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December 1948

FETAL ANOXIA AT BIRTH AND CYANOSIS OF THE NEWBORN: Differential Diagnosis and Management

Author Affiliations

From the Boston Lying-In Hospital and the Departments of Obstetrics and Pediatrics, Harvard Medical School.

Am J Dis Child. 1948;76(6):666-678. doi:10.1001/archpedi.1948.02030030681007

ANOXIC INJURY is the primary cause of 60 per cent of deaths among full term and premature infants and of at least as high a proportion of neonatal morbidity. Anoxia may occur in utero at any time; it always occurs to some degree during the birth process, and it may develop after birth. The oxygen lack may be an isolated episode; it may be intermittent or continuous and of greater or less severity and duration. The condition is an overwhelming force that affects every organ and tissue of the body to a variable and unpredictable degree. The chaotic collection of clinical symptoms that oxygen lack can produce becomes better understood when these variables are considered and when the physiologic and pathologic changes produced by anoxia are appreciated.

Anoxia may produce an increased hydrogen ion concentration through an accumulation of carbonic and lactic acids. This acidosis in turn may result in

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