birth asphyxia

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nursing care

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By: docaksood (18 month(s) ago)

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Presentation Transcript

BIRTH ASPHYXIA : 

BIRTH ASPHYXIA

Introduction : 

Introduction Birth asphyxia is a leading cause of neonatal mortality & morbidity .It is also important cause of developmental delay & Neurological problems both term & preterm newborn. Approximately 5 t0 10% neonates experience asphyxia a t birth.

Meaning : 

Meaning Birth asphyxia, also called asphyxia neonatorum, is the inability of an infant to establish regular respiration Following birth.

Definition : 

Definition Birth asphyxia is the non establishment of satisfactory pulmonary respiration at birth. It is failure of initiation & maintenance of spontaneous respiration with hypoxia, hypoventilation , hypercapnia, hypo perfusion, & metabolic acidosis.

Etiological factor : 

Etiological factor Approximately 90% of asphyxia events occur as a result of placental insufficiency due to ante partum & intrapartum factors. Postnatal factors account for the remaining. Ante partum Intrapartum Postpartum

Ante partum: 

Ante partum placental insufficiency due to Pre-eclampsia Hypertension Anemia Diabetes Mellitus Post maturity Other factor include ante partum hemorrhage mal presentation Multifetal pregnancy

PowerPoint Presentation: 

poor fetal growth maternal systemic diseases maternal drug therapy (eg.lithum) poly or oligohydromnios placental malformation vascular anomalies of the cord congenital anomalies of the fetus.

Intra partum : 

Intra partum Emergency CS Instrumental delivery Abnormal position Premature labour Precipitous labour Prolonged rupture of membranes Prolonged labour > 24 hrs Prolonged 2 nd stage of labour

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Fetal bradycardia Non-reassuring fetal heart rate pattern General anaesthesia Narcotics administered within 4 hours of delivery Meconium stained liquor Prolapsed cord Abruptio placenta Placenta previa

POST NATAL FACTOR: 

POST NATAL FACTOR pulmonary, cardio vascular & neurological abnormalities of the neonate Aspiration

CLINICAL FEATURES: 

CLINICAL FEATURES Clinical manifestations depends upon the etiology, intensity, duration of oxygen lack, plasma carbon dioxide level & acidosis. There are 2 stages Asphyxia livida or stage of cyanosis, primarily due to respiratory failure with apgar score 4 to 6. Asphyxia pallida or stage of shock due to combined respiratory & vasomotor failure with apgar score 0- 3.

MANAGEMENT : 

MANAGEMENT

COMPLICATION : 

COMPLICATION BRAIN: hypoxic- ischemic encephalopathy intracranial hemorrhage convulsion HEART: hypoxic cardiomyopathy cardiac dysrrhythmias congestive cardiac failure. shock

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LUNGS: meconium aspiration syndrome hyaline membrane disease pulmonary hemorrhage pneumonia KIDNEYS: Hematuria renal failure renal vein thrombosis GASTR0 INTESTINAL: necrotizing entrocolitis paralytic ileus & obstruction

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HEMATOLOGIC : DIC, hyperbilirubinemia and sepsis ENDOCRINE: Adrenal hemorrhage IMMUNOLOGIC: septicemia

PROGNOSIS : 

PROGNOSIS It is depends upon associated factors, maturity of the baby, duration & intensity of hypoxia & acidosis & initiation of resuscitative measures in the delivery room. Subsequent competent care & available facilities also influence the out come following birth asphyxia

NURSING DIAGNOSIS : 

NURSING DIAGNOSIS Ineffective Airway Clearance R/T Aspiration Meconium & mucus Impaired breathing pattern r/t immaturity of the lungs Impaired thermoregulation (hypothermia) r/t immature thermoregulatory state of neonates Risk for complication r/t loss of oxygen supply to the vital organ

PREVENTIVE MEASURES : 

PREVENTIVE MEASURES Intensive antenatal care Intranatal assessment of fetal hypoxia Careful use & intelligent use of anesthetic agents & depressant drugs in labor Care of neonates at birth Special attention to avoidance of preterm delivery Care of pre term & low birth wt baby