Episodios de disminución de la saturación de oxígeno en recién nacidos en contacto piel con piel

Résumé

Early skin-to-skin contact (ESSC) immediately after birth is currently the standard of care due to the benefits for both mother and infant. Along with the widespread application of ESSC, an increase in the number of reports regarding sudden unexpected postnatal collapse (SUPC) during ESSC has been observed. The etiology of SUPC remains unknown. The following factors have been associated with SUPC: ESSC; breastfeeding; newborn placed in a prone position over the mother’s bare chest; primiparous mothers; mothers who have used medications that cause drowsiness or sedation; tiredness and sleepiness after childbirth; absence of an appropriate surveillance of the mother-infant dyad by a companion or healthcare professionals; mothers with a body mass index (BMI) >25 kg/m2; and the mother being distracted by electronic devices (mobile phone, etc.). Measures currently implemented among different maternity wards to avoid episodes of SUPC have particularly focused in a close clinical surveillance. Perhaps, placing the newborn during ESSC in a more upright position, by changing mother’s bed angle of inclination, may reduce the risk of airway obstruction and improve respiratory mechanics, and consequently, reduce the number of episodes of peripheral oxygen desaturation or changes in heart rate during that procedure. Furthermore, the use of pulse oximetry as a method of continuous monitoring during ESSC would allow an early detection of SUPC. However, the systematic implementing of this monitoring method is not accepted by most authors. The identification of the group of healthy term newborns (HTNs) with a higher risk of desaturations (peripheral oxygen saturation [SpO2] <91%) or heart rate (HR) modifications (HR <111 beats per minute [bpm] or >180 bpm) while the mother and newborn are on ESSC, by the application of a prognostic assessment of particular maternal and neonatal factors, would allow for better identification of those newborns who could benefit from the use of a pulse oximeter...