NCM 101 SKILLS

FINALS

Care of Mother, Child and Family

APGAR SCORING
 APGAR SCORING
Dr. Virginia Apgar, an
anesthesiologist
developed the score in
1952 in order to
quantify the effects of
obstetric anesthesia on
babies.
 APGAR SCORING
• The APGAR is a quick, overall
assessment of newborn well-being.

• The Apgar score provides an accepted

and convenient method for reporting the
status of the newborn infant immediately
after birth and the response to
resuscitation if needed.
 APGAR SCORING
1ST minute
determines how well the baby tolerated the
birthing process
5TH minute
tells the health care provider how well the
baby is doing outside the mother's womb.
15TH minute (optional)
 KEYPOINTS..
• The Apgar score describes the condition of
the newborn infant immediately after birth
and, when properly applied, is a tool for
standardized assessment

• It also provides a mechanism to record fetal-

to-neonatal transition.
 KEYPOINTS..
• The Apgar score is affected by many factors,
including gestational age, maternal
medications, resuscitation, and
cardiorespiratory and neurologic conditions.
See checklist
CUTTING AND CLAMPING
OF CORD
At the time of birth, an infant is still attached
to the mother via the umbilical cord, which is
part of the placenta.

The infant is usually separated from the

placenta by clamping the umbilical cord.
Optimal timing of cord clamping:
1.Early cord clamping/immediate cord
clamping
•carried out in the first 60 seconds after birth
2. Delayed cord clamping (DCC)
•more than one minute after the birth
3. When cord pulsation has ceased
WHO recommendations
WHO recommendations
•Delayed umbilical cord clamping (not earlier
than 1 min after birth) is recommended for
improved maternal and infant health and
nutrition outcomes.
 Delayed cord clamping
• Prolongation of the time between the delivery
of a newborn and the clamping of the
umbilical cord.
• Allows more blood to transfer from the
placenta to the baby, sometimes increasing
the child’s blood volume by up to a third.
• The iron in the blood increases the
newborn’s iron storage, which is vital for
healthy brain development.
 Delayed cord clamping
BENEFITS
1. Increase in placental transfusion:
60% increase of RBCs and a 30%
increase in neonatal blood volume
2. decreased risk of iron deficiency anemia:
reduces the risk of the baby suffering
from the severe side effects associated
with iron deficiency
 Delayed cord clamping
BENEFITS
3. Lungs get more blood so that the
exchange of oxygen into the blood can take
place smoothly
 Delayed cord clamping
RISKS
1.Hyperbilirubinemia
2.Polycythemia
3.Respiratory distress
 Delayed cord clamping
RISKS
1.Hyperbilirubinemia
Bilirubin levels build up too much in the
blood that causes a yellowish tint to the eyes
and skin, called jaundice due to increased
iron stores.
Often requires phototherapy to reduce it
 Delayed cord clamping
RISKS
2. Polycythemia
Occurs when there is an excess of red blood
cells in circulation.
This can cause issues with breathing,
circulation, and may lead to
hyperbilirubinemia.
 Delayed cord clamping
RISKS
3. Respiratory distress
Occurs when there is not enough of a liquid coating
in the lungs (surfactant) after birth to keep the
airways and tiny alveoli of the lungs open.
Delayed absorption of lung fluid due to the
increase in blood volume may cause transient
tachypnea (rapid breathing).
• See checklist
VITAL STATISTICS/
ANTHROPOMETRIC
MEASUREMENTS
 CREDE’S PROPHYLAXIS
-eye prophylaxis
-prevents Opthalmia Neonatorum
Gonnorheal Conjunctivitis
-Erythromycin (0.5%) or Tetracycline (1%)
ophthalmic ointment
SEE CHECKLIST
 VITAMIN K ADMINISTRATION

(Phytomenadione; Aquamephyton)
a.Prevents hemorrhage related to
physiologic hypoprothombinemia
b.Preterm: 0.5 mg IM; term: 1-1.5 mg IM
c.Via vastus lateralis or lateral anterior thigh
See checklist
OIL BATH
BATHING AN INFANT