PESHAWAR: Neonatal resuscitation skills are essential for all healthcare providers involved in the delivery of newborns to prevent deaths through supply of oxygen to brain immediately after birth, according to experts.

“A few seconds delay in resuscitation can lead to complications, which are totally avoidable through timely resuscitation,” says an article published in Khyber Medical College (KMC)’s newsletter ‘Health Beat’.

The 39-page article authored by Dr Mohammad Kashif Afridi, Dr Shazia Bihar and Dr Hamid Bangash under the supervision of Dr Sabahat Amir, the chairperson of KMC’s paediatric department, says that five to 10 per cent of all newborns require assistance to establish breathing at birth and simple warming, drying, stimulation and resuscitation may reduce neonatal mortality and prevent brain damage.

It says that of 100 babies, 90 need no resuscitation but they should be just kept dry. Entitled “Neonatal Resuscitation Training,” it seeks to minimise delay in newborn resuscitation by imparting practice-based skills to staff including doctors, nurses and midwives to enable them to participate effectively in newborn resuscitation, update their knowledge skills and competencies and importance of golden minute.

Say delay in resuscitation can lead to complications

Dr Hamid Bangash, who is also focal person for neonatal resuscitation, told Dawn that newborns were at high risk of a condition known as “Hypoxic Ischemic Enclopathy” soon after delivery and neonatal resuscitation was a series of emergency procedures performed by a doctor to support the babies, who were not breathing or were gasping or had a weak heartbeat at birth.

“These skills allow a doctor to save the lives of newborn babies. The infants, who do not require resuscitation, can generally be identified by a rapid assessment of the three characteristics including term gestation, crying or breathing and good muscle tone,” he said.

Dr Hamid said that each year, approximately two million pregnancies ended in stillbirth and more newborns died within the first month after birth. The first step in implementing quality resuscitation is to ensure that healthcare providers have the appropriate knowledge and skills to help a newborn breathe.

According to him, over 90pc of such deaths occur in low and middle-income countries, most which are preventable. More than one-third of neonatal deaths are attributed to events that occur during the intrapartum period. A common consequence of these events is a failure of the newborn to breathe, which is referred to as respiratory depression.

Neonatal asphyxia accounts for 20.9 per cent of neonatal deaths. Although 90 per cent of newly-born infants don’t require intervention to breathe during transition from intrauterine to extrauterine life, approximately 10 per cent of them need some assistance to start breathing at birth while one per cent of them require extensive resuscitative measures.

“The goals of neonatal resuscitation are to prevent the morbidity and mortality associated with hypoxic-ischemic tissue (brain, heart, and kidney) injury and also to re-establish adequate spontaneous respiration and cardiac output,” said. Dr Hamid.

He said that there were 18,984 live births on average per day, 791 in an hour and 4,797 deaths on average per day. “We have imparted training to 60 health professionals in eight sessions,” he added.

Published in Dawn, April 17th, 2023