Prevalence of intrapartum fetal asphyxia

The classification of fetal asphyxia in the research laboratory is based upon continuous measures of the degree and

Table 8.2 Prevalence of intrapartum fetal asphyxia

Rate per

1000 live births

Fetal asphyxia

Preterm

Term

Prevalence

73

25

Mild

38

21

Moderate/severe

35

4

duration of the asphyxia and the quality of the fetal cardiovascular response. Since most measures obtained in the laboratory are not available in the clinical setting, the clinical classification of asphyxia as mild, moderate or severe is based on the presence of metabolic acidosis to confirm the occurrence of asphyxia with measures of neonatal encephalopathy and other organ system complications to express the severity of the asphyxia [9].

Clinical studies in recent years have provided insight into the prevalence of mild, moderate and severe fetal asphyxia during the intrapartum period. The prevalence and severity of fetal asphyxia at delivery in preterm and term pregnancies at delivery is outlined in Table 8.2.

There is no evidence of an association between mild fetal asphyxia and major deficits while long-term follow-up has demonstrated no association with minor disabilities later in childhood [10]. These findings suggest that mild fetal asphyxia represents a window of opportunity in clinical management when a diagnosis of fetal asphyxia can be confirmed and if necessary intervention initiated to prevent cerebral dysfunction and deficits in these children.

Although the prevalence of intrapartum fetal asphyxia as determined at delivery has been established the duration and nature of the asphyxia in most cases is not known. Since the duration and nature of the asphyxia cannot be determined it is not known when the asphyxia identified at delivery began before the onset of labour and how often the asphyxia identified at delivery represents the last in a series of asphyxial exposures that may have begun before the onset of labour.

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Getting Back Into Shape After The Pregnancy

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Once your pregnancy is over and done with, your baby is happily in your arms, and youre headed back home from the hospital, youll begin to realize that things have only just begun. Over the next few days, weeks, and months, youre going to increasingly notice that your entire life has changed in more ways than you could ever imagine.

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