What should you do if a newborn is delivered still in the amniotic sac?

When a newborn is delivered still in the amniotic sac, it is crucial to puncture the sac and clear the airway. The amniotic sac is a protective membrane that surrounds the baby during pregnancy; when it remains intact at birth, it can obstruct the newborn’s breathing.

By carefully puncturing the sac, you create an opening that allows amniotic fluid to escape and ensures that the airway is clear. Clearing the airway is essential to prevent asphyxia, which can occur if the baby cannot breathe due to fluid blocking the nose and mouth. This step is crucial for the newborn's respiratory transition to breathing outside the womb.

Other actions, while potentially important, do not address the immediate need to clear the airway. Waiting for the placenta to deliver can delay necessary care, performing CPR is not the immediate response if the baby is not breathing but is still alive, and wrapping the newborn in a blanket is important for maintaining body temperature but does not address the critical need for airway management when the sac is intact. Therefore, the priority in this situation is to ensure that the newborn can breathe effectively, which is why puncturing the sac and clearing the airway is the correct response.