Abstract:
An integrated approach is lacking for the management of childbirth and newborn care, even though their codependence is critical for improving maternal and newborn outcomes. FIGO\'s Prep-for-Labor rapid triage methods for women arriving at a clinical facility are addressed in earlier papers in this Supplement, but do not include newborn care. Immediate postpartum rapid triage using established Apgar score helps determine whether standard of care can be followed on site with available staff/tools. If not, newborn transfer alone or with the mother to a higher-level center as soon as feasible may be required. Updated newborn management tools with special emphasis on pragmatic steps that are applicable for any clinical setting including low- and middle-income countries (LMICs) are presented in this article. Given that more than 80% of newborn care can be managed at the birthing facility, transfer to a higher-level center for care is required only in selected cases. Management steps for healthy newborns are described and the actions needed for those requiring resuscitation are summarized. The simple noninvasive kangaroo mother care approach-universally applicable for both term and preterm newborns-is associated with a significant reduction in morbidity and mortality. Kangaroo mother care involves continuous maternal skin-to skin contact from birth, exclusive breastfeeding, and home support after discharge. Hence, hypothermia, hypoglycemia, and acquired infections are frequently prevented. It is anticipated that implementing simple noninvasive management steps will have a substantial positive impact on improving maternal and newborn outcomes.
摘要:
分娩和新生儿护理管理缺乏综合办法,尽管它们的共同依赖性对于改善孕产妇和新生儿结局至关重要。FIGO为到达临床设施的妇女提供的临产快速分诊方法在本补编的早期论文中有所论述,但不包括新生儿护理。使用已建立的Apgar评分立即进行产后快速分诊,有助于确定是否可以在现场使用可用的工作人员/工具来遵循护理标准。如果不是,可能需要新生儿单独或与母亲一起尽快转移到更高级别的中心。本文介绍了更新的新生儿管理工具,特别强调适用于包括低收入和中等收入国家(LMICs)在内的任何临床环境的务实步骤。鉴于超过80%的新生儿护理可以在分娩机构进行管理,只有在某些情况下,才需要转移到更高级别的中心进行护理。描述了健康新生儿的管理步骤,并总结了需要复苏的新生儿所需的措施。简单的非侵入性袋鼠母亲护理方法-普遍适用于足月和早产新生儿-与发病率和死亡率的显着降低相关。袋鼠母亲护理包括从出生起持续的母亲皮肤与皮肤接触,纯母乳喂养,出院后的家庭支持。因此,体温过低,低血糖,获得性感染经常被预防。预计实施简单的非侵入性管理步骤将对改善孕产妇和新生儿结局产生重大积极影响。