What is the gestational age?
Is the amniotic fluid clear?
How many babies are expected?
Are there additional risk factors?
TABLE 31.1 Perinatal Risk Factors for Delivery C omplication
TABLE 31.2 Equipment Checklist for Neonatal Resuscitation
Does the baby appear to be full term?
Is there good muscle tone?
Is the infant breathing or crying?
Figure 31.2: Picture of a vigorous term infant. (From Ricci S. Essentials of Maternity, Newborn, and Women’s Health Nursing. 4th ed. Philadelphia, PA: Wolters Kluwer; 2016.)
of newborn care should be initiated: provide warmth, position head and neck to open the airway, clear airway secretions if necessary, dry, and stimulate (Figure 31.5).
Figure 31.4: Picture of a preterm infant with poor tone. (From MacDonald MG, Seshia MM. Avery’s Neonatology. 7th ed. Philadelphia, PA: Wolters Kluwer; 2015.)
at 74°F to 77°F and the newborn’s temperature should be kept between 36.5°C and 37.5°C.7 A servo-controlled temperature sensor can be applied to the skin to monitor the temperature. Additional support is needed to retain warmth in premature infants such as with a polyethylene plastic bag or wrap and thermal mattress.8
with blue lips, tongue, and torso. At the time of birth, healthy infants transition from an intrauterine state of 60% blood oxygenation to more than 90%.10 This transition can take several minutes (Figure 31.10). If persistent cyanosis is suspected, a pulse oximeter should be used to monitor the newborn’s oxygenation.
Figure 31.10: Preductal SpO2 changes after birth. (From Dawson JA, C. Kamlin OF, Vento M, et al. Defining the reference range for oxygen saturation for infants after birth. Pediatrics. 2010; 125(6): e1340-e1347.)