Obstetric dating accuracy
Obstetric dating accuracy - bones temporada 8x6 online dating
In the absence of randomized, controlled trials, there is insufficient evidence to recommend a change in the current practice of performing endotracheal suctioning of nonvigorous babies with meconium-stained amniotic fluid (Class IIb, LOE C).However, if attempted intubation is prolonged and unsuccessful, bag-mask ventilation should be considered, particularly if there is persistent bradycardia.
Oxyhemoglobin saturation may normally remain in the 70% to 80% range for several minutes following birth, thus resulting in the appearance of cyanosis during that time.Infants born to febrile mothers have been reported to have a higher incidence of perinatal respiratory depression, neonatal seizures, and cerebral palsy and an increased risk of mortality.and that suctioning of the trachea in intubated babies receiving mechanical ventilation in the neonatal intensive care unit (NICU) can be associated with deterioration of pulmonary compliance and oxygenation and reduction in cerebral blood flow velocity when performed routinely (ie, in the absence of obvious nasal or oral secretions).Several studies have demonstrated that a cesarean section performed under regional anesthesia at 37 to 39 weeks, without antenatally identified risk factors, versus a similar vaginal delivery performed at term, does not increase the risk of the baby requiring endotracheal intubation.With careful consideration of risk factors, the majority of newborns who will need resuscitation can be identified before birth.Recent studies have examined several aspects of these initial steps. Other techniques for maintaining temperature during stabilization of the baby in the delivery room have been used (eg, prewarming the linen, drying and swaddling, placing the baby skin-to-skin with the mother and covering both with a blanket) and are recommended, but they have not been studied specifically (Class IIb, LOE C).
All resuscitation procedures, including endotracheal intubation, chest compression, and insertion of intravenous lines, can be performed with these temperature-controlling interventions in place (Class IIb, LOE C).
Other studies have shown that clinical assessment of skin color is a very poor indicator of oxyhemoglobin saturation during the immediate neonatal period and that lack of cyanosis appears to be a very poor indicator of the state of oxygenation of an uncompromised baby following birth.
Optimal management of oxygen during neonatal resuscitation becomes particularly important because of the evidence that either insufficient or excessive oxygenation can be harmful to the newborn infant.
When a pulse is detectable, palpation of the umbilical pulse can also provide a rapid estimate of the pulse and is more accurate than palpation at other sites.
A pulse oximeter can provide a continuous assessment of the pulse without interruption of other resuscitation measures, but the device takes 1 to 2 minutes to apply, and it may not function during states of very poor cardiac output or perfusion.
Those newly born infants who do not require resuscitation can generally be identified by a rapid assessment of the following 3 characteristics: If the answer to all 3 of these questions is “yes,” the baby does not need resuscitation and should not be separated from the mother.