Attendance at delivery (when requested by the delivering physician or other qualified health care professional) and initial stabilization of newborn
CPT4 code
Name of the Procedure:
Attendance at Delivery and Initial Stabilization of Newborn
Summary
This procedure involves a healthcare professional being present during the birth of a baby to assist and ensure the newborn is stable immediately after delivery.
Purpose
The purpose is to provide immediate care to the newborn, addressing any potential health issues right after birth. The goal is to ensure the baby is breathing well, has a stable heart rate, and any immediate medical needs are quickly addressed to prevent complications.
Indications
This procedure is necessary when there are concerns about the baby's health during labor and delivery, such as premature birth, distress in the mother or baby, or other high-risk factors. It is also performed when requested by the delivering physician or healthcare provider.
Preparation
No specific preparation is needed from the patient, but the healthcare team may review the mother's and baby's medical history and monitor vital signs closely during labor.
Procedure Description
- The healthcare professional attends the delivery of the baby.
- Once the baby is born, they are immediately assessed for breathing, heart rate, and overall condition.
- If necessary, interventions such as suctioning the airways, providing oxygen, or performing resuscitation may be done.
- The newborn is typically dried, kept warm, and monitored for any signs of distress.
- Apgar scores are recorded at 1 and 5 minutes post-birth to assess the baby's health.
Tools and equipment used can include a suction device, oxygen mask or bag, resuscitation bag, and warming blankets. Anesthesia is not applicable to the newborn but may be used for the mother during delivery.
Duration
The initial stabilization typically takes about 10 to 15 minutes but could extend longer if the baby requires intensive care.
Setting
This procedure is performed in a hospital's labor and delivery room or a specialized birthing center.
Personnel
The procedure involves:
- Pediatricians or neonatologists
- Labor and delivery nurses
- Respiratory therapists (if needed)
Risks and Complications
Although it is generally safe, possible complications include:
- Trauma during rapid interventions
- Infection if sterile procedures are not followed
- Hypothermia if the baby is not kept warm These risks are managed by closely monitoring the baby and using well-established protocols.
Benefits
The immediate benefit is ensuring the newborn's vital signs are stable and addressing any issues quickly to promote a healthy start to life. Benefits are typically realized within minutes to hours after birth.
Recovery
Post-procedure, the baby will be monitored closely for any changes in their condition. Follow-up includes continued observations and, if necessary, transfer to a neonatal intensive care unit (NICU). Instructions for parents may include feeding guidance and signs to watch for indicating the baby needs medical attention.
Alternatives
Alternatives depend on the situation but could include:
- Expectant management with a lower level of immediate intervention
- Transfer to a higher-care facility if anticipated risks are higher
The pros of the described procedure include immediate care and stabilization. The cons are the inherent risks of intervention. In cases of lower risk, less immediate intervention may be appropriate.
Patient Experience
Parents may feel anxious during the procedure but are usually reassured by the presence of a specialized team. For the newborn, the experience can involve discomfort during interventions but is generally brief. Pain management for the baby is usually unnecessary, and comfort measures like skin-to-skin contact with the mother are used whenever possible.