Resuscitation at birth.

Birth asphyxia is frequent and often severe, occurring in about 10% and 1% respectively of all births; in a third it is unexpected. Delivery rooms must be organised and equipped and trained staff readily available so as to provide appropriate and timely resuscitation of the newborn. Simple procedures designed to prevent hypothermia, maintain a patent airway, improve oxygenation and ventilation are sufficient for the majority of babies. Circulatory support and biochemical resuscitation will be needed in a few. In the absence of other abnormalities, the long term prognosis for newborns who respond promptly to resuscitation is good. Every baby, no matter how severely asphyxiated must therefore be promptly and vigorously resuscitated. Only those with a Apgar score of less than 4 at 10 minutes, prolonged hypotonia or seizures have a poor prognosis. With the needs in cardio-pulmonary resuscitation understood and met, research is now being directed at neuroresuscitation.