At 4:43 p.m. Mrs. Veronica L. (age 28) arrives to the hospital. Twin pregnancy 36+3 weeks of pregnancy, contractions started an hour ago. Upon examination, obstetrician agrees that it is possible for her to have vaginal delivery.
After 6 hours, Elisabeth is born, weight 2.87 kg, measuring 48 cm.
Second baby, Phillip, is born two hours later due to breech position, amniotic fluid is dirtied with meconium. He weights 2.32 kg and measures 43 cm.
As an obstetritian present at the delivery room, you have the responsibility of assessing both newborns according to adequate scoring system and clasify them into one of the categories – HAPPY (score between 10 and 8), NOT SO HAPPY (score between 7 and 5) or BAD (score 4 and less). Your evaluation takes place in 5th minute after birth.
Phillip is cyanotic, breathes irregularly and muscle tone is fairly weak. He reacts to stimulus by grimacing face.
Elisabeth has cyanotic extremities, but breathes regularly and reacts to stimulus by coughing. Muscle tone is evaluated as good and heart rate is 120 bpm.
Help
HAPPY – newborn has pink skin, moves, breathes and cries, heart rate is above 100. NOT SO HAPPY – newborn has acrocyanosis, is floppy, not breathing, heart rate around 100. BAD – newborn is cyanotic all over, floppy, does not breathe and heart rate is under 100.
