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Asphyxia Neonatorum

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Description: Asphyxia neonatorum is a condition where a newborn baby is deprived of oxygen before, during, or just after birth, leading to potential brain damage or death.
Type: Asphyxia neonatorum is not a genetic disease but a medical condition that occurs in newborns due to insufficient oxygen supply during or immediately after birth. Therefore, it does not involve any type of genetic transmission.
Signs And Symptoms: Signs and symptoms of asphyxia neonatorum include:

1. Poor Apgar scores (typically less than 3 at one minute and less than 7 at five minutes)
2. Abnormal breathing patterns (such as gasping or apnea)
3. Low heart rate (bradycardia)
4. Poor muscle tone
5. Weak or absent cry
6. Pale, bluish, or mottled skin (cyanosis)
7. Low blood pressure
8. Meconium-stained amniotic fluid
9. Seizures or unusual movements
10. Reduced reflexes or lack of response to stimuli
Prognosis: Asphyxia neonatorum, or neonatal asphyxia, refers to a condition in which a newborn baby does not start breathing or has difficulty breathing at birth. Prognosis largely depends on the severity and duration of the asphyxia, as well as the promptness and effectiveness of medical intervention.

If treated promptly, many infants recover fully without lasting effects. However, severe or prolonged asphyxia can lead to significant complications, including neurological damage, developmental delays, and in severe cases, it may result in death. Intensive care, including respiratory support, therapeutic hypothermia, and continuous monitoring, plays a critical role in improving the outcome for affected infants.
Onset: Asphyxia neonatorum onset refers to the condition occurring at or around the time of birth, where a newborn is unable to establish adequate, sustained breathing. This can lead to lower oxygen levels and potential damage to vital organs.
Prevalence: The prevalence of asphyxia neonatorum, or neonatal asphyxia, varies globally but is estimated to occur in about 1 to 5 per 1,000 live births in developed countries. In developing regions, the prevalence can be significantly higher, due to factors such as inadequate prenatal care and limited access to skilled birth attendants.
Epidemiology: A 2008 bulletin from the World Health Organization estimates that 900,000 total infants die each year from birth asphyxia, making it a leading cause of death for newborns.In the United States, intrauterine hypoxia and birth asphyxia was listed as the tenth leading cause of neonatal death.
Intractability: Asphyxia neonatorum, also known as neonatal asphyxia, is not inherently intractable. It refers to a condition where a newborn is deprived of oxygen before, during, or just after birth, leading to difficulty in establishing respiration. Prompt and effective medical intervention, such as resuscitation, can often successfully manage the condition. However, the outcomes can vary, with some infants recovering fully while others may experience long-term complications depending on the severity and duration of oxygen deprivation.
Disease Severity: Asphyxia neonatorum refers to newborns experiencing an insufficient supply of oxygen before, during, or after birth. Its severity can range from mild to severe. Mild cases may involve temporary breathing problems and recover quickly, while severe cases can lead to significant complications, including brain damage or death.
Healthcare Professionals: Disease Ontology ID - DOID:11088
Pathophysiology: Pathophysiology:
Asphyxia neonatorum, or neonatal asphyxia, occurs when a newborn does not receive adequate oxygen before, during, or immediately after birth. This lack of oxygen can lead to hypoxia and hypercapnia (excess carbon dioxide in the bloodstream), resulting in metabolic acidosis. The condition can damage vital organs, particularly the brain, due to the insufficient oxygen supply. The brain injury, if severe, can result in hypoxic-ischemic encephalopathy (HIE), which may lead to long-term neurological deficits or death.

Nan:
Please provide clarification or context for what "nan" refers to for further assistance.
Carrier Status: Asphyxia neonatorum is a condition that occurs when a newborn baby does not get enough oxygen before, during, or just after birth. This results in hypoxia, which can cause damage to various organs. The concept of carrier status does not apply to asphyxia neonatorum, as it is not a genetic condition or inherited disease.
Mechanism: Asphyxia neonatorum, also known as perinatal asphyxia, is a condition resulting from a lack of oxygen supply to a newborn infant for a sufficient period during the birth process to cause harm. This can lead to various complications including brain damage, organ failure, and even death.

### Mechanism:
The primary mechanism involves the reduction or cessation of oxygen (hypoxia) and blood flow (ischemia) to the neonate. This often occurs due to compromised placental or umbilical circulation, which can be caused by:

1. **Umbilical Cord Problems**: such as prolapse, true knots, or cord compression.
2. **Placental Abruption**: premature separation of the placenta from the uterus.
3. **Placenta Previa**: the placenta covering the cervix.
4. **Prolonged Labor or Difficult Delivery**.
5. **Maternal Hypotension or Shock**: leading to decreased uteroplacental perfusion.
6. **Infection**: maternal or fetal infection affecting oxygen transport.

### Molecular Mechanisms:
The molecular mechanisms underlying asphyxia neonatorum involve multiple biochemical pathways that respond to hypoxia and ischemia. Key processes include:

1. **Hypoxia-Inducible Factors (HIFs)**: These transcription factors are stabilized under low oxygen conditions and activate the expression of genes involved in angiogenesis (formation of new blood vessels), erythropoiesis (production of red blood cells), and metabolic adaptation to hypoxia.

2. **Oxidative Stress**: Hypoxia followed by reoxygenation can lead to the generation of reactive oxygen species (ROS), which can damage cellular membranes, proteins, and DNA.

3. **Excitotoxicity**: Hypoxia can cause an excessive release of excitatory neurotransmitters like glutamate, leading to overactivation of NMDA (N-methyl-D-aspartate) receptors and subsequent neuronal injury or death.

4. **Inflammatory Response**: Hypoxia and resulting tissue damage can trigger an inflammatory response, exacerbating injury through the release of cytokines, chemokines, and other inflammatory mediators.

5. **Mitochondrial Dysfunction**: The interruption of oxygen supply impairs mitochondrial function, resulting in decreased ATP production and disruption of cellular energy metabolism.

6. **Apoptosis**: Severe or prolonged hypoxia can trigger programmed cell death pathways in various tissues, including the brain, through the activation of pro-apoptotic proteins and pathways such as caspases.

Understanding these mechanisms is crucial for developing strategies to prevent and treat asphyxia neonatorum, which may include prompt resuscitation, therapeutic hypothermia, and supportive care to mitigate the effects of oxygen deprivation.
Treatment: A= Establish open airway: Suctioning, if necessary endotracheal intubation
B= Breathing: Through tactile stimulation, PPV, bag and mask, or through endotracheal tube
C= Circulation: Through chest compressions and medications if needed
D= Drugs: Adrenaline .01 of .1 solution
Hypothermia treatment to reduce the extent of brain injury
Epinephrine 1:10000 (0.1-0.3ml/kg) IV
Saline solution for hypovolemia
Compassionate Use Treatment: In cases of asphyxia neonatorum, where standard treatments such as oxygen administration and therapeutic hypothermia might not be sufficient or available, compassionate use or experimental treatments can be considered. Some of these include:

1. **Erythropoietin (EPO):** Investigational studies have shown that EPO can have neuroprotective effects and improve outcomes if administered soon after birth.
2. **Xenon Inhalation:** Research is ongoing, but xenon gas combined with hypothermia has shown potential in animal studies for neuroprotection.
3. **Stem Cell Therapy:** Experimental use of stem cells aims to repair and regenerate damaged neural tissues, though it is still in early stages of research.
4. **Magnesium Sulfate:** Off-label use may reduce the risk of cerebral palsy and other complications when administered antenatally in preterm infants at risk of hypoxic-ischemic encephalopathy.

These treatments are typically accessed under strict protocols and regulatory oversight due to their experimental nature.
Lifestyle Recommendations: Lifestyle recommendations are generally not applicable for asphyxia neonatorum, as it affects newborns typically around the time of birth. Instead, this condition requires prompt medical evaluation and intervention. The focus is on ensuring optimal prenatal care to reduce risk factors, such as managing maternal health conditions, ensuring proper fetal monitoring during labor, and preparing for potential resuscitation at birth if needed. It is critical for expectant mothers to attend regular prenatal check-ups and follow healthcare providers' advice to minimize risks associated with childbirth.
Medication: Asphyxia neonatorum, also known as neonatal asphyxia, is a condition where a newborn is deprived of oxygen at birth. Treatment primarily focuses on immediate resuscitation and supportive care rather than medication. Key interventions may include:

- **Immediate Resuscitation**: Using suction to clear airways, providing oxygen, and performing chest compressions.
- **Ventilation Support**: Mechanical ventilation or continuous positive airway pressure (CPAP) if needed.
- **Fluids and Medications**: Administering intravenous fluids, and in some severe cases, medications like epinephrine may be required during resuscitation.
- **Therapeutic Hypothermia**: Inducing mild hypothermia in infants with hypoxic-ischemic encephalopathy to reduce brain injury.

Close monitoring and further supportive care in a neonatal intensive care unit (NICU) are crucial for recovery.
Repurposable Drugs: For asphyxia neonatorum, current treatment mainly focuses on immediate resuscitation and supportive care. Specific repurposable drugs are not commonly highlighted. However, hypothermia therapy and supportive measures like oxygen supplementation and mechanical ventilation are typically employed. Research into potential pharmacological treatments, including repurposable drugs, is ongoing but currently limited in conclusive findings.
Metabolites: Asphyxia neonatorum is a condition caused by insufficient oxygen supply at birth. Metabolically, it leads to acidosis, as cells switch to anaerobic metabolism, generating excess lactic acid. Key metabolites implicated include elevated levels of lactate and reduced pH (acidosis). Urgent medical intervention is critical to mitigate irreversible damage.
Nutraceuticals: Asphyxia neonatorum, or neonatal asphyxia, is a condition in which a newborn is deprived of adequate oxygen supply during the birth process. This condition can lead to severe complications including brain damage and death if not promptly treated. The primary focus is on immediate resuscitation and stabilization of the newborn. Nutraceuticals are not standard in the treatment or prevention of asphyxia neonatorum; the management relies on medical interventions and supportive care. Early and proficient medical response is critical.
Peptides: Asphyxia neonatorum is a condition characterized by impaired gas exchange in a newborn, leading to a lack of oxygen and potential organ damage. Treatment does not typically involve peptides or nanotechnology. Instead, it focuses on immediate resuscitation efforts, which may include clearing the airway, providing oxygen, and supporting breathing and circulation.