Skip to Main Content

THE IMPACT OF NEWBORN RESUSCITATION

The vast majority of newborn infants have a successful transition from intrauterine to extrauterine life without need of assistance; however, approximately 10% require some degree of resuscitative support in the delivery room. The presence of certain antepartum, intrapartum, or postpartum risk factors predicts many but certainly not all infants who require help in the delivery room (Table 44-1). Premature infants, when compared to term infants, are at particular risk for a difficult transition following birth. The most common contributing factor for infants in need of resuscitation is asphyxia. Asphyxia results in concomitant hypoxia and hypercapnia and causes a mixed metabolic and respiratory acidosis. The asphyxia can result from either failure of placental gas exchange before birth or deficient pulmonary gas exchange once the newborn is delivered.

TABLE 44-1ANTEPARTUM, INTRAPARTUM, AND POSTPARTUM FACTORS ASSOCIATED WITH NEED FOR NEWBORN RESUSCITATION

Prompt, effective reversal of asphyxia (with a major focus on effective ventilation) can potentially prevent or minimize multiorgan failure, death, and disability. Nearly 1 million newborns worldwide die from birth asphyxia. As a result, development of competence in effective newborn resuscitation could make a profound global impact on the health of children.

ANTICIPATION AND PREPARATION

Anticipation and planning for both expected and unexpected neonatal emergencies is essential for success. If a fetus is at high risk for needing resuscitation in the delivery room, antepartum triage to a center with expertise in high-risk stabilization should be attempted if it is safe to do so. Regardless, every birth should have at least 1 person immediately available to focus solely on the newborn to assess the need for and to perform resuscitation, if required. That ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.