48. Management of the newborn after delivery

Question 1

what are the steps to manage a newborn after delivery (6)?

Answer 1

1. clear the airway
2. dry the newborn
3. clamp the cord
4. Ensure onset of respiration
5. correct surfactant deficiency
6. manage skin- to- skin

Question 2

what is done to clear the airway (1)?

Answer 2

• When the head emerges from the vagina, the physician should use a towel or gauze pad to remove secretions from the face.
• Suction may be used to aspirate secretions from the oropharynx.
• If a moderate amount of meconium is present, placing a nasal tracheal catheter into the oropharynx and applying suction before delivering the body are thought to decrease the risk of meconium aspiration.

Question 3

what is done during drying of the newborn (2)?

Answer 3

• The newborn should be placed in a preheated environment and dried off with a towel
  before cutting the cord.
• This also serves to stimulate the onset of respiration.

Question 4

when and why is the clamping of the cord done?

Answer 4

usually performed 2-3 minutes after birth, referred to as
delayed cord clamping.
Recommended for both term and preterm deliveries, it allows
more blood to transfer from the placenta to the fetus, increasing the newborn’s blood volume by up to ⅓.

Question 5

If respiration has not commenced by 30 seconds, or if the heart rate is less than 100 beats/min’ what should be done?

Answer 5

the infant should be taken to the resuscitation team for further management

Question 6

how do we correct surfactant deficiency in premature infants?

Answer 6

Can be given by tracheal injection at birth to prevent the respiratory distress syndrome, or after the syndrome has developed to reduce its severity and to prevent mortality.

Question 7

when is skin- to-skin managed?

Answer 7

When possible, healthy, term babies should be managed skin-to-skin with their mothers after birth

Question 8

what is APGAR score?

Answer 8

Assessment of newborn vital signs following delivery via a 10-point scale; evaluated at 1 minute and 5 minutes.

Question 9

APGAR score of <7 ?

Answer 9

require further evaluation

*If the Apgar score remains low at later time points, there is an increased risk the child will develop long-term neurologic damage.

Question 10

what is A in APGAR?

Answer 10

Appearance
2- pink
1- extremities blue
0- pale or blue

Question 11

what is P in APGAR?

Answer 11

Pulse
2- >100 bpm
1- <100 bpm
0- no pulse

Question 12

what is G in APGAR?

Answer 12

Grimace
2-cries and pulls away
1- grimaces or weak cry
0- no response to stimulation

Question 13

what is the other A in APGAR score?

Answer 13

Activity
2- active movement
1- arms, legs flexed
0- no movement

Question 14

what is R in APGAR?

Answer 14

Respiration
2- strong cry
1- slow, irregular
0- no breathing