, 2003).

Fetal distress or birth asphyxia means that there has been a change in organ systems due to the lack of oxygen in the body. Breech delivery is when the babies buttock comes out first instead of the head during birth. “Meconium is when the baby’s first stool is passed during pregnancy into the amniotic fluid.” If the baby is born with nuchal cord this means that the umbilical cord was around the baby’s neck (http://www.lpch.org).

* During pregnancy-: If the mother smokes ,takes drugs, becomes ill or suffers from stress or anxiety this can result in premature birth and health problems for the baby such as -: low birth weight, undeveloped organs, problems with sight and hearing. These are all problems that could delay their development. Some children are born with conditions that could affect their development such as a blood disorder.

Compared to the general adult population the maternal airway management can be more challenging as changes during pregnancy can increase the difficulty of intubation (Brien and Conlon, 2013). Its makes hard to insert laryngoscope when the patient have a large breast, the chance of bleeding and swelling increases due to oedema and vascularity of the upper respiratory tract, and the patient desaturate quicker as there is increase in oxygen requirements and there is reduced in functional residual capacity (Mushambi et al, 2015). As a result of all the changes during pregnancy, if the problems encountered during the intubation of Mrs D were to happen to an obstetric patient, it is important to provide optimal surgical condition for to progress rapidly while aiming for a good neonatal outcome (Local theatre policy, 2015b). In obstetric patients, much of the issue is about the urgency with which the foetus must be delivered and the surgical operation must be done as quickly as possible - therefore making decisions in the event of certain clinical situations occurring will require a much quicker decision making process because there is an immediate threat to the life of the woman or foetus (Mushambi et al, 2015). This is why emergency obstetric anaesthesia is such a potentially hazardous

Premature birth has been linked to a vast array of lungs problems, the earlier the birth the greater risk of health complications(Davis R and Mychaliska G, 2013). A majority of the health problems will affect the infant for the rest of their life (Davis R and Mychaliska G, 2013). Infants born between the canalicular and the saccular period (week 25) have lung development that is unsuitable for gas exchange (Davis R and Mychaliska G, 2013). Two major complications that arise with undeveloped lungs is bronchopulmonary dysplasia, and pulmonary arterial hypertension (Mahgoub L. et al. 2017).

Premature babies sometimes have apnea. It may happen together with a slow heart rate. Respiratory distress syndrome or RDS is a breathing problem most common in babies born before 34 weeks of pregnancy.” Babies with RDS don’t have a protein called surfactant that keeps small air sacs in the lungs from collapsing. “Intraventricular hemorrhage or IVH is bleeding in the brain. It usually happens near the ventricles in the center of the brain. A ventricles is a space in the brain that’s filled with fluid. Patent ductus ateriosus or PDA is a heart problem that happens in the connection between two major blood vessels near the heart. If the ductus do not close properly after birth, a baby can have breathing problems or heart failure. Heart failure is when enough blood can’t get pumped into the heart causing it to shut down. Necrotizing enter colitis (NEC) is a problem with a baby’s intestines. It causes feeding problems, a swollen belly and diarrhea. It sometimes happens 2 to 3 weeks after a premature bay has been born. Retinopathy of prematurity (ROP) is an abnormal growth of blood vessels in the eye. ROP can lead to vision loss. Jaundice is when a baby's eyes and skin look yellow. A baby has jaundice when his liver isn't fully developed or isn't working well. Anemia is when a baby doesn’t have enough healthy red blood cells to carry oxygen to the rest of the body. Bronchopulmonary dysplasia (BPD) is a lung condition that can develop in premature babies as well as babies who have treatment with a breathing machine. Babies with BPD sometimes develop fluid in the lungs, scarring and lung damage. Premature babies often have trouble fighting off germs because their immune systems are not fully formed. Infections that may affect a premature baby include pneumonia, a lung infection; sepsis, a blood infection; and meningitis, an infection in the fluid around the brain and

In 2006, data was collected on 303 babies who were diagnosed with anencephaly and were not terminated. Of those 303 babies, about 40% were born prematurely (before 37 weeks) and 4% beyond 42 weeks. Two-thirds of the mothers were either induced or had a planned cesarean section for those born at term. Polyhydramnios was present in 30% of the cases which accounted for 60% of those born prematurely. When delivered by cesarean section, 4% died during birth, 53% died within twenty-four hours, 30% lived up to five days, and 13% lived longer than six days. For vaginal births, 37% of babies died during birth when a doctor or midwife ruptured the amniotic bag, opposed to 18% if the amniotic bag ruptured naturally.

When baby is still in the womb, the oxygen saturation is well below what it should be

According to the World Health Organisation [WHO] (2014) pre-term babies are at increased risk of illness, disability and death. It also states that globally 15 million babies are born pre-term and the figures are rising. In England and Wales during 2012 7.3% of live births were pre-term under 37 weeks nearly 85% of all babies born prematurely will have a very low birth weight (Office for National Statistics, 2012). Pre-term birth is associated with respiratory complications and lung disease, long-tern neurological damage and problems with bowel function (Henderson & Macdonald, 2011). Neonatal services provide care to babies who are born prematurely or are ill and require specialist care. It is seen that sixty per cent of infant deaths occur in the neonatal period (DH,

Low birth weight. Premature birth or being part of a multiple birth increases the likelihood that a baby's brain hasn't matured completely, so he or she has less control over such automatic processes as breathing and heart rate.

Neonatal cerebral hypoxia-ischemia (HI) remains a major cause of death and neurological disability. Neural stem cells (NSCs) shows great promise in restoring HI-associated neurological tissue damage and hypothermia is reported to be beneficial for HI recovery in animal studies. We aimed to investigate whether mild hypothermia after neonatal cerebral hypoxia-ischemia (HI) could enhance the therapeutic effect of NSCs transplantation with a neonatal HI mouse model. Postnatal day 7 mice underwent right common carotid artery ligation followed by 1.5 h of hypoxia. After HI, these mice underwent different treatments with hypothermia, NSCs transplantation, or both. Animals were sacrificed at 24, 48, 72 h and 1, 2, 4 week after the HI. The numbers of apoptotic cells, survived, and differentiated grafted cells were counted. The levels of caspase-3 and NF-κB protein were analyzed. And the restoration of sensorimotor and behavioral functions of HI mice was assessed. We found caspase-3-dependent apoptosis and inflammation were significantly lower in the NSCs+hypothermia group. Meanwhile, transplanted cells survived and differentiated better in the NSCs+hypothermia group, and animals of this group exhibited enhanced functional recovery in sensorimotor and behavioral tests. These observations suggest that mild hypothermia enhances the therapeutic effect of NSCs in HI mice through protecting grafted cells, suppressing apoptosis, and attenuating NF-κB signaling.

In the year of 2010, more than 450 billion babies were born prematurely (Truong, Reifsnider, Mayorga, & Spitler, 2013). At least 35% of infant deaths each year are caused from preterm births, which also costs the U.S health care more than 26 billions of dollars in the year of 2005 alone (Malloy, 2013).Premature birth affects the growth of the child and leads to various complications. Babies born before 37 weeks are at an amplified risk for an assortment of medical complications, such as respiratory, cardiac, neurological, and gastrointestinal problems and infections. The exact cause of premature birth is still unknown till this day, but many researchers found factors that contribute to premature deaths. According to Truong, Reifsnider, Mayorga and Spitler (2013) physical abuse and substance abuse are two of the most significant factors that play a role in premature birth.

MCS has been shown to negatively impact the neurological development of a fetus, with serious damage to the nervous system. Medical studies have also concluded that smoking during pregnancy is a known cause of fetal hypoxia, or lack of oxygen, which can stunt fetal brain development. Studies have suggested that these physical