Positioning of term infants during delivery room routine handling - analysis of videos.
BACKGROUND
Delivery room management (DR) of the newly born infant should be performed according to international guidelines, but no recommendations are available for an infant's position immediately after birth. The present study was performed to answer the following questions: 1. How often is DR-management performed in term infants in side position? 2. Is routine DR-management possible in side position? 3. Is there any benefit of side position with respect to agitation or vital parameters?


METHODS
Cross-sectional study of video-recorded DR-management in term newborns delivered by C-section in 2012. Videos were analysed for infant's position, administered interventions, vital parameters and agitation.


RESULTS
187 videos were analysed. The Main Position (defined as position spent more than 70% of the time) was "supine" in 91, "side" in 63 and "not determinable" in 33 infants. "Supine" infants received significantly (p < 0.001) more often stimulation (12.5% of the total time) than "side" infants (3.9% of time). There were no differences between both groups with regard to suctioning; CPAP was exclusively (98%) administered in supine position. Newborns on side were less agitated than those on supine. There was a trend towards a better oxygenation in "side" positioned infants (p = 0.055) and significantly (p = 0.04) higher saturation values in "left-sided" infants than "right-sided" infants at 8th minute. "Side" positioned infants reached oxygen saturation values >90% earlier than "supine" positioned infants (p = 0.16).


CONCLUSIONS
DR-management is feasible in the side position in term infants. Side position seems to be associated with reduced agitation and improved oxygenation. However, it remains unclear whether this represents a causal relationship or an association. The study supports the need for a randomized controlled trial.
Dimitrios
D
Konstantelos
Heidrun
H
Gurth
Renate
R
Bergert
Sascha
S
Ifflaender
Department of Neonatology and Pediatric Intensive Care, Medizinische Fakultät Carl Gustav Carus, TU Dresden, Fetscherstraße 74, Dresden 01307, Germany. mario.ruediger@uniklinikum-dresden.de.
Mario
M
Rüdiger
D003430:Cross-Sectional Studies; D003696:Delivery Rooms; D006801:Humans; D007231:Infant, Newborn; D056888:Patient Positioning / Q000379:methods*; D047929:Term Birth; D014741:Video Recording