The Neonatal Period

Successful delivery and satisfactory condition of the mother and depend upon the proper prenatal, intranatal and postnatal care.

The mother’s mental and physical health during pregnancy is of great importance to her unborn child. Effective care of the pregnant woman includes her preparation for the nursing and care of her child, and also her education in caring for her own health and that of her family.

Every pregnant woman must be given regular gynecologic and obstetric examinations at her district women’s consultation. These examinations include external examination, pelvimetry, internal gynecologic examination, measuring the patients’ weight and height and laboratory studies. Constant supervision and care during the prenatal period may help in detecting and preventing possible complications of pregnancy, difficulties of labor, neonatal morbidity and mortality.

At birth the fetus is forced to change the whole order of its existence from parasitic to individual life. The physiological readjustments consequent upon birth involve most of the child’s systems, and danger may arise if the respiratory apparatus, the temperatureregulating mechanism or the antibacterial defenses do not begin to function satisfactorily.

Formerly, morbidity and mortality in the newborn were the exclusive concern of the obstetrician. Now, pediatrics has added to itself the new and exciting filed of neonatology. The part played by the pediatrician in the maternity service has become very important, as it is clear now that beneficial results of adequate neonatal care or its lack extend through entire life span.

During the immediate neonatal period the pediatrician must concern himself with three major aspects. Firstly, some babies will require special care because of prematurity, low birth weight, congenital malformations, birth trauma, or other disabilities. For such cases the pediatricians assume full clinical responsibility. Secondly, all normal fullterm babies should be under pediatric management and receive specialized evaluation and supervision. Thirdly, it is important for all newborn infants to be thoroughly examined shortly after birth and before discharge, to exclude developmental defects and deviations from normal. Many neonatal problems may arise after the second day of life in apparently well babies. These problems include the adjustment of correct breast feeding, detection of some congenital malformations and such conditions as hyperbilirubinemia, postnatal infection and tetany. The factors which predispose to infection and should alert pediatricians suspicion are maternal perinatal infection, premature birth, prolonged rupture of amniotic membranes and prolonged labor.

In the early 40s it was revealed that maternal infection with some viruses, rubella virus, for example, in the first trimester of pregnancy may cause, in the infant, deafness, cataract, cardiac anomalies, and sometimes brain damage resulting in mental and motor retardation, microcephaly, or hydrocephaly. A more close and extensive study of the neonatal rubella syndrome sequelae has shown that it includes a much wider range of clinical abnormalities.

Thanks to the achievements of medical science it has become possible to treat and to prevent many fatal neonatal disorders and to recognize at an early stage defects which may cause chronic diseases. Acute observation and intensive care have improved survival statics for newborns with developmental anomalies.