Fetal hypoxia causes oxygen deprivation in the fetus, leading to damage and impairment. It can result in conditions such as cerebral palsy, ADHD, and epilepsy. Treatment includes hypothermic therapies and anticonvulsant treatments. The mortality rate is high, and survivors require lifelong treatment.
Fetal hypoxia is not a disease per se; it is a set of pathological processes that occur within the uterus, causing severe oxygen deprivation of the fetus for a period of time, resulting in damage and impairment. Organ activity and metabolic processes become disordered and congenital anomalies may develop. Damage to the central nervous system, including the brain, and respiratory disorders are common, leading to conditions such as hypoxic ischemic encephalopathy, cerebral palsy, ADHD, epilepsy, and numerous neurological and neuropsychiatric conditions. The mortality rate is high in many cases, and although the baby may survive the birth, the risk of sudden infant death syndrome (SIDS) is high.
In many cases, the exact timing and cause of oxygen deprivation from fetal hypoxia remain unknown. The resulting conditions are what point parents and doctors to fetal hypoxia as the cause. For example, in hypoxic ischemic encephalopathy, a mild condition may manifest itself as poor muscle tone, transient feeding, crying, and sleep abnormalities, and neurological findings approach normal only three to four days after birth. Moderate levels of the disease produce a lethargic infant, with almost absent deep tendon reflexes, sleep apnea, and seizures occurring within 24 hours of birth. Severe levels of this cellular neurological disease are typically stupor or coma, no response to physical stimulus, irregular breathing, vision abnormalities, seizures, and no ability to suck. The risks for the severe forms are irregular heartbeat, blood pressure variability and cardiovascular failure.
Intrauterine or fetal hypoxia and subsequent perinatal brain damage carry extraordinary costs in terms of time and money, including lifelong treatment for survivors. In the United States, it is listed as the tenth leading cause of neonatal death. The World Health Organization (WHO) has estimated that globally there are between 4 and 9 million newborns each year, causing about 1.2 million deaths and about the same number of survivors with severe disabilities.
The initial treatments for newborns with fetal hypoxia are immediate immersion of the newborn in hypothermic therapies to increase the chances of survival. Imaging studies usually show severe brain damage and some bleeding. Electrolytes are often severely low, requiring immediate suffusions of sodium, potassium, and chloride, as well as treatments for severely reduced urine output. Newborns usually need resuscitation and stabilization, careful fluid management, supportive ventilation treatments, and anticonvulsant treatments for seizures. Hypoglycemia and hyperglycemia are a risk and appropriate treatments are usually started immediately to give the child good nutrition.
Spontaneous shortness of breath at birth within the first 20 to 30 minutes is almost always indicative of death. If the abnormal neurological findings extend beyond seven to ten days after birth, the prognosis is that if the baby survives it will experience severely limited life. Mild to severe cases of hypoxic ischemic encephalopathy may know a 60% survival rate with lifelong treatments and monitoring needed. The presence of seizures indicates a poor prognosis, particularly as further brain damage is likely to occur.
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