Prolonged second stage labour and consequences of hypoxia in the neonate: A review

• Main Authors: P. Martz, P. Georgiev, A. Wehrend
• Format: Article
• Language: English
• Published: Faculty of Veterinary Medicine, Trakia University, Stara Zagora, Bulgaria 2019-06-01
• Series: Bulgarian Journal of Veterinary Medicine
• Subjects: acidosis; foetal stress; hypoxia; meconium; neonates
• Online Access: http://tru.uni-sz.bg/bjvm/BJVM%20June%202019%20p.131-142.pdf

Hypoxia due to dystocia and its repercussions are serious issues concerning the health of neonates. In order to gain a better understanding of the cause and especially the effects and potential long-term disorders, a critical analysis of peer-reviewed literature was made. As shown by many authors, ini-tially the most devastating peripartal cause of ill health in neonates is associated with the serious ef-fects of prolonged and severe acidosis. Other life threatening complications are related to disorders such as meconium aspiration syndrome (MAS), neonatal respiratory distress syndrome, hypoxic is-chaemic encephalopathy and necrotising enterocolitis. Despite the astonishing ability of neonates to compensate mixed metabolic and respiratory acidosis with breathing onset directly postpartum, the longer second stage labour takes and the more extreme the acidosis is, the more detrimental its consequences. Lungs are especially vulnerable in this phase of life, aspired meconium can result in in-creased expression of pro-inflammatory chemotactic cytokines, phospholipase A2 and PGE2 levels , exacerbating inflammatory reactions of lung tissue and exerting a deleterious effect on alveolar cells. Neonates experiencing dystocia could greatly benefit from administration of buffering substances and non-steroidal anti-inflammatory drugs.