The effect of measures minimizing body heat loss on the prevention of neonatal hypothermia in the delivery room.

ABSTRACT

The prospective study was undertaken to observe the pattern of fall in the rectal temperature that occurred in neonates after birth and to determine the birth rectal temperature, the relationship of birth temperature between mothers and babies and the effect of measures minimizing body heat loss on the prevention of neonatal hypothermis in the delivery room. The measure given were placing a radiant warmer close to the mother’s lower extremities to provide a higher thermal environment for the neonate before the anticipated time of delivery, drying the neonate immediately after birth with a prewarmed dry towel, placing it under a preheated overhead rediant warmer from the time it was moved to the bathing area to the time being transferred to the nursery. Rectal temperatures were taken immediately after birth, immediately transferred to the bathing area, after cleaned and on admission to the nursery. Three groups, each of 37 infants, of term infants with normal deliveries and with Apgar scores of > 8 were studied. Infants in group 1 receiving routine care provided in the delivery room were observed for the fall in the rectal temperature. Those in group 2 and 3 were studied to evaluate the effect of measures minimizing body heat loss on the prevention of hypothermia group 2 received only routine care; group 3 received both routine care and the measures minimizing heat loss. The mean birth rectal temperature was 37.6+0.5 oC (range 36.7 – 39.1). The correlation coefficient of the relationship between the birth and temperatures of mothers and babies was 0.61 (p = 0.01). Under routin care newborns lost heat rapidly at birth and during the period they were in the delivery room. Washing soon 5 – 20 minutes after birth caused a rapid fall in body temperature. By 18.7 mins after birth the mean rectal temperature was 36.4 oC and at a mean age of 68.5 mins 95% of the neonates had hypothermia. Swaddling neonates with towel could not prevent body heat loss. The fall in body temperature that occurred in group 3 was significantly less when compared to group 2 and non in group 3 suffered from hypothermia. This study demonstrates that efforts to limit heat loss should be concentrated immediately after birth and on the practice of cleaning neonates in the delivery room. Measures minimizing heat loss can effectively prevent hypothermia in the dilvery room.