Integrated Maternal and Newborn Care Basic Skills Course ...

CAUSES OF BIRTH ASPHYXIA
Some causes of birth asphyxia are noted below. It should be noted, however, that up to 50
percent of newborns who require resuscitation may have no identifiable risk factors before birth.
Hence, persons attending any delivery should be prepared and ready to initiate resuscitation, if
required.
Maternal causes for birth asphyxia include:
• eclampsia
• bleeding (e.g., placenta previa/abruption)
• fever
• maternal sedation/anesthesia
• abnormal presentations
• prolonged/difficult labor
• infections such as malaria, syphilis, tuberculosis, and HIV/AIDS
Causes in the newborn include:
• cord prolapse/knot
• thick meconium in the amniotic fluid (may be due to fetal distress, but if aspirated into
the lungs may perpetuate asphyxia after birth)
• prematurity/IUGR
• post-maturity
• multiple births
• selected congenital malformations
PREPARATION FOR RESUSCITATION
The cry of the baby at birth is generally considered to be the first sign of extrauterine life and
good health. Most newborns cry and start breathing immediately after birth and adapt well to the
extrauterine environment. All that is needed is to be surrounded by a clean and warm
environment and to be carefully monitored. Breathing must be established before the baby is
given to the mother to be kept warm.
A suitable room and the necessary equipment should be ready, and health workers should be
well prepared for resuscitation at every birth without delay. The life and brain of the infant are
at stake. While routine essential care of the baby can be carried out while the baby is placed on
the mother’s abdomen or chest, it is convenient to designate a “newborn baby corner or area”
where resuscitation and other special care for the baby can be carried out. It should have a
table with a firm mattress covered with a clean rubber or plastic sheet and a clean, preferably
sterile cloth, under a warmer where all necessary equipment and supplies can be placed and
readily accessed.
Equipment for Preventing Hypothermia
The following equipment is recommended for preventing hypothermia:
• A warm room. Make sure the room is warm, with no drafts or open windows.
• A source of heat.
• A clean treatment surface/table should be available, preferably with an overhead
warmer. Where overhead heaters are very expensive, a “warming table” can be
manufactured locally by fixing either a heating rod or 2-3 bulbs on a wooden frame (as
shown in Figure 8.1), taking care that the wiring is well done in order to avoid inadvertent
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Integrated maternal and newborn care
Basic skills course