Managing Complications in Pregnancy and Childbirth: - IAWG

S-146 Immediate newborn conditions or problemsIf the mother received pethidine or morphine, naloxone is the antidotefor counteracting respiratory depression in the newborn caused by thesedrugs.Note: Do not administer naloxone to newborns whose mothers aresuspected of having recently abused narcotic drugs.• If there are signs of respiratory depression, begin resuscitationimmediately:- After vital signs have been established, give naloxone 0.1 mg/kgbody weight IV to the newborn;- Naloxone may be given IM after successful resuscitation if theinfant has adequate peripheral circulation. Repeated doses may berequired to prevent recurrent respiratory depression.• If there are no signs of respiratory depression, but pethidine ormorphine was given within 4 hours of delivery, observe the babyexpectantly for signs of respiratory depression and treat as above ifthey occur.CARE AFTER SUCCESSFUL RESUSCITATION• Prevent heat loss:- Place the baby skin-to-skin on the mother’s chest and coverthe baby’s body and head;- Alternatively, place the baby under a radiant heater.• Examine the newborn and count the number of breaths per minute:- If the baby is cyanotic (bluish) or is having difficulty breathing(less than 30 or more than 60 breaths per minute, indrawing ofthe chest or grunting), give oxygen by nasal catheter orprongs (below).• Measure the baby’s axillary temperature:- If the temperature is 36°C or more, keep the baby skin-toskinon the mother’s chest and encourage breastfeeding;- If the temperature is less than 36°C, rewarm the baby (pageS-148).