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Birth Asphyxia(Hypoxic Ischaemic Encephalopathy)

Birth Asphyxia (Hypoxic Ischaemic Encephalopathy)

Hypoxic Ischaemic Encephalopathy (Birth Asphyxia) is defined as a lack of sufficient oxygen and blood perfusion to the brain, resulting in brain injury.

Pathophysiology

When a baby does not breath at birth, the oxygen supply to the brain cells called neurons is interrupted. This causes death of the neurons with its associated brain damage.

Clinical Presentation

  • In children with HIE, the primary symptoms arise from the brain such as limpness, poor breathing, seizures, poor sucking among others.
  • Other body organs may also be affected and show symptoms of damage such as coagulopathy (bleeding tendency), abnormal liver and kidney function / failure, low BP, lung failure.
Newborn baby receiving neonatal intensive care in an incubator after birth asphyxia or oxygen deprivation at birth

Investigations

  • Frequent neurological examination.
  • Blood tests to identify other organ dysfunction
  • Sepsis (infection) screen.
  • EEG.
  • Neurosonogram (brain scan)
  • MRI of brain.

Prognosis (Outcome)

  • Mild (stage I): Survival is expected. Some disability is expected.
  • Moderate (stage 2) or Severe (Stage 3): These babies may or may not survive. About 20-25% of these babies do not survive. The disability rate is also higher.

Management

  • Therapeutic hypothermia / cooling: To maintain core body temperature between 33-34C for 72 hours followed by gradual rewarming over 12 hours. Evidence shows that cooling of neonates with moderate to severe HIE is safe and reduces the risk of death or disability at 18 to 22 months of age.
  • Other routine NICU management such as ventilator, oxygen, CPAP as needed.
  • Fluid management, antibiotics and other medications as needed.

Follow-Up

All infants showing signs of HIE require developmental follow-up program and intervention as needed.

Southern Gem Hospital

Frequently Asked Questions

Find answers about Birth Asphyxia, Hypoxic Ischaemic Encephalopathy (HIE), treatment and neonatal care at Southern Gem Hospital in Hyderabad.

What is Birth Asphyxia (Hypoxic Ischaemic Encephalopathy)?

Hypoxic Ischaemic Encephalopathy (Birth Asphyxia) is defined as a lack of sufficient oxygen and blood perfusion to the brain, resulting in brain injury. When a newborn baby does not cry or breathe spontaneously at birth, the oxygen and nutrition supply to various body organs, especially the brain, is cut off, which could lead to all organs suffering in the short and long term.

What causes Birth Asphyxia?

When a baby does not breathe at birth, the oxygen supply to the brain cells called neurons is interrupted. This can cause injury or death of neurons with associated brain damage. The lack of sufficient oxygen and blood perfusion to the brain results in brain injury known as Hypoxic Ischaemic Encephalopathy.

What are the symptoms of Birth Asphyxia (HIE)?

In children with HIE, the primary symptoms arise from the brain and may include limpness, poor breathing, seizures and poor sucking, among others.

Other body organs may also be affected and show symptoms of damage, such as coagulopathy (bleeding tendency), abnormal liver and kidney function or failure, low blood pressure, and lung failure.

How is Birth Asphyxia (HIE) diagnosed?

HIE is diagnosed through a combination of clinical and diagnostic assessments, including frequent neurological examinations, blood tests to identify other organ dysfunction, sepsis (infection) screening, EEG, neurosonogram (brain scan), and MRI of the brain.

What is the outcome or prognosis of Birth Asphyxia?

The prognosis depends on the severity of HIE. In Mild (Stage 1) HIE, survival is expected, though some disability may occur. In Moderate (Stage 2) or Severe (Stage 3) HIE, babies may or may not survive. About 20-25% of these babies may not survive, and the disability rate is also higher.

What is therapeutic hypothermia (cooling) for Birth Asphyxia?

Therapeutic hypothermia (cooling) involves maintaining the baby's core body temperature between 33-34°C for 72 hours, followed by gradual rewarming over 12 hours.

Evidence shows that cooling of neonates with moderate to severe HIE is safe and reduces the risk of death or disability at 18 to 22 months of age.

How is Birth Asphyxia (HIE) treated?

Birth Asphyxia (HIE) is managed with:

1. Therapeutic Hypothermia (Cooling): Maintaining the baby's core body temperature between 33-34°C for 72 hours, followed by gradual rewarming.

2. NICU Support: Routine NICU management, including ventilator, oxygen and CPAP support as needed.

3. Supportive Treatment: Fluid management, antibiotics and other medications may be provided as required.

All infants showing signs of HIE also require a developmental follow-up program and intervention as needed.

Is Birth Asphyxia (HIE) treatment available at Southern Gem Hospital Hyderabad?

Yes. Southern Gem Hospital, Hyderabad offers comprehensive management of Birth Asphyxia (HIE), including therapeutic hypothermia (cooling), NICU respiratory support and developmental follow-up at both its Basheerbagh and Banjara Hills branches. Treatment is led by Dr. Nitesh Agarwal, Neonatologist.

Basheerbagh: +91 40 6658 5555
Banjara Hills: +91 91778 20007
Email: info@southerngem.in

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