title: Evaluation of the alert line of partogram in recognizing the need for neonatal resuscitation.
abstract: BACKGROUND
  A major problem of the first moments of childbirth, especially in "prolonged labor," is perinatal asphyxia which necessitates neonatal resuscitation. This study aimed at evaluating the alert line of the partogram in recognizing the need for neonatal resuscitation 20-30 s after delivery.
  
  
  METHODS
  140 full-term pregnant women were kept under surveillance through using a partogram. In order to decide on the onset of resuscitation, the three indicators of fetal respiration, heart rate, and skin color were used 20-30 s after delivery. The findings from the evaluation of fetal conditions were compared to the position of the ultimate cervical dilatation graph to the alert line of the partogram, and through using appropriate statistical procedures, sensitivity, specificity, and positive and negative prediction values of the alert line to recognize the need for neonatal resuscitation were computed.
  
  
  RESULTS
  There was a significant relationship between the need for neonatal resuscitation within 20-30 seconds after delivery and the graph of the cervical dilatations on the partogram (P = 0.001). The indices of the alert line for predicting the need for resuscitation 20-30 s after birth had a sensitivity of 97.5%, specificity of 80.2%, positive prediction value of 97.2%, and negative prediction value of 98.7%.
  
  
  CONCLUSIONS
  In mothers who had normal vaginal delivery, with normal fetal heart rate, and with no oxytocin administration or omniotomy, the alert line showed appropriate sensitivity, specificity, and negative prediction value. So, it can assist in predicting the necessity of action for neonatal resuscitation 20-30 s after delivery.
authors.affiliation: Department of Midwifery, Faculty of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran.
authors.forename: Nahid
authors.initials: N
authors.lastname: Bolbol-Haghighi
authors.affiliation: Department of Midwifery, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Keshavarz
authors.affiliation: Department of Public Health, Faculty of Health, Shahroud University of Medical Sciences, Shahroud, Iran.
authors.forename: Mehri
authors.initials: M
authors.lastname: Delvarianzadeh
authors.affiliation: Department of Laboratory Sciences, Islamic Azad University, Shahroud Branch, Shahroud, Iran.
authors.forename: Sahar
authors.initials: S
authors.lastname: Molzami
keywords: Alert line; Iran; negative prediction value; partogram; positive prediction value; sensitivity; specificity