Lower perinatal and neonatal mortality have been achieved in the developed countries following advancement of neonatal care, introduction of high technologies, and better knowledge of pathophysiology of the newborn infants. Other contributing factors are organised delivery room care with skillful resuscitative techniques as well as risk identification and efficient transport of the sick infants including in utero transfer of the fetus, etc. It cannot be assumed that similar results can be attained in developing countries where financial and human resources are the problems. With limited resources, it is necessary to prioritize neonatal care in the developing countries. It is essential to collect minimum meaningful perinatal data to define the problems of each individual country. This is crucial for monitoring, auditing, evaluation, and planning of perinatal health care of the country. The definition and terminology in perinatology should also be uniform and standardised for comparative studies. Paediatricians should be well trained in resuscitation and stabilisation of the newborn infants. Resuscitation should begin in the delivery room and a resuscitation team should be formed. This is the best way to curtail complication and morbidity of asphyxiated births. Nosocomial infections have been the leading cause of neonatal deaths. It is of paramount importance to prevent infections in the nursery. Staff working in the nursery should pay attention to usage of sterilised equipment, isolation of infected babies and aseptic procedures. Paediatricians should avoid indiscriminate use of antibiotics. Most important of all, hand-washing before examination of the baby is mandatory and should be strictly adhered to. Other simpler measures include warming devices for maintenance of body temperature of the newborn babies, blood glucose monitoring, and antenatal steroid for mothers in premature labour. In countries where neonatal jaundice is prevalent, effective management to prevent kernicterus is essential. Simple assisted ventilatory device such as nasal continuous positive airway pressure (nCPAP) is also useful.
PIP: Levels of perinatal and neonatal mortality have declined in the developed countries following advances in neonatal care, the introduction of high technology, and better knowledge of the pathophysiology of newborn infants. Organized and skilled delivery room care together with risk identification and the efficient transport of sick infants, including in utero fetal transfer, also contribute to the reduction in mortality. However, in developing countries constrained by limited financial and human resources, the nature and delivery of neonatal care must be prioritized. Meaningful perinatal data must first be collected to define the problems of each country related to the monitoring, auditing, evaluation, and planning of perinatal health care services. Definitions and terminology in perinatology should be standardized to facilitate comparative study. Pediatricians should be well trained in the resuscitation and stabilization of newborn infants, infections should be prevented in the nursery, warming devices must be made available to maintain the body temperature of newborns, blood glucose should be monitored, and antenatal corticosteroids provided to women in premature labor. In countries where neonatal jaundice is prevalent, proper and effective management to prevent kernicterus is essential. Finally, a simple assisted ventilatory device such as nasal continuous positive airway pressure is also useful.