Calling The Neonatology Team To The Labor And Delivery Unit

1. 
   TITLE:

Calling The Neonatology Team To The Labor And Delivery Unit

2. PURPOSE:

To ensure that adequate timely Pediatric services is available for delivering woman in need.

3. CONDITION/ APPLICABILITY:

This policy applies to all OB Doctors, Nurse /Midwives and neonatology team.

4. DEFINITION:

Neonatology team – NRP cerified Pediatric specialist/Consultant , NRP cerified Nursery/NICU nurse, if needed call for additional help

5. POLICY:

The Pediatric Specialist shall be informed of all risk deliveries to be present at the time of delivery of the baby.

6. PROCEDURE:

1. The obstetric resident / specialist will inform the pediatric specialist before delivery about all high risk cases

2. The obstetric resident /specialist will document the response of pediatric doctor and the time of notification in the medical record of the patient.

3. When pediatrecian needed to come immediately the L&D charge nurse will contact him/her by bleep

4. In emergency cases where no prior arrangement could be made with pediatrecian the L&D charge nurse will contact him/her by bleep.

5. Cases indicated to call the pediatrecian  In labor prior to 2nd stage:

1. Preterm labour, under 37/52 gestation.

2. Known fetal abnormality.

3. Multiple delivery – allow Pediatricians to organize number of doctors (one Pediatrician for each baby).

4. Severe fetal distress, as to possibility of instrumental delivery or Cesarean section.

5. Iso-immunized mothers with anti-D antibodies.

6. Mothers with hypertension or  pre eclampsia, re:type of delivery.

6. At Delivery: 

1. - emergency and elective Cesarean section.

2. Instrumental delivery, e.g. Forceps, Ventouse

3. Breech

4. Fetal distress

5. Meconium-stained liquor

6. Suspected macrosomia, IUGR

7. Maternal  Diabetes

8. Maternal cardiac,renal or pulmonary problem

9. Poly hydramnios and oligo-hydramnios

10. Fetal Hydrops 

11. Percipitous labor

12. Chorioamnionitis

13. Category 2 or 3 fetal heart rate pattern

14. Uterine tachysystole with fetal heart rate changes

15. Narcotics administered to mother within 4 hours of delivery

16. Abruptio pacenta

17. Prolapsed cord

18. Unbooked Patient

7. RESPONSIBILITY:

1. Consultant Obstetrician , specilest or Resident 

2. Registered Nurse (or midwife)

3. Pediatric team

4. Anesthesia team

8. FORMS/ EQUIPMENT:

None

9. REFERENCE:

1. Neonatal resuscitation, American Heart Association,7th edition

2. Maternal and Child Care by: Lippincott

3. REVISION:

11. APPROVALS: