Abstract
Apparently stillborn neonates are born in the terminal stage of secondary apnoea and respond poorly to basic resuscitation procedures proposed by the Neonatal Resuscitation Program (NRP). Increasing experimental and clinical evidence shows that stringently adhering to the NRP guidelines may delay sufficient ventilation and chest compressions and consequently prolong the duration of asystole in apparently stillborn neonates. To add to this information, we summarized our experience with the resuscitation of apparently stillborn neonates and reported the neonatal outcomes in a cohort of apparently stillborn neonates resuscitated at a tertiary care center in China.
Highlights
The definition of apparent stillbirth is inconclusive, it generally refers to a severely asphyxiated neonate with a 1-min Apgar score (AS1) of 0–1 in a clinical setting [1–3], a neonate who had a heartbeat before or during labor
It is estimated that 44% of stillbirths and 73% of newborn deaths occur around the time of labor and within the first week after birth, with birth asphyxia among the most common causes of deaths [4]
Stillborn neonates are often born in the stage of secondary apnoea, a situation in which their central nervous system and direct diaphragmatic functioning are depressed due to prolonged hypoxia [6]
Summary
The definition of apparent stillbirth is inconclusive, it generally refers to a severely asphyxiated neonate with a 1-min Apgar score (AS1) of 0–1 in a clinical setting [1–3], a neonate who had a heartbeat before or during labor. Sharma et al investigated the time that resuscitators needed to perform the steps required for corrective ventilation (MRSOPA) and the time to initiate chest compressions in bradycardic and asystolic newborns. The authors reported that many resuscitators preferred early endotracheal intubation instead of the MRSOPA method considering that corrective steps may delay the initiation of intubation and chest compressions in newborns with severe cardiovascular. Apparent stillbirth in this report refers to neonates with continuous fetal bradycardia (
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