WORKING PAPER

”BABY ASPHYXIA”

DI SUSUN OLEH :
GROUP 2
FREDERIKA TULADAN JUSTIKA NURDIN
HARDIANTI KHUSNUL AMIRAH
HARIYANTI P SARI MUSTIKA RAMADHANTI
IKA RAHMAWATI NABILA ZHANAZH NADILA
INDAR SUKRIANI NUR AIN AL
INKA DEWI SAFITRI MUNAWWARAH

KEMENTRIAN KESEHATAN REPUBLIK INDONESIA

POLITEKNIK KESEHATAN MAKASSAR
JURUSAN KEBIDANAN
 FOREWORD

Praise and thank God in the presence of Almighty God, because

thanks to His grace, a paper entitled "Asphyxia on Babies Birth and Handling
Bari" can be solved. The purpose of writing this paper is to increase
knowledge about asphyxia in newborns and their handling in order to reduce
mortality and morbidity in neonates. So that by knowing the correct handling,
a health worker can immediately take action so that it can improve optimal
neonatal health services.

The author also expressed his gratitude to the Lecturer who has given
the task to write this paper, as well as to anyone who has been involved in
the writing process, which always motivates.

Finally, the authors hope that this paper will be useful for the reader.
The author has tried as much as possible to complete this paper, but the
author realizes this paper is not yet perfect. Therefore, the authors expect
constructive criticisms and suggestions to perfect this paper.

Makassar……..2018
 CHAPTER 1

PRELIMINARY

A. BACKGROUND

According to WHO, every year, approximately 3% (3.6 million) of the

120 million babies born experience asphyxia, nearly 1 million of these babies
die.

In Indonesia, of all infant deaths, 57% died in the neonatal period

(under 1 month of age). Every 6 minutes there is 1 neonate who dies. The
causes of neonatal death in Indonesia are low birth weight 29%, 27%
asphyxia, birth trauma, tetanus neonatorum, other infections, and congenital
ailments.

Various safe and effective efforts to prevent and overcome the main
causes of newborn deaths, including quality antenatal care, normal or basic
maternity care, and neonatal care services by professionals. To reduce the
mortality rate of newborns due to asphyxia, childbirth must be carried out by
health workers who have the ability and skills of asphyxia management in
newborns, these abilities and skills must be used every time to help delivery.

Therefore, the skills and ability to manage neonatal resuscitation is

very important for every professional who is involved in handling newborn
babies.
 CHAPTER II

LITERATURE REVIEW

A. Definition of Neonatoral Asphyxia

Asphyxia is a condition where newborns cannot breathe

spontaneously and regularly. Infants with a history of fetal distress before
birth, will generally experience asphyxia at birth. This problem is closely
related to health problems of pregnant women, umbilical cord disorders, or
problems that affect the well-being of the baby during or after childbirth
(Normal Delivery Care, 2007).

Neonatal Asphyxia is a condition where the baby cannot immediately

breathe spontaneously and regularly after birth. This is caused by fetal
hypoxia in the uterus and hypoxia is related to factors that arise in pregnancy,
labor, or immediately after the baby is born. Asphyxia effects will get worse if
the baby's handling is not done perfectly. Action what will be done on the
baby aims to maintain its survival and limit any further symptoms that may
arise. (Wiknjosastro, 1999)

B. Asphyxia causes newborns

Some certain conditions in pregnant women can cause disruption of

uteroplacental blood circulation so that the supply of oxygen to the baby is
reduced. Infant hypoxia in the uterus is indicated by fetal distress that can
progress to asphyxia of the newborn.
Certain factors are known to be the cause of asphyxia in newborns, including
maternal factors, the following baby's clamping umbilical cord

1. Maternal factors
a) Preeclampsia and eclampsia
b) Abnormal bleeding (placenta previa or abruption of the placenta)
c) The old partus or parturition is congested
d) Fever during childbirth Severe infections (malaria, syphilis,
tuberculosis, HIV)
e) Overdue Pregnancy (after 42 weeks of pregnancy)

2. Cord Factor
a) The umbilical cord
b) Short umbilical cord
c) Cord cord
d) Umbilical cord prolapsed

3. Baby Factors
a) Premature baby (before 37 weeks of pregnancy)
b) Action by delivery (breech, twins, shoulder dystocia, vacuum
extraction, extraction
c) forceps)
d) Congenital abnormalities
e) Meconium mixed amniotic water (greenish color)

Childbirth helpers must know the risk factors that have the potential to
cause asphyxia. If a risk factor is found, it must be discussed with the mother
and her family about the possibility of resuscitation. However, sometimes risk
factors become difficult to recognize or (helper's knowledge) not found but
 asphyxia still occurs. Therefore, helpers must always be ready to carry out
infant resuscitation at every aid

C. Signs of Symptoms and Diagnosis in Newborns with Asphyxia

1. Symptoms and Signs of Asphyxia
a) Not breathing or breathing gasping
b) Bluish skin color
c) Seizures
d) Decreased awareness

2. Midwifery Diagnosis
Asphyxia that occurs in infants is usually a continuation of fetal anoxia /
hypoxia. Diagnosis of fetal anoxia / hypoxia can be made in labor with
signs of fetal distress.
Three things that need attention are:
a) Fetal heart rate
The increase in heart rate is generally not much meaning, but if
the frequency drops to below 100 times per minute outside of his, and
especially if it is irregular, it is a sign of danger
b) Mekonium in amniotic fluid
Meconium at breech presentation is meaningless, but in the
presentation the head may show an oxygenation disorder and must
be aware of. The presence of meconium in the amniotic fluid in the
presentation of the head can be an indication to end labor if it can be
done easily.
c) Examination of fetal blood pH
Using an amnioscope inserted through the cervix, a small
incision is made on the fetal scalp, and fetal blood samples are taken.
This blood is checked for pH. The presence of acidosis causes a
 decrease in pH. If the pH drops below 7.2 it is considered a danger
sign that fetal distress may be accompanied by asphyxia.
(Wiknjosastro, 1999)

D. Assessment of Asphyxia in Newborns

A very important aspect of newborn resuscitation is assessing the
baby, determining the actions to be taken and finally carrying out
resuscitation actions.
Efficient and effective resuscitation efforts take place through a series
of actions namely assessing decision making and follow-up actions. The
assessment for resuscitation is solely determined by three important signs,
namely:

1. Disclaimer

2. Heart rate

3. Skin color

Apgar values are not used to determine when to start resuscitation or

make decisions about the course of resuscitation. If the respiratory
assessment shows that the baby is not breathing or breathing is not strong,
then the basis of conclusions for the act of vertilation with positive pressure
(VTP) must be immediately determined.

E. Treatment of Asphyxia in Newborns

1. Preparation of Resuscitation Tools
Before helping with childbirth, in addition to childbirth, also prepare
resuscitation equipment in a state ready for use, namely:
 a) strands of cloth / towel.
Baby's shoulder pad material. Material can be in the form of
cloth, t-shirts, scarves, small towels, rolled up 5 cm high and easily
adjusted to adjust the position of the baby's head.
b) Slime de lee or rubber ball suction device.
c) Tubes and hoods or balloons and neonatal hoods.
d) Resuscitation tool box.
e) Clock or timekeeper.

(Wiknjosastro, 2007).

2. Treatment of Asphyxia in Newborns

The newborn resuscitation action follows the stages known as ABC
resuscitation, that is :
a) Ensure open channels
1) Place the baby in the position of the shoulder deflection head 2-3
cm thick.
2) Sucking mouth, nose and sometimes trachea.
3) If necessary enter the endo trachel pipe (ET pipe) to ensure the
airway is open.
b) Start breathing
1) Using taxitic stimuli to start breathing
2) Using VTP if necessary, such as: hoods and balloons of ET pipes
and balloons or mouth to mouth (avoid exposure to infection).
c) Maintain circulation
1) Stimulation and maintain blood circulation in a way
2) Chest compression.
3) Treatment
 CHAPTER III

COVER

A. Conclusion

Asphyxia is a condition where newborns cannot breathe

spontaneously and regularly. Infants with a history of fetal distress before
birth, will generally experience asphyxia at birth. This problem is closely
related to maternal health problems, cord disorders, or problems which
affects the welfare of the baby during or after childbirth. The treatment is by
resuscitation. The resuscitation of newborns follows the stages known as
ABC resuscitation, namely:

1. Ensure the channel is open.

2. Start breathing
3. Maintain circulation

Resuscitation steps, including 2 stages. The first stage is the first step,
and the second stage is ventilation.

B. Suggestions

With the writing of this paper, the authors hope that it can add
knowledge to readers. Therefore, the authors hope for all readers to provide
constructive criticism and suggestions.
 BIBLIOGRAPHY

RI Health Department: Asphyxia Management of Newborn Babies for

Midwives (2007). Jakarta

Sarwono prawirohardjo.2002. National Reference Book for Maternal Health

Services and Neonatal.Jakarta: Bina Pustaka Foundation Sarwono
Prawirohardjo.

Wiknjosastro, 1999.Asphyxia in newborns.