Risk factors
1.3. Risk factors for resuscitation: maternal, fetal & intrapartum
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| Photograph courtesy of The Age, 2005 |
Maternal
- Prolonged rupture of membranes
- >18 hours before the birth of the baby
- Bleeding in 2nd or 3rd trimester
- Severe pregnancy-induced hypertension
- Chronic hypertension
- Chronic maternal illness
- Cardiovascular
- Thyroid
- Neurological
- Pulmonary
- Renal
- Diabetes mellitus
- Anaemia or isoimmunisation
- Maternal substance abuse
- Maternal drug therapy
- Lithium
- Adrenergic blocking agents
- Magnesium sulphate
- Narcotics
- Selective serotonin reuptake inhibitors
- Fever, other acute illness, infection
- Chorioamnionitis
- Polyhydramnios & oligohydramnios
- Heavy sedation
- Previous fetal or neonatal death
- No antenatal care
- Size/dates discrepancy
- Young maternal age < 16 years
- Advanced maternal age > 35 years
- Indigenous mother
Fetal
- Multiple gestation
- Twins
- Triplets
- Quads and higher
- Preterm gestation, especially < 35 weeks
- Post-term gestation > 41 weeks
- Large for gestational age (LGA)
- Fetal growth restriction
- Rhesus or other isoimmunisation
- Reduced fetal movement before onset of labour
- Congenital abnormalities which may affect breathing
- Intrauterine infection
- Perinatal trauma
Intrapartum
- Sinusoidal fetal heart rate, indicating severe fetal anaemia or prolonged fetal hypoxia (N.B. requires immediate intervention)
- Non-reassuring fetal heart rate patterns on CTG
- Abnormal presentation
- Transverse lie
- Breech
- Face
- Brow
- Shoulder
- Prolapsed cord
- Prolonged labour > 24 hours
- Prolonged 2nd stage of labour > 2 hours
- Precipitate labour
- Antepartum haemorrhage
- Abruptio placenta
- Placenta praevia
- Vasa praevia
- Meconium in the amniotic fluid with a non reassuring CTG
- Narcotic administration to mother within 4 hours of birth of the baby
- Forceps or vacuum-assisted (Ventouse) birth
- Caesarean section under general anaesthetic
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