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Neonatal resuscitation in the delivery room

Caraciolo J Fernandes, MD
Section Editor
Leonard E Weisman, MD
Deputy Editor
Melanie S Kim, MD


The successful transition from intrauterine to extrauterine life is dependent upon significant physiologic changes that occur at birth. Although most newborns successfully make this transition at delivery without requiring any special assistance, a small but significant number will require additional support, including resuscitation in the delivery room.

The indications and principles of neonatal resuscitation will be reviewed here. The physiological changes that occur in the transition from intrauterine to extrauterine life are discussed separately. (See "Physiologic transition from intrauterine to extrauterine life".)


Being prepared is the first and most important step in delivering effective neonatal resuscitation [1]. Most newborns in the United States are healthy and do not require additional special assistance, and the need for resuscitation is often not anticipated even in tertiary birth centers [2,3]. However, in the United States, 10 percent of all newborns need some intervention, and 1 percent will require extensive resuscitative measures at delivery [1]. As a result, at every birthing location, personnel who are adequately trained in neonatal resuscitation should be readily available to perform neonatal resuscitation whether or not problems are anticipated [1].

In all instances, at least one healthcare provider is assigned primary responsibility for the newborn infant. This person should have the necessary skills to evaluate the infant, and, if required, to initiate resuscitation procedures, such as positive pressure ventilation and chest compressions. In addition, either this person or another who is immediately available should have the requisite knowledge and skills to carry out a complete neonatal resuscitation, including endotracheal intubation and administration of medications.

Equipment needed for resuscitation should be available at every delivery area (table 1), and routinely checked to ensure the equipment is functioning properly [1,4].

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Literature review current through: Nov 2017. | This topic last updated: Oct 27, 2017.
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