1.3 Risk factors for resuscitation

Question 1

MATERNAL risk factors for resuscitation

Answer 1

• Bleeding in 2nd/3rd trimester
• Prolonged rupture of membranes (>18 hours before birth)
• HTN (either chronic or pregnancy induced)
• Chronic health conditions (esp. CV, thyroid, NEUR, RESP, RENAL, diabetes)
• Anaemia or isoimmunisation
• Previous foetal/infant death
• No antenatal care

Question 2

What is isoimmunisation

Answer 2

Mother’s blood type is incompatible with infants

Question 3

MATERNAL risk factors relating to drugs for resuscitation

Answer 3

• Substance abuse
• Specific prescribed drug therapies:
  > Lithium
  > Adrenergic blocking agents
  > MgSO4
  > Narcotics
  > SSRIs

Question 4

MATERNAL risk factors relating to age for resuscitation

Answer 4

< 16 or >35

Question 5

FOETAL risk factors for resuscitation

Answer 5

• Multiple gestation
• Pre-term (esp <35/40) or post term (>41/40)
• Large for gestational age (LGA)
• Reduced foetal movements before onset of labour
• Isoimmunisation
• Intrauterine infection or perinatal trauma
• Congenital abnormalities which may affect breathing

Question 6

INTRAPARTUM risk factors for resuscitation

Answer 6

• Foetal HR indicating anaemia or prolonged foetal hypoxia
• Non-reassuring foetal HR patterns on CTG
• Abnormal presentation (e.g. breech, face, brow, shoulder)
• Prolapsed cord
• Prolonged labour (>24 hours) or prolonged 2nd stage labour (>2 hours)
• Antepartum haemorrhage
• Forceps or vacuum-assisted birth
• C-section under GA
• Meconium in amniotic fluid with non-reassuring CTG
• Narcotic administration to mother within 4/24 of birth