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Dr: Abir Mohedien Said 2011

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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.

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Preterm deliveries Vaginal breech deliveries Thick meconium Significant fetal distress Antepartum haemorrhage Serious fetal abnormality Forceps and vacuum deliveries Acute caesarean section Multiple deliveries

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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

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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

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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 )

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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

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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

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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

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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 )

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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

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Not breathing or HR