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PubMed1994

[The influence of perinatal asphyxia on the occurrence of respiratory distress syndrome in preterm labor].

During the period 1985-1992, the influence of perinatal asphyxia on the frequency of RDS was investigated in preterm neonates. Two thousand one hundred and sixty-eight premature infants born alive without congenital malformations weighing from 900 g to 2500 g were in the investigated group. The frequency of the occurrence of RDS and its most severe form--hyaline membrane disease (HMD)--was evaluated depending on state at birth in the first and fifth minute of life. The clinical diagnosis of HMD was verified during the postmortem examination. The state at birth was evaluated using Apgar score. In the statistical analysis, the F-Snedecor variance test was used. During this study, the influence of perinatal asphyxia on the occurrence of RDS, and particularly its most severe form--HMD, was evaluated.

Analysis of Variance↗
PubMedDate not supplied

Central cortico-subcortical involvement: a distinct pattern of brain damage caused by perinatal and postnatal asphyxia in term infants.

OBJECTIVE: The MR findings in a characteristic pattern of hypoxic-ischemic brain damage in term infants are described. MATERIALS AND METHODS: The MR images of seven patients with cerebral palsy and a specific pattern of central cortico-subcortical cerebral damage were studied retrospectively and correlated with clinical findings. RESULTS: All seven patients were born at term. Five of the seven patients had a clear history of severe perinatal asphyxia. All children had severe encephalopathic symptomatology, including spastic tetraplegia, extrapyramidal symptoms, and a mental deficit. The MR showed localized atrophy of the cortex and in addition cystic changes, gliosis, and tissue loss of the adjacent white matter. In all patients, the lesions were band shaped in the left-right direction and characteristically located in areas bordering the central sulcus. The segment of the corpus callosum underlying the affected area was always thin. In some patients, lesions were also found bilaterally in the occipital regions, hippocampus, and basal ganglia. The areas involved match the regions that are known to show active myelination on MR in the term neonate. CONCLUSION: Recognition of this specific pattern on MR in children with cerebral palsy enables the classification of such lesions as resulting from peri- or postnatal asphyxia, even if the perinatal history is unknown or equivocal, and makes other etiologies less likely.

Asphyxia Neonatorum↗
PubMedDate not supplied

[The microscopic diagnosis of different forms of mechanical asphyxia by the hemodynamic status].

Two types of mechanical asphyxia are analyzed, strangulation and obturation. Based on the hemodynamic status, the authors distinguished the venous and venoarterial variants. The venous variant was referred to the complete, and the venoarterial one to incomplete form of mechanical asphyxia. The incomplete form in prolonged course of hypoxia was shown to involve disturbances in blood rheology.

Adult↗
PubMed1993

The definition of acute perinatal asphyxia.

Perinatal asphyxia remains a concern for physicians, patients, and attorneys. The history of concern for this condition is reviewed, and efforts in neonatal-perinatal medicine to identify at risk patients and prevent serious sequelae are discussed. A definition consistent with the American Academy of Pediatrics-American College of Obstetrics and Gynecology Guidelines for Perinatal Care, requiring multiple biochemical and clinical indices for asphyxia, is given.

Acidosis, Respiratory↗
PubMed1997

Traumatic asphyxia in children.

Eight children with traumatic asphyxia were evaluated retrospectively. There were five boys and three girls. The mechanism of injuries was motor vehicle accidents in six children. A fall in one patient and compression by lift in one patient. Clinical features of traumatic asphyxia developed in all patients. Five patients were disoriented and consciousness. Associated injuries were noted in all patients often involving thorax and head. Cerebral seizures complicated head injury in one patient. No mortality was recorded.

Abdominal Injuries↗
PubMedDate not supplied

[Asphyxia and intracranial hemorrhage in high-risk neonates of various gestational ages].

The aim of this study was to compare the type and severeness of brain damage in vitally most endangered newborn infants of different gestational age. We retrospectively analyzed the records of 75 newborn infants treated and decreased at the Department of Intensive Care and Therapy of the Institute of Children's and Adolescents' Health Care in Novi Sad. Diagnoses of hypoxic-ischemic lesion and intracranial hemorrhage in the case of grade four PVH-IVH (periventricular hemorrhage-intraventricular hemorrhage) were established by ultrasonography of the brain and lumbar punction in the case of subarachnoid hemorrhage. These diagnoses were confirmed after forensic-medical expertise. The volume and degree of the damage were compared in regard to the gestational age, Apgar score and time of initial mechanical ventilation and initial parameters of the mechanical ventilation, as well as to values of acido-basic status, concentration of gases in arterialized capillary blood and type of lung damage which always occurred in these patients. In all 75 examined newborns perinatal asphyxia was the dominant etiologic factor for the course and outcome of the disease (in all patients Apgar score was 4 or less). 75% of examines were born before 32 weeks gestation and of low or very low body weight, whereas 72% had intracranial hemorrhage (periventricular-intraventricular) and hypoxic-ischemic damage of the brain parenchyma. The rest of examinees had intracranial hemorrhage or hypoxic-ischemic damage of the brain parenchyma. Although 92% of examinees received mechanical ventilation in the first 3 days of life, only 20% of newborn infants had satisfactory values of acido-basic status and gas concentrations in the blood. We concluded that in the most severe cases of perinatal asphyxia, especially in preterm newborns of low or very low body weight, both intracranial hemorrhage and hypoxic-ischemic encephalopathy develop. Damages of other organs or systems of organs, especially lungs, as a rule contribute to infaust ending.

Asphyxia Neonatorum↗
PubMed1997

Obstetric interventions and perinatal asphyxia in growth retarded term infants.

BACKGROUND: The monitoring of fetal growth during pregnancy is usually justified because of the increased perinatal risk of these babies. METHODS: In 1552 infants from the Scandinavian Small for Gestational Age Study the need for obstetric interventions, risk of fetal asphyxia and immediate neonatal outcome at term have been studied in relation to different types of fetal growth retardation, including sub-groups with low ponderal index or low amount of subcutaneous fat. RESULTS: The need for obstetric intervention indicated by suspected fetal asphyxia before or during labor was increased 3-fold (6-8%) for growth retarded infants both in SGA infants in general and infants with asymmetric body proportions. The immediate perinatal outcome, however, was favorable with Apgar below 8 at 5 min in only 2% irrespective of the type of growth retardation, in spite of the fact that less than 25% of the SGA pregnancies and 10% of those with asymmetric fetal growth had been eligible for close antenatal fetal monitoring. CONCLUSION: With a moderate increase in interventions at delivery, perinatal outcome was highly favorable for term infants with a weight for gestational age, weight for length or skinfold for weight below the 10th percentile in this population of Scandinavian parous mothers.

Apgar Score↗
PubMed1997

Brainstem auditory evoked response in neonates with birth asphyxia.

OBJECTIVE: To determine the brainstem auditory evoked response (BAER) abnormalities and their reversibility in neonates with birth asphyxia. DESIGN: Prospective case control study. SETTING: Tertiary care teaching hospital. METHODS: 30 term Neonates with 5-min Apgar < 6 and hypoxic ischemic encephalopathy (HIE) underwent BAER testing with follow up at 3 months. An equal number of normal term neonates served as controls. RESULTS: 13 out of 30 (43.3%) neonates with birth asphyxia showed some abnormality in BAER wave form. The commonest type of BAER abnormalities seen were transient prolongation of latencies of various waves (69.2%) and prolonged interside latency difference (69.2%). Other abnormalities observed were prolonged interwave interval (23.1%) and prolonged interside interval difference (7.7%). Abnormalities in BAER were significantly associated with stages of HIE and duration of neurological abnormalities more than 5 days. On follow up of 16 cases at 3 months of age, BAER abnormalities reverted back to normal in all the neonates. The Denver Developmental Screening Test (DENVER II) was suspect in 4 cases but the BAER was normal. CONCLUSION: BAER abnormalities in asphyxic neonates are transient and revert back to normal at 3 months of age. BAER does not appear to be a useful tool for early detection of neurological handicaps.

Analysis of Variance↗
PubMed1998

Traumatic asphyxia following stadium crowd surge: stadium factors affecting outcome.

BACKGROUND: Stadium crowd surges frequently occur following major athletic events. A recent crowd surge injured more than 80 persons by trampling and/or crushing. This incident was reviewed to identify injury patterns consistent with crush-related injury. In addition, the incident was reviewed to determine which stadium policy and design factors may have potentiated this event. METHODS: A recent crowd surge occurred following a college football game. This resulted in 86 people being transported to the University of Wisconsin and other area hospitals. All charts were reviewed to evaluate patient outcomes. The stadium was examined as were security system video tapes to evaluate stadium factors that contributed to this event. Current policies were obtained through the university sports administration. RESULTS: Of 86 patients transported for evaluation of stadium-related injuries, 10 were treated for traumatic asphyxia. Other injuries requiring hospital admission included musculo-skeletal trauma in two patients and one grade II liver injury. Six others were admitted overnight for observation. Several stadium factors were identified that contributed to the event, and appropriate changes in crowd control policies and stadium design were instated to prevent recurrence. CONCLUSIONS: This report details the largest single report of traumatic asphyxia second to the England Hillsborough disaster. Several stadium factors were identified that resulted in crush-related injury. Cooperative review and modification of stadium policies and design may prevent such events in the future.

Adolescent↗
PubMed1976

[Morphology of pneumopathies and their role in the development of asphyxia neonatorum].

Histories of deliveries and development records of 44 newborns with penumopathies who had died on the first days of life in the presence of phenomena of the syndrome of respiratory disorder were analysed and the newborns' lungs were morphologically investigated. The investigation made it possible to single out the following forms of pneumopathy in newborns: edematous-hemorrhagic, hyaline, atelectatic, aspirated, and mixed. In the majority of cases the syndrome of respiratory disorder was a sequela of hypoxia of the intrauterine origin which continued during the first hours and days of life after birth. Such "primary asphyxia" may lead to the development of pneumopathy in a neonate. On the other hand, "secondary asphyxia" in many cases represent sequelae of penumopathy destructural and functional immaturity of the pulmonary tissue, hypoxia, a higher permeability of vessels of the microcirculatory bed, spasm of small pulmonary arteris contributed considerably to the development of penumopathies.

Asphyxia Neonatorum↗
PubMed1976

Forensic problems in practice. VII.--Asphyxia.

In summary, asphyxial deaths and deaths due to pressure on the neck form a considerable proportion of homicides in Britain, as well as many suicides and some accidents, as in infancy and in masochistic practices. Although the detailed examination of fatal asphyxia is the province of the coroner's pathologist, the general practitioner and the casualty officer are usually the first medical men to have the opportunity of detecting the external signs of such cases. Unfortunately, very many instances in the past have revealed that the clinician's examination of dead persons is so superficial that numerous cases of trauma to the neck (and even florid asphyxia) have gone unnoticed. A rapid examination of the skin, conjunctivae and neck takes but a few seconds and, if done routinely, would save subsequent embarrassment to the doctors concerned.

Airway Obstruction↗
PubMed1984

Enzymatic adaptations to asphyxia in the harbor seal and dog.

The activities of the glycolytic enzymes were determined in heart, liver, kidney cortex and cerebrum from the harbor seal (Phoca vitulina ) and the adult and newborn dog. Activities were similar in the four dog tissues as well as myocardium and brain tissue from both the newborn dog and seal. Most of the enzyme activities were markedly lower in kidney cortex and liver of the seal and the newborn dog, suggesting that the organs which are rendered ischemic in the diving seal or asphyxiated newborn dog have a lowered demand for glycolytic metabolism. This is perceived as an adaptation to prolong the time tissues can rely on anaerobic metabolism. Expression of the enzyme data in a 'similarity criterion' by dividing activity from an organ likely to be perfused during long diving or asphyxia (e.g., heart), by that from one rendered ischemic (e.g., kidney), yields a quotient which provides a convenient indicator of anaerobic potential. Such a treatment would reflect the contribution of a discrete tissue to the total anaerobic demand of the whole animal. The values thus generated for the glycolytic enzymes are generally higher in the seal and the newborn dog than in the adult dog, and suggest an index for determining the capacity of an animal to withstand repeated and variable asphyxia.

Adaptation, Physiological↗
PubMed1992

Electrophysiological responses of the cochlea to transient asphyxia are influenced by arachidonate metabolites.

The influence of a transient asphyxia on cochlear potentials, i.e. endolymphatic potential (EP), summating potential (SP) and cochlear microphonics (CM) was investigated in guinea pigs when pretreating the animals with various substances interacting with the arachidonic acid (AA) cascade at the level of thromboxane. The controls showed the well-known decline of the EP, CM and the SP increase. When infusing a thromboxane synthetase inhibitor (dazoxiben) or two different thromboxane receptor blockers (daltroban or sulotraban) before the 3-minutes' period of asphyxia was started, the electrophysiological responses of the inner ear (cochlea) could significantly be influenced. The results indicate that a shift of the thromboxane (TXA2)/prostacyclin (PGI2)-balance in favour of the last improve the metabolic conditions for a survival of the cochlea when it is challenged.

Analysis of Variance↗
PubMed2003

A delayed increase in hippocampal proliferation following global asphyxia in the neonatal rat.

Adult neurogenesis has been shown to be upregulated following a wide variety of brain injury paradigms. During the first weeks of postnatal life there is around 50 fold more neurogenesis occurring than in the adult CNS, yet little is known regarding the effect of neonatal brain injury on this developmental proliferation. We have investigated the effect of a global perinatal birth asphyxia on postnatal proliferation at 2, 5, 8, 11, 15, 21 and 28 days after birth (injury) using a 3H-thymidine tracer study. We found a specific upregulation of proliferation at 5 days after the injury within the injured hippocampus only, with an associated increase in hippocampal mass and without any changes in GFAP content at any timepoint. Perinatal asphyxia did not alter proliferation within the cerebellum, sub ventricular zone, olfactory bulb, cervical or thoracic spinal cord. Similarly, no changes in corticosterone levels were induced by the injury. Since there were no changes in GFAP content we hypothesize that this increased proliferation is likely neurogenetic, similar to what is seen in the adult brain following injury. Further we show that the dramatic increase in corticosterone at the end of the stress hyporesponsive period is not responsible for the equally dramatic decrease in postnatal proliferation within the CNS.

Animals↗
PubMed1999

Killing tools in mechanical asphyxia.

In homicidal deaths, many countries, including Jordan, used to differentiate between an intention to kill some person and whether or not this intention is preceded by premeditation or planning in advance. A retrospective review of 42 homicidal mechanical asphyxial deaths was carried out with special regard to the types of tools used and their impact on the intention and premeditation to kill. Two major causes of homicidal asphyxia-hand and ligature-accounted for 95% of the deaths (35.7% and 59.3%, respectively). Many of the victims of homicidal asphyxia were women (40.5%) and infants under the age of one year (26%). Most of the women were killed by their in-laws (24%). A sexual motive or unlawful sexual relationship outside the bonds of marriage was proven in 14 out of 17 adult female victims. This suggests how difficult it can be to support a criminal charge in cases of mechanical asphyxial deaths.

Journal Article↗
PubMed1995

Neuronal damage in the developing brain following intrauterine asphyxia.

Perinatal asphyxia is thought to be a significant cause of still birth and neurological sequelae. Although several different patterns of neuronal injury are seen in the newborn, previously little was known about the precise cause and effect relationships. This brief review summarizes recent research which has identified how prenatal factors such as recurrent episodes of asphyxia, gestational age, growth retardation and cerebral temperature may influence the severity and regional distribution of neuronal loss.

Animals↗
PubMed1978

Asphyxia-induced disaggregation of cerebral polyribosomes in rhesus monkey fetuses.

The effects of 3 hours of controlled intrauterine asphyxia (acidotic hypoxia) on the sedimentation patterns of cerebral polyribosomes and on polyribosome supported in vitro protein synthesis were examined in 16 term monkey fetuses. Three outcomes resulted. Four fetuses showed no changes in polyribosome sedimentation profile or in sedimented polyribosome supported in vitro protein synthesis. Four showed changes in sedimentation profiles indicating partial breakdown of polyribosomes and significant decreases in polyribosome supported in vitro protein synthesis. Finally, 8 fetuses showed almost complete disaggregation of cerebral polyribosomes into 80-S monosomal units. This was associated with marked reduction in sedimented ribosomal mediated in vitro portein synthesis. Both the disaggregation of polyribosomes and the associated loss of in virto protein synthesis were related to the severity of the acidosis produced by asphyxia.

Animals↗
PubMed1979

Pressure passive cerebral blood flow and breakdown of the blood-brain barrier in experimental fetal asphyxia.

Cerebral blood flow (CBF) was studied in non-exteriorized near-term sheep fetuses using the radioactive microsphere technique. By partially occluding the umbilical vessels for a period of 1--1 1/2 hours a progressive and severe asphyxia with a final arterial pH of 6.90 was achieved. Varying the mean arterial blood pressure in the fetuses by blood withdrawal or infusion in this state, CBF was measured at different perfusion pressures (mean arterial blood pressure (MABP) minus central venous pressure (CVP)). A passive flow/pressure relationship--loss of autoregulation--was found, with hyperemia reaching CBF values up to 6 times normal at normal MABP of about 60 to 70 mmHg, and severe ischemia reaching CBF values close to zero in large cortical areas at MABP of 30 mmHg. CVP remained essentially unchanged at 10--15 mmHg. The severe and prolonged asphyxia rendered the blood-brain barrier leaky to the albumin tracer Evans blue. In four other fetuses umbilical cord clamping was omitted. However, only in one of these cases was acidosis completely avoided, and CBF autoregulation maintained. The three other fetuses were acidotic at the end of the surgical procedure and had impaired autoregulation.

Animals↗