Aspects récents de la prise en charge du nouveau-né en salle de naissance

The need for resuscitation of a distressed newborn in delivery room is more and more easily predictible. The two principal reasons are improvment of obstetrical survey and best perinatal regionalisation. Perinatal asphyxia and premature labour, especially before 32 weeks of gestational age, are the more frequent situation needing rescuscitation at birth. A good survey of pregnancy and labor, verification of availability and efficiency of care devices and material in the delivery room are essential. In all guidelines respiratory resuscitation is today the priority in the first minutes. Non invasive positive pressure ventilation and early use of exogeneous surfactant are the recent advances for the care of very premature baby in delivery room. Having a neonatal ventilator and pulse oximetry monitoring is recommanded and can improve results. For the pregnant woman and the baby, maternal transfer if no contrindications exist and when it is possible, is prefered to postnatal transportation in case of very premature labor or high risk pregnancy. In all the other situations neonatal transport must be strickly organised and realised by well-trained pediatric 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.