Complications sometimes occur that indicate the existence of problems during the birth of the child, and these complications may affect the mother or the child. Among these complications, there is a syndrome known as the aorta syndrome during childbirth. Although it is usually considered as one of the complications that do not threaten the life of the child, it may lead to great risks if not treated. In this article's  Dalili Medical,, we will cover all the important information about amniotic fluid syndrome during childbirth.

What is the aorta syndrome?

 

The occurrence of amniotic fluid syndrome occurs when the newborn inhales a mixture of amniotic fluid and amniotic fluid in the near term of birth. This can lead to breathing difficulties and other health problems in newborns.

**Causes of the acetabular syndrome**

There are several height factors that increase the risk of developing aorta syndrome. Here are some common reasons:

Fetal distress is one of the main causes of colic syndrome. When the fetus is exposed to stress during labor, such as lack of oxygen, it passes the placenta to the amniotic fluid.

**Pregnancy after the specified date** Children born after 42 weeks of pregnancy are more likely to expel the placenta before birth. The longer the fetus stays in the womb, the more likely the amniotic fluid is.

**Complicated delivery** Difficult or prolonged labor conditions can lead to colic syndrome. Pressure and stress during complicated childbirth lead to the exit of the placenta from the fetus to the amniotic fluid.

**Symptoms of Acromegaly Syndrome**

Early recognition of the symptoms of MAS is vital to ensure immediate treatment. Here are some common symptoms:

- The appearance of amniotic fluid or signs similar to dark green lines, in addition to the presence of clots in the amniotic fluid.

- Considerable changes in the color of the child's skin, depending on the height, ranging from blue or green to the right side.

- Breathing problems, such as increased breathing rate, shortness of breath, and in some cases, complete cessation of breathing.

- Decreased heart rate of the child before birth in a short period.

- The child achieves low scores on the Abghar scale, which is a test used to evaluate skin color, heart rate, reflexes, muscle strength, and breathing rates after birth.

- Appearance of signs of physical weakness on the child.

- Repeated pregnancies.

- Shortness of breath.

Most of the time, newborn babies suffering from aspiration syndrome show symptoms of shortness of breath, which include rapid breathing, wheezing, and expansion of the nostrils.

- **Blue** Blue is a condition in which the color of the baby's skin, lips, and fingernails turns blue due to lack of oxygen. This condition is a serious sign that the child is not getting enough oxygen.

**Falling** The height of the child with Massachusetts syndrome appears to be flabby or suffering from muscle weakness. And this is a sign of difficulty in breathing, which requires immediate medical attention.

**complications of the aorta syndrome**

MAS disease can lead to many complications if not treated quickly and effectively. Here are some possible complications:

**Pneumonia** Inhalation of algal leads to inflammation and infection in the child's lungs, which leads to pneumonia. This serious condition requires intensive medical treatment.

**Persistent pulmonary hypertension** MAS can lead to persistent pulmonary hypertension in newborns (PPHN), a condition in which the blood pressure in the lungs remains high, making it difficult for the baby to breathe.

**Airway obstruction** Agae can lead to airway obstruction, which makes it difficult for the child to breathe. This may lead to low oxygen levels and damage to the baby's organs.

- **Air leak** As a result of the existence of a thick alkyd, which sometimes causes the effect of the spherical valve, air leakage can occur due to overexpansion of the alveoli, which leads to pneumothorax, or pneumomediastinum, and increases The possibility of air leakage when employing mechanical ventilation. In case of suspicion of air leakage due to the presence of weakness in lung or heart functions, a quick examination and treatment should be performed, such as: aspiration with a needle, or continuous drainage, in order to prevent further oxygen deficiency and airway obstruction.

- ** Cerebral palsy and other neurological conditions ** Children who are deprived of oxygen for a long time may suffer from brain damage, which may lead to cerebral palsy, seizures, brain disease caused by oxygen deficiency and ischemia (HIE), and even stroke. In these cases, it is recommended to perform magnetic resonance imaging of the brain. In addition, the appearance of long-term respiratory complications as a result of inhalation, such as the need for oxygen, and symptoms similar to asthma, poor growth, and the recurrence of viral or bacterial pneumonia.

**Diagnosis of aorta syndrome**
**Physical examination** Usually, doctors diagnose the syndrome of the aorta during a comprehensive physical examination. Where they listen to the child's voice to discuss any abnormal sounds, and verify the presence of signs of respiratory distress.

**X-rays on the chest** X-rays on the chest can contribute to the confirmation of the diagnosis during the description of the areas affected by the brain in the lungs.

**Blood tests** Blood tests help in measuring oxygen and carbon dioxide levels in the baby's breath, which provides additional information about the condition.

**How ​​to treat aspiration syndrome in newborns**

The treatment of the syndrome depends on the degree of respiratory distress suffered by the newborn. While some affected children do not need additional support, the children who suffer from moderate to severe respiratory distress are the majorityWe need specialist respiratory support, in addition to treatment with antibiotics and surfactant.

- **Suctioning** The National Institute for Cleanliness in Health Care (NICE) does not recommend routinely suctioning secretions from the nasal pharynx and oral pharynx before the delivery of the shoulder and trunk. If the baby is born breathing and crying normally, there is no need for special treatment. However, if there is a lump in the oral cavity, or if the newborn suffers from breathing difficulties, it may be necessary to take additional measures to remove excreta from the upper airways after the delivery of the shoulders. In some cases, the height of the child requires support in breathing, which necessitates resorting to tracheal intubation. The baby can breathe with the help of a ventilator, and in other cases, a continuous positive airway pressure (CPAP) device can be used to help the baby learn to breathe independently.

**Giving oxygen via nasal cannula** Oxygen must be given early to any infant suspected of oral inhalation, with the aim of investigating oxygen saturation between 91 to 95 percent, with a partial pressure of oxygen ranging between 60 to 90 mmHg. The treatment can be stopped if the child does not show any signs of respiratory distress or if there is clinical improvement. When using oxygen, the risks should be evaluated against the benefits, as is the case with any other medicine. Pulmonary blood vessels in term infants are particularly sensitive to oxygen pressure, and failure to treat oxygen deficiency may lead to a gradual increase in pulmonary blood pressure.

**Nasal CPAP device** Continuous positive airway pressure (CPAP) device must be used for newborn babies who breathe normally and have a high respiratory effort. However, the use of CPAP causes some side effects, such as air trapping, so it is recommended to perform close monitoring during regular chest x-rays.

**Endotracheal intubation and mechanical ventilation** Endotracheal intubation is a medical procedure that involves inserting a tube into the trachea through the mouth or nose. In emergency situations, the tube is usually inserted through the mouth. Yusya advises to vaccinate when the following signs appear on the baby:

- Continuous lack of oxygen (oxygen saturation at least 90%, and oxygen pressure at least 50 mm Hg) despite the use of continuous positive airway pressure and the percentage of oxygen in my blood is at least 60%.

- Respiratory acidosis with a minimum pH of 7.20.

As for the guidelines for endotracheal intubation:

- Except for the delivery room, babies born on time and those suffering from acute respiratory syndrome need anesthesia and muscle relaxation during the intubation process.

- Most of the time, newborns who suffer from aspiration syndrome require high peak inspiratory pressures (30-35 cubic centimeter of water) to achieve active gas exchange.

- The goal of ventilation should be to increase the oxygen level while reducing the pressure shock that may lead to pleural or pleural effusion.

### - Supportive Care**- Newborn babies should be placed under a special heating device, as hypothermia inhibits the production of surfactants.

- It is necessary to monitor the level of oxygen saturation continuously.

- It is necessary to reduce the handling of newborns who suffer from aspiration syndrome, as these infants are prone to anxiety easily, which leads to oxygen deficiency and acidosis quickly.

Blood pressure must be monitored, and in some cases blood transfusion or systemic vasopressors are required to maintain systemic blood pressure higher than pulmonary blood pressure, which reduces right-to-left shunting through the ductus arteriosus.

- Nutritional support should be started on the first day in the form of intravenous infusions at slightly limited rates (60 to 70 milliliters/kg/day) using 10% dextrose. Al-acids, proteins, lipids, and vitamins are gradually added to ensure adequate nutrition and prevent the deficiency of essential amino acids and fatty acids, with the final goal of transitioning to complete nutrition.

** Antibiotics ** Usually we prescribe antibiotics for newborns who are suspected of having clinical complications. Treatment can be stopped if the results of blood transfusion and clinical examination are negative after 48 hours. The antibiotics used usually depend on the local instructions of intensive care units.

Usually, ampicillin** (Ampicillin) is given intravenously in a dose ranging from 50 to 100 mg per kilogram per day, and Gentamicin (Gentamicin) intravenously in a dose of 4-5 mg per kilogram per day in cases of acute inhalation syndrome. However, the evidence indicates that the routine use of antibiotics does not reduce the rates of infection or mortality.

**- Surface tension-lowering substance (Surfactant)** I can give a dose of surfactant to newborn babies who suffer from moderate alveolar-pulmonary inhalation syndrome, or in cases of chest asthma, or in severe cases. It is also possible to perform bronchial lavage using this material.

** Inhaled nitric oxide ** may be useful in the treatment of persistent pulmonary hypertension associated with acute inhalation syndrome, and it is believed that it works by relaxing the smooth muscles in the pulmonary vessels, which causes expansion, in addition to enhancing the expansion of the bronchi. .

**Steroids** Inhaled or systemic steroids have been used well in some studies, and Budesonide has been shown to improve the effects of the substanceSuperficial anxiolytics in children suffering from acute inhalation syndrome. However, the evidence is not yet conclusive to suggest that it is used routinely.

**Is it possible to prevent aspiration syndrome in newborns?**

Sometimes, the baby's mucus discharges before or during labor as part of the body's natural response to the stress of childbirth. In these cases, it may be difficult to prevent the occurrence of acute inhalation syndrome. This natural discharge often happens when the child is due or later. In general, the best way to prevent ectopic inhalation syndrome is to reduce stress on the fetus. Therefore, health care providers must monitor the mother and the child closely for signs of fetal distress. The following reproductive practices can contribute to reducing the occurrence of this syndrome:

Fetal heart monitoring during delivery (FHR) Continuous or periodic monitoring of the fetal heart has become a standard of care in many countries, including the United States, especially in pregnancy situations that are believed to be at greater risk of hypoxia in the fetus during delivery. Like full-term pregnancy, late intrauterine growth, and late pregnancy. The main purpose of monitoring the heart rate is to evaluate the oxygen adequacy of the fetus during labor, although the combination of monitoring the abnormal heart rate and the presence of amniotic fluid in the amniotic fluid is associated with an increased risk of aspiration syndrome, but the effectiveness of monitoring the fetus during labor in preventing I have confirmed this syndrome later. However, there is agreement that heart rate monitoring can detect signs of hypoxia in the blood, allowing caregivers to take prompt action to reduce the risk of AES.

Amnioinfusion can be performed through the cervix or through the abdomen, where the volume of amniotic fluid increases. Usually, saline solution or Ringer's lactate solution is administered, which may help to reduce problems related to acute decrease or absence of amniotic fluid, such as severe and variable delay during labor. It seems that this procedure reduces the risk of developing aspiration syndrome in newborns in the presence of amniotic fluid contaminated with al-Samik.

**-Prevention of late birth** Increased probability of inhalation in late birth (ie after 42 weeks of pregnancy). Therefore, the prohibition of giving birth after the specified date of birth reduces the risk of aspiration inhalation syndrome. Induction of labor at 39 weeks or more is considered an acceptable option for low-risk women who enjoy reliable and well-cared for pregnancy. It seems that this procedure contributes to reducing the incidence of respiratory diseases in newborns and other obstetric complications.

**Management of maternal health conditions** Diabetes and high blood pressure, these conditions must be dealt with actively during pregnancy, while adhering to the health care advice. Pregnant women are also advised to refrain from smoking, drinking alcohol, or using drugs..