Cerebral ischemia is a serious ailment, which is characterized by the lack of oxygen in the brain along with blood. The reason for it is the blockage of one or more vessels. For this reason, the baby cannot form the brain correctly. If no measures are taken in a timely manner, the consequences can be far more serious than it seems at first glance. It is a timely visit to a doctor and correctly selected treatment of cerebral ischemia in newborns that will help to avoid serious and irreversible consequences.
How does ischemia develop?
Oxygen, which, together with blood, enters every cell of the body, is vital for the proper functioning of each organ and system. If its content decreases, then the redistribution of blood occurs in the organs. The brain and heart receive a large proportion of oxygen, but other cells and tissues experience starvation.
If asphyxia lasts a long period of time, then for the vital activity of nerve cells the compression abilities are not enough. As a result, they begin to die. As a result of this, hypoxic-ischemic encephalopathy appears. The more tissue affected, the worse the prognosis for the patient. In rare cases, cerebral ischemia in newborns can cause cerebral hemorrhage, which increases the risk of an adverse outcome.
Causes of ischemia in newborns
The main cause of ischemia in infants is a violation of the blood flow in the placenta. According to statistics, this diagnosis is given to babies born to mothers who are less than 20 years of age and older than 35. It is also observed in infants of women who have a history of chronic ailments (especially dangerous hypertension and diabetes mellitus), or those who during the period of gestation, he suffered from acute infections. In a healthy woman, risk factors can be considered:
- preeclampsia is a form of late toxicosis that causes swelling and high blood pressure;
- overstretching, during this period, the placenta is aging, so the amount of nutrition for the baby is reduced or prematurity occurs;
- entwining the umbilical cord or clamping it in the womb or during childbirth;
- rapid or prolonged childbirth.
Rapid labor causes cerebral ischemia in newborns because the baby is not yet ready to take a first independent breath. But prolonged childbirth leads to the fact that the fetus does not leave the uterus for a long time, is not able to start breathing on its own, and the connection with the womb has already been interrupted. In this case, ischemia is caused by a combination of asphyxia and hypoxia, in simple terms, mechanical suffocation.
Degrees of Ischemia and Symptoms
Cerebral ischemia of newborns is divided into several degrees. Thanks to such a classification, it is easier for doctors to determine how serious the condition of the baby is, and what measures in each case are better to take.
Cerebral ischemia of 1 degree
This is a mild form, which is characterized by mild signs in the first five days after birth. It manifests itself in the form:
- nervous depression and arousal;
- small muscle tone;
- amplification of tendon reflexes.
The doctor is constantly watching the child, the symptoms pass without complications.
Second degree ischemia
This is a serious form of the disease, which is accompanied by such signs:
- frequent stops in breathing, especially during sleep;
- decreased sucking reflex;
- weak muscle tone;
- an increase in the head due to accumulated fluid in it;
- impaired coordination;
- loss of consciousness;
- discoloration of the skin.
In most cases, this ailment manifests itself in the first day after the birth of the baby, and symptoms can persist for up to a month. During this period, experts observe him, and he undergoes a course of treatment. If necessary, they recommend surgery that involves the removal of a blood clot.
Grade 3 cerebral ischemia in newborns
This is one of the hardest forms during which:
- the newborn has no reflexes;
- the baby has a coma;
- malfunctions in the heart rhythm;
- sharply jumps in blood pressure;
- there are problems in the respiratory system;
An experienced specialist after the birth of the baby will be able to determine the signs of the disease. The newborn is immediately sent to intensive care, if necessary, it is connected to the lung ventilation apparatus.
Clinical manifestations of ischemia in infants
The clinic of manifestations of ischemia in newborns is expressed by a number of symptoms, which are divided into three main degrees according to the degree of manifestation.
The easy degree has such a clinic:
- The baby's behavior changes: tearfulness, lethargy, drowsiness, and appetite appear.
- Muscle tone is increased.
- Tendon reflexes increase slightly.
- The condition normalizes over three days.
In premature infants, on the contrary, muscle tone and reflexes are reduced.
With an average degree, the clinic looks like this:
- Muscle tone is reduced.
- Tendon reflexes are lowered.
- Sluggish or complete absence of sucking and grasping reflexes, a decreased Moro reflex - during the throwing of the baby's head, the arms also pop up.
- Respiratory disorders, frequent long pauses in breathing.
- The appearance of all the described symptoms in the first day after birth.
If the condition of the baby is normalized within two weeks, then cerebral cerebral ischemia of the newborn will not cause harm.
A severe degree is manifested by such a clinic:
- Coma or stupor.
- The need to use mechanical ventilation because respiratory function is severely affected.
- A sharp decrease in muscle tone and reflexes.
- The complete absence of reflexes.
- Disorders of the eye reflexes: squint, inconsistent movement of the eyeballs.
- Cramps.
- Low blood pressure and heart rhythm disturbances.
Based on this, at the 1st and 2nd degrees of cerebral ischemia in a newborn, functional neurological disorders arise, and they are reversible. If you approach this issue correctly, then treatment will bring positive results.
A severe degree can cause organic damage to the baby.
Diagnostic methods for ischemia
Most often, the first signs of cerebral ischemia in newborns can be determined by visual inspection. But in some cases, other techniques will be required:
- The overall condition of the baby is assessed. Vital reflexes on the Apgar scale are checked immediately after birth. If disturbing moments are manifested, then the baby is left under the close supervision of doctors, since its condition can worsen with every minute, even after a short normalization.
- Laboratory tests are prescribed to help evaluate how the internal organs and systems of the body work.
- MRI is prescribed in the most severe cases when it is necessary to determine how seriously damaged the brain is.
- Electroencephalography helps determine the echoes of cerebral ischemia in newborns. It makes it possible to accurately set the degree of the disease, after which it is easier to choose a treatment that will help the child cure the pathology without consequences.
Treatment
The main goal of treating cerebral ischemia in newborns of the 1st degree is the restoration of blood flow and the creation of normal conditions for the work of damaged cells.
With a mild degree, the use of drugs is not required. It is enough to undergo a course of therapeutic massage, and this will be enough to restore the functions of the body.
Medium and severe forms require treatment in a hospital. In severe form, the baby is sent to intensive care. For each newborn, individual therapy is selected depending on its clinical manifestations. Subsequently, throughout the year he needs rehabilitation.
There is no special therapy that would help restore brain cells affected by a lack of oxygen. However, there are a number of drugs that can help:
- general strengthening and diuretics;
- to stop cramps, anticonvulsants, for example, Phenobarbital, are used, such a solution does not damage the brain in the future;
- funds are introduced that positively affect the work of the heart: "Dopamine" or "Dobutamine";
- At present, hypothermia is actively used, the baby is lowered body temperature by several degrees, it is thanks to this that further development of brain tissue necrosis can be prevented.
But there are drugs that are not recommended for the treatment of newborns with ischemia. Parents, seeing the child's symptoms of the disease, begin to ask friends and prescribe medications for their children on their own, without thinking about the consequences. Grade 1 cerebral ischemia in newborns does not generally involve the use of any drugs, especially such:
- vascular agents;
- neotropes;
- homeopathic remedies;
- herbal remedies such as motherwort or valerian.
The safety of these drugs for the newborn is not proven. It is not known how the body will react to them, therefore, in order not to provoke complications, it is better not to use them.
The role of massage in the treatment of ischemia in newborns
The first degree of cerebral ischemia in newborns (doctors' reviews confirm this fact) is treated mainly with massage. After all, it favorably affects muscle tone and overall well-being of the child.
It is impossible to do therapeutic massage on your own in any case, it is better to entrust it to a specialist. The best effect will be if you massage 4 times in the first year of life. The interval between courses should be at least 3 months. Therapeutic massage helps:
- relax the nervous system;
- improve muscle tone;
- improve the overall condition of the baby.
That is why it is better to entrust the massage to a professional, and take the full course.
Consequences and forecast
If treatment is started in a timely manner, cerebral ischemia of grade 3 in newborns will not cause consequences, most of these small patients live a full life. Some children have consequences, but they are relatively safe for their lives: quick fatigue, poor memory, danger of cramps at high temperature. With focal atrophy of certain parts of the brain, the consequences are much more dangerous. But, as practice shows, the most common consequences of ischemia are the following symptoms:
- frequent headaches;
- sleep disturbances, irritability;
- inability to concentrate;
- epilepsy;
- mental retardation;
- mental abnormalities.
In the most severe cases, children after ischemia may develop cerebral palsy. But while the child is growing, his nerve cells continue to divide, therefore, with timely and proper treatment, the consequences go away or significantly weaken.
Prevention of ischemia of newborns during pregnancy
In women who are at risk, a serious condition can be prevented even while carrying the baby. To do this, you must follow simple rules throughout your pregnancy:
- as much as possible to relax, move and take daily walks in the fresh air;
- give up all bad habits;
- try to avoid unrest and stressful situations;
- look to the future with a positive;
- eat right, including as many vitamins and minerals as possible in the diet;
- observe the regimen of the day, fully sleep and get enough sleep;
- comply with all the recommendations of the doctor;
- timely submit all recommended tests and undergo an ultrasound examination.
Also, careful planning of pregnancy, when a woman and a man are ready to become parents, can be attributed to prevention. Before these two partners, you need to undergo a thorough examination to identify the pathology initially and cure it.
Cerebral ischemia in newborns: reviews
Cerebral ischemia is a serious ailment that can harm a child’s fragile body. Therefore, it is very important to recognize the symptoms in time and begin the correct treatment. In the reviews of doctors and parents who had to deal with this ailment, they say that the children who underwent the course of treatment live a full life, and does not recall anything that he had to survive in the first days of his life.
Doctors keep statistics and know for sure that most of the children after this disease feel fine and play sports. Even those who were given a severe form, after a few years forget about treatment.