HIGH RISK CONDITIONS IN NEW BORN

HIGH RISK CONDITIONS IN NEW BORN
High risk newborns are those neonates whose condition is very severe at birth and
requires immediate interventions to prevent further complications and death of
neonate.

**Birth Asphyxia: -
Failure to initiate and maintain proper respiration characterized by hypoventilation,
anaerobic glycolysis and lactic acidosis.

ETIOLOGICAL FACTOR: -

(a)Antepartum Factors: -

▪ Malnutrition

▪ Anemia

▪ Gestational hypertension

▪ Pre-eclampsia

▪ Substance abuse

▪ Infections

▪ DM

(b) Intra partum Factors: -

▪ Prolonged labor

▪ Cord prolapses

▪ Tight umbilical cord around the fetal neck.

(c)Post partum factors: -

▪ Pulmonary cardiac vascular or neurological abnormalities of the new born.

CLINICAL MANIFESTATION: -
(a) Asphyxia livida:-

▪ Moderate distress

▪ It is stage of cyanosis

, ▪ Apgar scoring is 4-6

(b) Asphynia pallida;-

▪ Severe distress.

▪ Stage of shock.

▪ Shock occurs due to vasomotor failure.

▪ Apgar scoring is 0-3

MANAGEMENT:-

Section the new born:-

▪ Cut the umbilical cord

▪ Receive the body in pre warmed linen.

▪ Place under radiant warmer

▪ Slightly extend neck and provide stimulation.

▪ Than asses respiration, HR, Skin colour.

I. Respiration regular, HR above 100 and Acrocyanosis

Intervention: - Provide Routine care.

II. Respiration regular, HR above too in cyanosis

Intervention: - Provide O2 therapy.

III. Irregular respiration, HR above 100 and cyanosis.

Intervention: - provide positive pressure ventilation by bag and mask, and provide O2
therapy.

IV. Irregular respiration, HR below 100 and cyanosis.

Intervention: - Provide positive pressure ventilation by beg, and mask and O2 therapy.

V. Irregular respiration, HR below 60, and cyanosis.

Intervention: - start CPR.

**➢ Neonatal-Resuscitation: -
▪ For chest compression two methods can be used.