Chapter 42 Neonatology - MedicNS：42章- medicns新生儿科.pptVIP

Neonatal Assessment The Need for Resuscitation Most term newborns require no resuscitation beyond maintenance of temperature, suctioning of the airway, and mild stimulation Approximately 6% of deliveries require life support Incidence of complications increases as birth weight decreases The Need for Resuscitation Antepartum (before labor and delivery) and intrapartum (during labor and delivery) risk factors may affect the need for resuscitation When any of these risk factors are present during delivery or imminent delivery, prepare equipment and drugs that may be required for neonatal resuscitation Medical direction should also be advised of the situation so that the appropriate destination hospital can be determined. Antepartum Risk Factors Multiple gestation Inadequate prenatal care Mother’s age Less than age 16 or more than 35 History of perinatal morbidity or mortality Post-term gestation Drugs/medications Toxemia, hypertension, diabetes Intrapartum Risk Factors Premature labor Meconium-stained amniotic fluid Rupture of membranes greater than 24 hours before delivery Use of narcotics within 4 hours of delivery Abnormal presentation Prolonged labor or precipitous delivery Prolapsed cord Bleeding The Premature Infant Refers to a baby born before 37 weeks gestation The weight of these newborns is often between 0.6 to 2.2 kg [1.5 to 5 pounds] Premature infants have an increased risk for: Respiratory depression Hypothermia Head and brain injury Resuscitation should be attempted if the infant has any signs of life Congenital Anomalies Choanal atresia A bony or membranous occlusion that blocks the passageway between the nose and pharynx Can result in serious ventilation problems in the neonate Cleft lip One or more fissures that originate in the embryo A vertical, usually off-center split in the upper lip that may extend up to the nose Congenital Anomalies Cleft palate A fissure in the roof of the mouth that runs along its midline May extend through both the hard and