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Neonatal Resuscitation | Obstetrics

This section is being included on both the OB/GYN and Pediatric Categories.

Neonatal Resuscitation

Newborn = first few hours of life
Neonate = first 28 days
Infant > 28 days < 1 year
About 6% of deliveries require some type of life support. Complications increase as birth weight goes down. 20x more likely to die.

Size : best chances for babies 3000-4000 grams and over 36 weeks gestation
Low birth weight is considered under 2500 grams
Moderately low is 1501 to 2500
Very low less than 1500
Extremely low less than 1000

Gestational age
Premature/Preterm born before 37 weeks
Full term 38-42 weeks
Postmature after 42 weeks

Mortality
Live birth: neonate that has any sign of breathing, heartbeat or any voluntary movement
Fetal death: after 20 weeks gestation, before delivery, no signs of life after birth
Early Neonatal death: first week, Neonatal death is first 28 days
Perinatal mortality: total # of fetal and early neonatal deaths per 1000 live births
Postnatal death: 28 days to 1 year

Life OUTSIDE:
Respiratory System: breathing is the most critical and immediate change required. Stimuli are thermal (cold outside the womb) and chemical (low O2, high CO2 and low pH). These factors stimulate the medulla.

Circulatory System: changes are more gradual and are a response to pressure changes. Fetal shunts close: the foramen ovale and the ductus arteriosus.
Thermoregulation: Large surface ares, thin layer of fat and can’t shiver, so wrap them up quick and cover their heads
Hemopoietic System: Full term newborn has 80-85 mL of blood/kg of body weight. Most have about 300 mL at birth

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