Breathing New Awareness: Infant Oxygen Deprivation and Negligence During Pre-and Post-Delivery Treatment

23.05.2017

Despite all our advances in technology and medicinal obstetrics, delivering a healthy child is a nine-month challenge, with a hopeful positive outcome. There are several risks that can occur during pregnancy, and during the delivery, that can create reverberating long-term cognitive and physical impairments for the infant.

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Despite all our advances in technology and medicinal obstetrics, delivering a healthy child is a nine-month challenge, with a hopeful positive outcome. There are several risks that can occur during pregnancy, and during the delivery, that can create reverberating long-term cognitive and physical impairments for the infant. 
 
What risk factors should medical professionals be forthcoming about, in the most direct way, to help parents understand (and avoid) situations that can exacerbate the risk factors for oxygen deprivation during delivery? 
 
How Infant Respiratory Disruptions Occur 
 
For infants, breathing is uncomplicated during the gestation period of pregnancy. While in the womb, oxygen is provided by the placenta to the baby, as the fetus’ lungs are filled with amniotic fluid that helps the tissues and respiratory system develop. During delivery, the umbilical cord is clamped, and the lungs are cleared of fluid to begin breathing oxygen. However, there are several factors that can complicate the natural transition of respiration both during pregnancy and while the delivery is occurring.
 
1. Preeclampsia and Eclampsia 
 
Typically developing after the 7th or 8th month of pregnancy, the condition is common for women in their first pregnancies, or women over the age of forty years. There is no way known to prevent the development of preeclampsia, but when it develops as a mild form early in the pregnancy, medical teams will monitor the mother closely to provide more time in utero for the baby to develop.  
 
Mother’s with preeclampsia experience high blood pressure (hypertension) and can experience seizures, liver and kidney damage or failure, blood clots, or a serious condition known as HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count). Delivery of the child is the only alternative as there is no cure or treatment for preeclampsia.
 
2. Prolapsed Umbilical Cord 
 
The umbilical cord can become prolapsed during gestation (pregnancy) or during delivery.  It is not uncommon for infants to periodically impinge upon the umbilical cord while in the uterus, but long-term blockages or disruptions decrease oxygen and blood flow to the infant, causing developmental problems, and impacting heart rate and other vitals.
 
During labor, the condition is treated with amnioinfusion to relieve pressure and help decompress the umbilical cord, while the infant is moved into position for delivery. More serious obstructions may result in emergency pre-delivery, typically by C-section, to avoid oxygen deprivation. 
 
3. Shoulder Dystocia
 
This occurs when the baby’s head has been successfully delivered through the birth canal and vagina, but the shoulders remain stuck inside the canal. The labor becomes difficult and dangerous both for mother and child and can result in chest compression that restricts respiration, causing damage to the brain and nervous system. 
 
4. Placenta Deficiencies
 
Placental insufficiency is believed to be caused by issues with circulation and maternal blood flow.  Other cardiac and vascular disorders, poor lifestyle habits, medications and supplements can contribute to the condition, but smoking, drug abuse, anemia, clotting disorders, diabetes and chronic hypertension are all contributing factors to the condition.
 
If the placenta loses integrity and strength, it may become detached from the uterine wall (placental abruption).  It is a common cause of pre-delivery, and other health risks for the infant, including:
 
 
The condition of placental abruption is particularly dangerous, as it disables the ability for the placenta to grow in a side, allowing room for fetal development.  The condition can be confirmed by ultrasound investigations to measure the thickness and size of the placenta and fetal growth, or by monitoring the alpha-fetoprotein level in maternal blood. Mother’s at risk of premature delivery (before 32 weeks) are required to engage with bed rest and may receive steroid treatments, to hasten the development of the infant’s lungs.
 
5. Physical Trauma in Utero 
 
Blunt trauma to the infant during pregnancy, is the leading cause of non-obstetric death for women in the United States, impacting approximately 0.3% of pregnant women. The most common causes of blunt trauma during pregnancy are domestic violence, falls, and motor vehicle collisions.  Trauma to the infant and the probability of fetal mortality is 3.4% to 38% depending on the severity of the impact, but both mother and child are at risk of death from placental abruption, and shock. Smoking and alcohol use by the mother during pregnancy also impact the survivability of infants, post-trauma. 
 
For mother’s in labor, childbirth is a complicated and physically demanding experience. The medical team is responsible for providing a safe labor and delivery for mother and child, but oxygen deprivation at birth is a leading cause of delivery complications and disability for infants. Parents need to be educated and informed of the risks, and how to improve outcomes with healthy lifestyle choices, and consistent medical evaluation and support during pregnancy.
 

Article last time updated on 23.05.2017.

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