title: [Conditions for neonatal resuscitation in Portuguese delivery rooms: a national survey (2009)].
abstract: BACKGROUND
  In Portugal, since 1989, the rates of maternal, perinatal and neonatal mortality present a significant decrease, after the implemented perinatal network. The continuous assessment of the existing conditions at the different levels of perinatal care is essential to identify deviations from normality and may allow the optimization of quality of care.
  
  
  OBJECTIVE
  To obtain information on and to evaluate the conditions and practices of neonatal resuscitation at the Portuguese delivery rooms, in order to propose measures for improvement of neonatal care.
  
  
  METHODS
  An electronic questionnaire was sent to 35 hospitals with maternity. The survey included questions regarding to human and material resources, characteristics of delivery room practices used in stabilization / resuscitation of the newborn, number of deliveries and number of newborns transferred after birth per year, as well as issues related with the collaboration of obstetric teams.
  
  
  RESULTS
  Thirty centres (86%) answered the questionnaire, 16 of the respondents were level III maternities/hospitals. In eight (27%) centres a paediatrician is present at all deliveries, whereas in the remaining centres a paediatrician is available only for risk situations. The material unavailable in some centres include cardio-respiratory monitoring equipment, support device with pressure controlled ventilation, oxygen blender, ventilator, CPAP (continuous positive airway pressure), neonatal transport incubators and equipments for thoracocentesis and paracentesis. The criteria used for prophylactic surfactant and oxygen use are very different among the various centres. All centres reported transferring newborns after birth, either because of lack of differentiation of care or vacant beds. The centres with perinatal support reported less cooperation of the obstetric teams.
  
  
  CONCLUSIONS
  The care of the newborn in the national delivery rooms can and should be improved. It is necessary to adapt the equipment and human resources to the needs of each centre. Protocols and practices such as oxygen and "prophylactic" surfactant must be updated, transport after birth must be reduced and the communication with the obstetric teams should be improved.
authors: Comissão de Investigação Científica, Secção de Neonatologia, Sociedade Portuguesa de Pediatria, Portugal.
authors: Gustavo
authors: G
authors: Rocha
authors: Joana
authors: J
authors: Saldanha
authors: Israel
authors: I
authors: Macedo
authors: Augusta
authors: A
authors: Areias
authors: André
authors: A
authors: Graça
authors: Teresa
authors: T
authors: Tomé
mesh_terms: D003696:Delivery Rooms; D006801:Humans; D007231:Infant, Newborn; D011174:Portugal; D012151:Resuscitation / Q000592:standards* / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires