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What are the critical facts in the history that should be elicited, if possible, prior to delivery?
The standard maternal history is important but may need to wait until after delivery because of the imminent birth of the infant. Critical information may need to be narrowed to facts that may affect the immediate preparation (equipment and personnel) for the delivery.
It is important to ask if the expectant mother knows if she is having twins. Additional resuscitation equipment as well as personnel should then be quickly gathered. Ideally there should be a resuscitation area, equipment, and personnel for each expected newly born infant.
The expected due date is crucial to determine if the newly born infant will be premature and, if so, approximately how premature. Infants born at less than 36 weeks’ gestation are more likely to be born “unexpectedly” and will more likely need resuscitation. Smaller caliber equipment will be needed.
The color of the amniotic fluid is important. If the fluid is meconium-stained (greenish), then one should anticipate a distressed newly born infant with or without airway obstruction from the meconium. The infant may require intubation with suctioning. Equipment should be available, and personnel should be aware of this clinical situation.
Sources
Hazinski MF (ed): Textbook of Pediatric Advanced Life Support. Dallas, American Heart Association, 2002.
