Asphyxia of the newborn - the clinical syndrome arising at a birth and in the first days of a life, described absence or an incompetence of independent respiration at presence of other attributes of a life. Distinguish primary (at a birth) and secondary (at the first o'clock and days of a life) an asphyxia of the newborn.

Etiology. The reasons of a primary asphyxia of the newborn are an acute and chronic fetal oxygen failure - a hypoxia of a fetus, an intracranial trauma, immunologic incompatibility of a blood of mother and a fetus, the fetal infection full or a partial occlusion of respiratory ways of a fetus or the newborn by slime, amniotic waters (an aspiration asphyxia), developmental anomalies of a fetus. Occurrence of an asphyxia of the newborn is promoted by extragenital diseases of the pregnant woman (cardiovascular, especially in stages of a decompensation, serious diseases of the lungs, the expressed anemia, a diabetes mellitis, a thyrotoxicosis, infectious diseases, etc.), long wearing of pregnancy, a premature placental detachment, a pathology of a cord, fetal environments and placentas, complications in sorts (a untimely pouring out of amniotic waters, to anomaly of patrimonial activity, disharmony of the sizes of a basin of the parturient woman and a head of a fetus, wrong insertions of a head of a fetus, etc.) . The secondary asphyxia can be bound to disturbance of a cerebral circulation at the newborn, pneumopathies, etc.

Pathogenesis. Irrespective of the reasons of an oxygen failure in an organism of the newborn there is a reorganization of metabolic processes, hemodynamics and microcirculation. The degree of their expression depends on intensity and duration of a hypoxia. The metabolic acidosis, accompanied a hypoglycemia, an azotemia and a hyperpotassemia, replaced deficiency of a potassium develops. Disbalance of electrolytes and a metabolic acidosis lead to a cellular overhydratation. At an acute hypoxia the volume of a circulating blood increases basically due to augmentation of volume of circulating erythrocytes. The asphyxia of the newborn which has developed on a background of a chronic hypoxia of a fetus, is accompanied by a hypovolemia. There is a pachemia, its viscosity is enlarged, ability of erythrocytes and thrombocytes raises. In a brain, heart, kidneys, adrenals and a liver of newborns as a result of microcirculatory frustration there are an edema, hemorrhages and sites of an ischemia, the fabric hypoxia develops. Are broken the central and peripheric hemodynamic that is shown by depression of shock and minute volumes of heart and falling of a BP. Frustration of a metabolism, a hemodynamic and microcirculation serve as the reason of disturbance for urine-secretory of function of kidneys.