Asphyxia Neonatorum Exam Study Notes

These flashcards cover key concepts, definitions, and management steps related to Asphyxia Neonatorum and its assessment using the Apgar scoring system.

Asphyxia Neonatorum

A condition in which a viable newborn infant fails to initiate and sustain respiration after delivery, leading to hypoxia, hypercapnia and metabolic acidosis.

Hypoxia

A deficiency in the amount of oxygen reaching the tissues.

Hypercapnia

An increase in the carbon dioxide content in the blood.

Apgar Scoring

A standardized method of assessing the newborn at birth, evaluating Appearance, Pulse, Grimace, Activity, and Respiration.

Appearance (Apgar)

Refers to the color of the newborn: Blue/pale all over (Score 0), Body pink, extremities blue (Score 1), Completely pink (Score 2).

Pulse (Apgar)

Refers to the heart rate of the newborn: Absent (Score 0),

Grimace (Apgar)

Refers to reflex irritability: No response (Score 0), Grimace only (Score 1), Pulls away/coughs/cries (Score 2).

Activity (Apgar)

Refers to muscle tone: Limp/floppy (Score 0), Some limb flexion (Score 1), Active movement (Score 2).

Respiration (Apgar)

Refers to breathing: Absent (Score 0), Slow/irregular (Score 1), Good cry (Score 2).

Mild Asphyxia

Apgar score of 7-10 indicating attempts to breathe with some limb flexion and minimal grimace.

Moderate Asphyxia

Apgar score of 4-6 indicating heart rate ≥ 100 bpm, slow or irregular respiration, and some flexion.

Severe Asphyxia

Apgar score of 0-3 indicating no or slow irregular breathing, poor muscle tone, and heart rate < 100 bpm.

Management Goals

To establish a clear airway, ensure effective circulation, and correct acidosis in newborns.

Immediate Management Steps

Steps to manage asphyxia include noting the time of birth, clearing the airway, and monitoring Apgar scores.

Resuscitation Stop Criteria

Stop resuscitation if there are no signs of life after 10 minutes or if the Apgar score remains < 3 after 20 minutes.

Normal Target Heart Rate

The normal target heart rate for neonates after resuscitation is 120-160 bpm.

Normal Target Respiratory Rate

The normal target respiratory rate for neonates after resuscitation is 30-60 breaths/min.

Normal Target Temperature

The normal target temperature for neonates after resuscitation is 36.5-37.5 °C.

Naloxone

A drug used to stimulate breathing in case of opioid overdose, with a dose of 0.01 mg/kg.

Sodium Bicarbonate

A drug used to correct acidosis, administered at a dose of 1–2 mL/kg of 4% solution.

Adrenaline

A drug used to stimulate circulation, diluted to a concentration of 1:10,000.

Prognosis

Depends on the duration of asphyxia; prolonged deprivation can cause severe damage or death.

Prevention of Asphyxia

Includes good antenatal care, sound management of labor, and correct timing of delivery.