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Perinatal Asphyxia (Acute Fetal Distress)

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Perinatology

Abstract

The fetus can be at risk of perinatal asphyxia by different pathophysiological processes, so the effectiveness of the various fetal tests depends on the underlying pathophysiological condition. The processes that can be related to fetal death or damage are decreased uteroplacental blood flow, decreased gas exchange at the level of the trophoblastic membrane, metabolic processes, fetal sepsis, fetal anemia, fetal heart failure, and umbilical cord accidents. Different ways and diseases lead the fetus to chronic fetal distress process, requiring, as a consequence, different obstetric procedures, according to each pattern of involvement of the fetus. Each of these is involved in one of the models of chronic fetal distress and requires a specific pattern of maternal-fetal surveillance for each condition in order to avoid perinatal morbidity and mortality.

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Notes

  1. 1.

    It is a fetal hemorrhage after the rupture of one or more vessels whose insertion is abnormal (veined and previous), occurring more frequently during rupture of the membranes. It is a serious complication (fetal mortality rate from 75% to 100%).

References

  1. Langer B. Repérage de l'asphyxie au cours du travail. Rev Méd Périnat. 2013;5:73–80.

    Article  Google Scholar 

  2. Groenendaal F, van Bel F. Perinatal asphyxia in term and late preterm infants. In: Martin R. UpToDate. Available at: https://www.uptodate.com/contents/perinatal-asphyxia-in-term-and-late-preterm-infants. Accessed June 2020.

  3. Executive summary: neonatal encephalopathy and neurologic outcome, second edition. Report of the American College of Obstetricians and Gynecologists’ task force on neonatal encephalopathy. Obstet Gynecol. 2014;123(4):896–901.

    Google Scholar 

  4. Locatelli A, Lambicchi L, Incerti M, et al. Is perinatal asphyxia predictable ? BMC Pregnancy Childbirth. 2020;20:186.

    Article  Google Scholar 

  5. Turner JM, Mitchell MD, Kumar SS. The physiology of intrapartum fetal compromise at term. Am J Obstet Gynecol. 2020;222(1):17–26.

    Article  CAS  Google Scholar 

  6. Martin CB Jr. Normal fetal physiology and behavior, and adaptive responses with hypoxemia. Semin Perinatol. 2008;32:239–42.

    Article  Google Scholar 

  7. Bhutta ZA. Pediatrics in the tropics. In: Farrar J, Hotez PJ, Junghanss T, et al., editors. Manson's tropical diseases. 23rd ed. Philadelphia: Saunders/Elsevier; 2014. p. 1197–214.

    Chapter  Google Scholar 

  8. Jensen A, Garnier Y, Berger R. Dynamics of fetal circulatory responses to hypoxia and asphyxia. Eur J Obstet Gynecol Reprod Biol. 1999;84:155–72.

    Article  CAS  Google Scholar 

  9. Boog G. La souffrance foetale aiguë. Journal de Gynécologie Obstétrique et Biologie de la Reproduction. 2001;30:393–429.

    CAS  Google Scholar 

  10. Gillam-Krakauer M, Gowen CW Jr. Birth asphyxia. [Updated 2020 Apr 23]. In: StatPearls [Internet]. Treasure Island: StatPearls Publishing; 2020. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430782/.

    Google Scholar 

  11. Ayres-de-Campos D, Arulkumaran S, FIGO Intrapartum Fetal Monitoring Expert Consensus Panel. FIGO consensus guidelines on intrapartum fetal monitoring: physiology of fetal oxygenation and the main goals of intrapartum fetal monitoring. Int J Gynaecol Obstet. 2015;131:5–8.

    Article  Google Scholar 

  12. Andres RL, Saade G, Gilstrap LC, Wilkins I, Witlin A, Zlatnik F, et al. Association between umbilical blood gas parameters and neonatal morbidity and death in neonates with pathologic fetal acidemia. Am J Obstet Gynecol. 1999;181(4):867–71.

    Article  CAS  Google Scholar 

  13. Simham HN. Umbilical cord blood acid-base analysis at delivery. In: Lockwood CJ, editor. UpToDate. Available at https://www.uptodate.com/contents/umbilical-cord-blood-acid-base-analysis-at-delivery#H4. Accessed on 12/07/20.

  14. Mokarami P, Wiberg N, Olofsson P. An overlooked aspect on metabolic acidosis at birth: blood gas analyzers calculate base deficit differently. Acta Obstet Gynecol Scand. 2012;91(5):574–9.

    Article  Google Scholar 

  15. ACOG Committee on Obstetric Practice. ACOG Committee Opinion No. 348, November 2006: Umbilical cord blood gas and acid-base analysis. Obstet Gynecol. 2006;108(5):1319–22.

    Article  Google Scholar 

  16. Tuuli MG, Stout MJ, Macones GA, Cahill AG. Umbilical cord venous lactate for predicting arterial lactic acidemia and neonatal morbidity at term. Obstet Gynecol. 2016;127(4):674–80.

    Article  CAS  Google Scholar 

  17. Jadhon ME, Main EK. Fetal bradycardia associated with maternal hypothermia. Obstet Gynecol. 1988;72(3 Pt 2):496–7.

    CAS  Google Scholar 

  18. Boutroy MJ. Fetal and neonatal effects of the beta-adrenoreceptor blocking agents. Dev Pharmacol Ther. 1987;10(3):224–31.

    Article  CAS  Google Scholar 

  19. Nunes I, Ayres-de-Campos D, Kwee A, Rosen KG. Prolonged saltatory fetal heart rate pattern leading to newborn metabolic acidosis. Clin Exp Obstet Gynecol. 2014;41(5):507–11.

    Article  CAS  Google Scholar 

  20. Holzmann M, Wretler S, Cnattingius S, Nordstrom L. Cardiotocography patterns and risk of intrapartum fetal acidemia. J Perinat Med. 2015;43(4):473–9.

    Article  CAS  Google Scholar 

  21. Turner JM, Mitchell MD, Kumar SS. The physiology of intrapartum fetal compromise at term. Am J Obstet Gynecol. 2020;222(1):17–26. https://doi.org/10.1016/j.ajog.2019.07.032.

    Article  CAS  Google Scholar 

  22. Dore S, Ehman W. SOGC Clinical Practice Guideline. No. 396-fetal health surveillance: intrapartum consensus guideline. JOGC. 2020;42(3):316–48.

    Google Scholar 

  23. Modanlou HD, Murata Y. Sinusoidal fetal heart rate pattern: reappraisal of its definition and clinical significance. J Obstet Gynaecol Res. 2004;30(3):169–80.

    Article  Google Scholar 

  24. Guidetti DA, Divon MY, Langer O. Postdate fetal surveillance: is 41 weeks too early? Am J Obstet Gynecol. 1989;161:91–3.

    Article  CAS  Google Scholar 

  25. Carbonne B. Asphyxie foetale au cours du travail in: Berlan M et al. Practice de lÁccouchement. 2016. Masson, Paris 6th; 185–194.

    Google Scholar 

  26. Carter BS, Haverkamp AD, Merenstein GB. The definition of acute perinatal asphyxia. Clin Perinatol. 1993;20:287–304.

    Article  CAS  Google Scholar 

  27. Carbonne B, Pons K, Maisonneuve E. Foetal scalp blood sampling during labor for pH and lactate measurements. Best Practice Res Clin Obstet Gynaecol. 2015.

    Google Scholar 

  28. Ramanah R, Martin ADR, Maillet RJS. Interested in the measurement of lactates on the scalp or on the crossings: comparative nature with the pH on the scalp. J Gynecol Obstet Biol Reprod. 2005;34:311.

    Google Scholar 

  29. Carbonne B, Langer B, Goffinet F, et al. Multicenter study on the clinical value of fetal pulse oximetry. II. Compared predictive values of pulse oximetry and fetal blood analysis. The French Study Group on Fetal Pulse Oximetry. Am J Obstet Gynecol. 1997;177(3):593–8.

    Article  CAS  Google Scholar 

  30. Neilson JP. Fetal electrocardiogram (ECG) for fetal monitoring during labor. Cochrane Database Syst Rev. 2015;(12). Art. No: CD000116. https://doi.org/10.1002/14651858.CD000116.pub5.

  31. Devane D, Lalor JG, Daly S, McGuire W, Smith V. Cardiotocography versus intermittent auscultation of fetal heart on admission to labor ward for assessment of fetal wellbeing. Cochrane Database Syst Rev. 2012;(2):CD005122.

    Google Scholar 

  32. Ayres-de-Campos D, Bernardes J, Costa-Pereira A, Pereira-Leite L. Inconsistencies in classification by experts of cardiotocograms and subsequent clinical decision. BJOG. 1999;106:1307–10.

    Article  CAS  Google Scholar 

  33. Alfirevic Z, Devane D, Gyte GML. Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labor (Review). Cochrane Library; 2007.

    Google Scholar 

  34. Bakketeig LS. Only a minor part of cerebral palsy cases begin in labor. But still room for controversial childbirth issues in court. BMJ. 1999;319(7216):1016–7.

    Article  CAS  Google Scholar 

  35. Ayres-de-Campos D, Spong CY, Chandraharan E; FIGO Intrapartum Fetal Monitoring Expert Consensus Panel. FIGO consensus guidelines on intrapartum fetal monitoring: cardiotocography. Int J Gynaecol Obstet. 2015;131(1):13–24. Screening and treatment if T ≥ 38 C - Check blood pressure and consider fluids Replacement - Providing analgesia.

    Google Scholar 

  36. Vintzileos AM, Smulian JC. Decelerations, tachycardia, and decreased variability: have we overlooked significance of longitudinal fetal heart rate changes for detecting intrapartum fetal hypoxia? Am J Obstet Gynecol. 2016;215:261–4.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Obstetrics, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, RJ, Brazil

    Fernanda Campos da Silva

  2. Fernandes Figueira Institut - FIOCRUZ, Rio de Janeiro, RJ, Brazil

    Renato Augusto Moreira de Sá

  3. Federal Fluminense University and Rio de Janeiro Federal University, Niteroi and Rio de Janeiro, Brazil

    Cristiane Alves de Oliveira

Authors
  1. Fernanda Campos da Silva
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  2. Renato Augusto Moreira de Sá
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  3. Cristiane Alves de Oliveira
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Editor information

Editors and Affiliations

  1. Maternal and Child Department, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil

    Renato Augusto Moreira de Sá

  2. Federal University of Paraíba, João Pessoa, Paraíba, Brazil

    Eduardo Borges da Fonseca

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da Silva, F.C., Moreira de Sá, R.A., de Oliveira, C.A. (2022). Perinatal Asphyxia (Acute Fetal Distress). In: Moreira de Sá, R.A., Fonseca, E.B.d. (eds) Perinatology. Springer, Cham. https://doi.org/10.1007/978-3-030-83434-0_51

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  • DOI: https://doi.org/10.1007/978-3-030-83434-0_51

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-83433-3

  • Online ISBN: 978-3-030-83434-0

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