Over 130 million babies are born worldwide every year, in the
industrialized countries less than 1% of these babies will die
where the death rate is 6% in least develop countries special among
premature babies.
The most usual assessment at birth, the reason for a low Apgar
score may not be asphyxia, but the baby certainly has a problem It
is helpful because it has become an internationally recognized
shorthand way of summarizing the condition of babies at birth and
their response to resuscitation The Apgar score is usually record
at 1 and 5 and 10 minutes If the Apgar score is still low at 5
minutes, further observations should be made at intervals
Slide 5
SignsignScore 0Score 1Score 2 Heart rateAbsent< 100> 100
Respiratory effort AbsentGasping or irregular Regular or crying
Muscle toneFlaccidSome limb tone Active ReflexNoneGrimaceCry or
cough ColorWhiteBluepink
Slide 6
Temp: new babies cool rapidly and need to be kept warm Drey and
wrap in a warmed, strile cotton blanket, room temp 25-27 degree c
Infection;all babies are at a higher risk of infection. ( wipe baby
clean of vernex, blood, meconium after birth. wash eyes, face, skin
and genitals, reguler cleaning of umbilical stump until separation
)
Slide 7
Exam; all newborn babies should be exam.after delivary General
observation Breathing pattern and rate Neurological behavior, cry
and movements Skin pallor and cyanosis Head Anterior fontanel
tention Eyes check epicanthic folds and subconjuctival HG Check for
cleft lip and pallat
Slide 8
Upper limbs: count digits and note intergital webbing, palmer
creases Chest: auscultate for respiration sounds, heart sound
Abdomen: umbilicus check tow arteries and one vein Umbilical hernia
Palpate abdomen for masses Groins for femoral pulses and hernia
Anus ; check patency
Slide 9
Genetalia Female:clitoris size Male:hypospadius,undescended
testes,hydrocele Back Myelomeningocele,midline hairy
patch,suggesting spina bifida, any kyphosis or scoliosis Lower
limbs Exam,hip for congenital dislocation Number of digits, talipes
deformity of ankles &feet
Slide 10
Measurements of body size Weight occipito frontal head
circumference crown heal length Cord care Reclamp cord with plastic
clip,keep dry after washing, separate on about 8-10 day Blood
glucose Small for date Preterm Infants of diabetic mothers( at risk
of hypoglycemia )
Slide 11
A healthy baby born blue but cries within seconds, god tone and
activity with HR > 100, and how rapidly turns pink, leave this
baby alone ( dry him, wrap him in a warm towel and give him back to
his mother, do not suck him out because risk of vagal bradycardia)
Non breathing regularly, but HR>100 bpm,and remaining centrally
cyanosed, dry the baby and place him under a radiant heat ( drying
often provides enough stimulation to induce breathing but gentle
rubbing can also be used) if there is no response, begin active
resuscitation using facemask