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What Is Fetal Hypoxia?

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  • Written By: Jo Dunaway
  • Edited By: S. Pike
  • Last Modified Date: 19 August 2016
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Fetal hypoxia is not a disease per se; it is a set of pathological processes that take place within the womb, causing the fetus to be seriously deprived of oxygen for a period of time and causing resultant damages and impairments. Organ activity and metabolic processes become disordered and congenital abnormalities may develop. Damages to the central nervous system, including the brain and breathing disorders are common, leading to conditions such as hypoxic-ischemic encephalopathy, cerebral palsy, ADHD, epilepsy, and numerous neurological and neuropsychiatric conditions. The mortality rate is high in many instances, and though the child may survive birth, the risk for sudden infant death syndrome (SIDS) is high.

In many cases, the exact timing and cause of oxygen deprivation from fetal hypoxia remain undiscovered. The resulting conditions are what point parents and physicians to fetal hypoxia as a cause. For example, in hypoxic-ischemic encephalopathy a mild condition may exhibit as poor muscle tone, transient feeding, crying and sleep abnormalities, and neurological findings only become close to normal after three to four days after birth. Moderate levels of the disease produce a lethargic infant, with nearly absent deep tendon reflexes, sleep apnea, and seizures occurring within 24 hours after birth. Severe levels of this cellular, neurological disease are typically of stupor or coma, no response to physical stimulus, irregular breathing, vision abnormalities, seizures and no sucking ability. The risks for severe forms are of irregular heartbeat, blood pressure variability, and cardiovascular failure.

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Intrauterine or fetal hypoxia and the resultant perinatal brain damages lead to extraordinary costs in time and money, including continuous lifelong treatments for the survivors. In the United States, it is listed as the tenth leading cause of neonatal death. The World Health Organization (WHO) has estimated that globally there are between 4 and 9 million such newborns each year, causing around 1.2 million deaths and around the same number of survivors who exhibit severe disabilities.

Initial treatments for fetal hypoxia infants are immediate submersion of the birthed infant into hypothermic therapies to increase the chances for survival. Imaging studies usually show severe brain lesions and some hemorrhages. Electrolytes are often severely low and require immediate suffusions of sodium, potassium, and chloride as well as treatments for severely reduced urinary output. The infants usually need resuscitation and stabilization, careful fluid management, supportive ventilation treatments, and anticonvulsants for seizures. Hypoglycemia and hyperglycemia are a risk and appropriate treatments are usually begun immediately to get good nutrition to the infant.

Lack of spontaneous breathing at birth within the first 20 to 30 minutes is nearly always indicative of death. If abnormal neurological findings extend beyond seven to ten days after birth, the prognosis is that if the infant survives it will experience a severely limited life. Mild to severe instances of hypoxic-ischemia encephalopathy can know a 60 percent survival rate with lifelong treatments and monitoring necessary. The presence of seizures indicates a poor prognosis, particularly as further brain damage will likely occur.

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