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Giving birth is a radical upheaval in human life. For it to occur successfully, structural and functional preconditions must be fulfilled. In the first stages of life numerous processes involving readaptation and adjustment of the organ systems to the extra-uterine conditions take place, especially of breathing, blood circulation and digestive organs. The newborn period cannot be exactly delimited biologically; for purposes of medical statistics, though, it lasts 28 days, divided into an early (1rst week of life) and later neonatal time.
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The care for the newborn is primarily determined by its vitality and maturity status.
The Apgar score (11) is a simple method to judge vitality. Heart activity, breathing, muscle tone, reaction to touch, and skin color are evaluated after one, five and ten minutes following birth with 0 (bad) to 2 (good). The five individual values are summed to form the Apgar score (asphyxia index) and documented. To some extent, the pH value in the blood of the umbilical artery is followed during the course of the delivery.
80% of newborns begin to breath within 20 seconds after delivery. A longer lasting apnea, as well as a bradycardia (frequency below 100/min.), is to be treated immediately. |
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Fig. 21 - Normal term baby |
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Fig. 21
The umbilical cord is pinched off. The small remainder of the umbilical cord dries very quickly and falls off. Caution regarding danger of infection (umbilical phlegmon) is advisable.
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In the newborn period several examinations, measures, and treatments that serve for early detection or prevention of disease take place. In this regard rachitis and hemorrhage prophylaxis (with vitamins D and K) can be mentioned.
Today, newborn screening comprises the following blood tests that can vary, depending on the maternity hospital:
- Hypothyroidism
- AGS (congenital AdrenoGenital Syndrome)
- Galactosemia
- Biotinidase insufficiency
- PKU (Phenylketonuria)
- Maple syrup disease
- Homocystinuria
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