Neonatal Asphyxia: Causes, Symptoms, Treatment, Management and Care of the Baby

They are also known as Asphyxia of the Newborn.

It refers to a pathological state in newborns, in which breathing is disturbed, and oxygen deficiency occurs.

This severe and dangerous condition can occur during childbirth or in the first days of the baby’s life.


Asphyxia in the newborn can not occur without any reason, but before talking about the causes, we will pay attention to the types of this pathological condition.

Neonatal Asphyxia is classified as primary and secondary.

Primary Asphyxia

It occurs in the fetus during childbirth. This type of choking is caused by:

  • Chronic or acute fetal hypoxia;
  • Intracranial injury inflicted during delivery;
  • Malformations of the fetus, which affect breathing;
  • Immunological incompatibility between the baby and the mother;
  • Obstruction in the airways with mucus or amniotic fluid.

Extra-genital diseases during pregnancy can also cause primary suffocation.

For example, the fetus may develop primary Asphyxia if the pregnant woman has diseases of the cardiovascular system, diabetes mellitus, and iron deficiency anemia.


The fetus may also develop suffocation if the mother is suffering from preeclampsia, accompanied by increased blood pressure and swelling in the extremities.

Very often, the pathological structure of the placenta, the umbilical cord, or the fetal membranes are the causes of primary neonatal Asphyxia.

Risk factors include:

  • Premature rupture of amniotic fluid.
  • Premature detachment of the placenta.
  • Improper positioning of the fetus’ head during delivery.

Secondary Asphyxia

It happens in a few hours or days after birth. Its causes can be:

  • Diseases of the heart of the newborn;
  • Disruption of cerebral blood flow;
  • Injury of the CNS (Central Nervous System);
  • The most common cause of secondary Asphyxia is pneumopathy – disperse and polysegmental atelectasis, hemorrhage in the lungs.
  • Pneumopathy occurs during pregnancy or birth and is the syndrome of respiratory disorders.

What happens in the body of newborns with Asphyxia?

The metabolic processes in the organism of a newborn initiate a change; the severity of this condition depends on the intensity and duration of the Asphyxia.

The symptoms of suffocation in a newborn

There is hypovolemia in the case of acute Asphyxia, which develops at the bottom of chronic hypoxia. This term refers to the reduction of the volume of circulating blood. The blood becomes denser and more viscous.

In the brain, heart, liver, and kidneys, hemorrhage and edema are possible, which develop due to lack of oxygen.

Hypoxia and Asphyxia in the newborn lead to a decrease in blood pressure. The number of heartbeats is significantly reduced, and urinary kidney function deteriorates.

The signs

Doctors will identify this pathological condition in the first seconds of a newborn’s life. The frequency and adequacy of breathing, skin color, muscle tone, heart rate, and irritability reflex are estimated.

The main signs of suffocation in a baby are respiratory problems, leading to essential changes in the body.

Immediately after the baby is born, the doctors perform a thorough inspection. The state of health of the newborn is assessed according to the Apgar score.

Doctors can distinguish the following forms of suffocation:

  • Light
  • Medium
  • Difficult
  • The clinical death

The state of a newborn with Asphyxia is calculated according to the score of Apgar 6-7: the baby takes his first breath, but his breathing weakens, the muscle tone is reduced, and the nasolabial triangle is bluish.

According to Apgar, a half range of suffocation is 4-5 points: the newborn baby makes the first breath within the first 60 seconds of life. Your breathing weakens (irregular or regular).

The baby may have tachycardia, loss of reflexes, decreased muscle tone, or bradycardia. The skin of the face, hands, and feet has a bluish tone.

The child with severe Asphyxia is estimated at 1-3 on the Apgar score: breathing is absent or has an erratic nature. The baby does not cry; it only moans sometimes. The heartbeat is slow; the reflexes are absent.

Doctors observe muscular atony or hypotension. The skin is pale. The umbilical cord is not pulsating. Adrenal insufficiency develops very often.

During clinical death, doctors punctuate the baby with zero (0) according to the Apgar score. The specialists immediately begin complex resuscitation procedures to save the baby’s life.

It should be noted that Asphyxia in the newborn is revealed not only by external examination and evaluation of the Apgar score.

The study of the acid-base state of the blood confirms the diagnosis. Using ultrasound and neurological research methods, doctors can detect damage to the central nervous system.

Neonatal Asphyxia Treatment

All babies, who are born with this pathological condition, need intensive therapy. The doctors carry out certain activities in the delivery room during the first minutes of the baby’s life.

The assessment of the main parameters of life:

  • Heart rate;
  • Frequency and depth of breathing;
  • Hematocrit.


So what do doctors do after a baby is born with suffocation?

First, when they see the baby’s head, they insert a special probe into the nasal cavity and mouth. This removes mucus and amniotic fluid from the upper respiratory tract.

After the baby came out of the womb, the doctors cut the umbilical cord. The baby is placed on the table and resuscitated.

After restoring cardiac and respiratory activity, the baby will be transferred to an intensive care unit.

Other activities will be aimed at eliminating the consequences of suffocation. They will seek to restore metabolism, eliminate brain inflammation, and normalize kidney functions.

Care of the baby after suffocation.

After the Asphyxia of the baby, special medical attention is required.

The newborn needs absolute rest. Your head should be in an elevated position. Oxygen therapy also plays an important role.

After severe suffocation, babies are placed in special boxes with high oxygen levels inside. Babies stay in such boxes for several hours to a few days.

The oxygen concentration in a box of this type should be about 40%.

Sometimes nasal cannulae or unique respiratory masks are used. Doctors need them to control the child’s body temperature and intestine functions.