Neonatology pp 217-220 | Cite as

Neonatal Care in the Delivery Room: Initial Management

  • Tara M. Randis


Ancient accounts of neonatal resuscitation strategies may be found in the Old Testament, the Talmud, and early writings of Hippocrates [1]. Mouth-to-mouth resuscitation of newborns was described as early as 1472 in a textbook on childhood diseases written by Bagellardeus [2]. While, some of these early resuscitation practices were truly revolutionary, the vast majority reflected a limited understanding of the dramatic physiologic changes that take place during birth. Techniques including swinging the infant upside down, immersion in cold water, electric shock, shaking, yelling, slapping and even insufflation of tobacco smoke into the rectum were widely practiced as recently as the early 20th century [1, 2, 3]. In 1953, Virginia Apgar wrote the following regarding the resuscitation of newborn infants:

Seldom have there been such imaginative ideas, such enthusiasm, and dislikes, and such unscientific observations and study about one clinical picture. There are outstanding exceptions to these statements, but the poor quality and lack of precise data of the majority of papers concerned with infant resuscitation are interesting. [4]


Positive Pressure Ventilation Delivery Room Minute Apgar Score Maternal Fever Admission Temperature 


  1. 1.
    O’Donnell CP, Gibson AT, Davis PG (2006) Pinching, electrocution, ravens’ beaks, and positive pressure ventilation: a brief history of neonatal resuscitation. Arch Dis Child Fetal Neonatal Ed 91:F369–F373PubMedCrossRefGoogle Scholar
  2. 2.
    Wiswell TE, Gibson AT (2005) Historical evolution of neonatal resuscitation. American Academy of Pediatrics, Neonatal Resuscitation Program, Instructor Resources 2005Google Scholar
  3. 3.
    Raju TN (1999) History of neonatal resuscitation. Tales of heroism and desperation. Clin Perinatol 26:629–640, vi-viiPubMedGoogle Scholar
  4. 4.
    Apgar V (1953) A proposal for a new method of evaluation of the newborn infant. Curr Res Anesth Analg 32:260–267PubMedGoogle Scholar
  5. 5.
    Chamberlain D (2005) The International Liaison Committee on Resuscitation (ILCOR)-past and present: compiled by the Founding Members of the International Liaison Committee on Resuscitation. Resuscitation 67:157–161PubMedCrossRefGoogle Scholar
  6. 6.
    Halamek LP (2008) The simulated delivery-room environment as the future modality for acquiring and maintaining skills in fetal and neonatal resuscitation. Semin Fetal Neonatal Med 13:448–453PubMedCrossRefGoogle Scholar
  7. 7.
    Carbine DN, Finer NN, Knodel E, Rich W (2000) Video recording as a means of evaluating neonatal resuscitation performance. Pediatrics 106:654–658PubMedCrossRefGoogle Scholar
  8. 8.
    Kattwinkel J (ed) (2011) Textbook of Neonatal Resuscitation, 6th edn. American Academy of Pediatrics and American Heart Association, Elk Grove Village, ILGoogle Scholar
  9. 9.
    Aziz K, Chadwick M, Baker M, Andrews W (2008) Ante-and intra-partum factors that predict increased need for neonatal resuscitation. Resuscitation 79:444–452PubMedCrossRefGoogle Scholar
  10. 10.
    Walker D, Walker A, Wood C (1969) Temperature of the human fetus. J Obstet Gynaecol Br Commonw 76:503–511PubMedCrossRefGoogle Scholar
  11. 11.
    Silverman WA, Fertig JW, Berger AP (1958) The influence of the thermal environment upon the survival of newly born premature infants. Pediatrics 22:876–886PubMedGoogle Scholar
  12. 12.
    Laptook AR, Salhab W, Bhaskar B (2007) Admission temperature of low birth weight infants: predictors and associated morbidities. Pediatrics 119:e643–e649PubMedCrossRefGoogle Scholar
  13. 13.
    Costeloe K, Hennessy E, Gibson AT et al (2000) The EPICure study: outcomes to discharge from hospital for infants born at the threshold of viability. Pediatrics 106:659–671PubMedCrossRefGoogle Scholar
  14. 14.
    Anderson GC, Moore E, Hepworth J, Bergman N (2003) Early skin-to-skin contact for mothers and their healthy newborn infants. Birth 30:206–207PubMedCrossRefGoogle Scholar
  15. 15.
    Cramer K, Wiebe N, Hartling L et al (2005) Heat loss prevention: a systematic review of occlusive skin wrap for premature neonates. J Perinatol 25:763–769PubMedCrossRefGoogle Scholar
  16. 16.
    Perlman JM (2006) Hyperthermia in the delivery: potential impact on neonatal mortality and morbidity. Clin Perinatol 33:55–63, viPubMedCrossRefGoogle Scholar
  17. 17.
    Shalak LF, Perlman JM, Jackson GL, Laptook AR (2005) Depression at birth in term infants exposed to maternal chorioamnionitis: does neonatal fever play a role? J Perinatol 25:447–452PubMedCrossRefGoogle Scholar
  18. 18.
    Impey L, Greenwood C, MacQuillan K et al (2001) Fever in labour and neonatal encephalopathy: a prospective cohort study. BJOG 108:594–597PubMedCrossRefGoogle Scholar
  19. 19.
    American Academy of Pediatrics, American College of Obstetricians and Gynecologists and Committee on Obstetric Practice (2006) The Apgar score. Pediatrics 117:1444–1447CrossRefGoogle Scholar
  20. 20.
    Casey BM, McIntire DD, Leveno KJ (2001) The continuing value of the Agar score for the assessment of newborn infants. N Engl J Med 344:467–71PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2012

Authors and Affiliations

  • Tara M. Randis
    • 1
  1. 1.Department of Pediatrics, Division of Neonatology/PerinatologyColumbia UniversityNew YorkUSA

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