Réanimation du nouveau-né en salle de naissance

The need for resuscitation of a distressed newborn in the delivery room has become easily predictable owing to improvements in obstetrical survey and organization of perinatal care. Perinatal asphyxia and premature labour, especially before 32 weeks of gestational age, are the more frequent situation needing ressuscitation at birth. A good survey of pregnancy and labour, verification of availability and efficiency of care devices and material in the delivery room are essential. In all guidelines, respiratory resuscitation in the first minutes has become a priority. Non invasive positive pressure ventilation and early use of exogenous surfactant are the recent advances for the care of very premature baby in the delivery room. Availability of a neonatal ventilator and pulse oximetry monitoring is recommended and can improve results. For both the pregnant woman and the baby, if no contraindications exist and when it is possible, maternal transfer is preferred to postnatal transportation in case of very premature labour or high risk pregnancy. In all other situations, neonatal transport must be strictly organised and realised by a well-trained paediatric team, with adapted material and in the best conditions for security and comfort. The goal is to prevent any rupture until arrival in the referring neonatal intensive car unit.