1: Neonatology: Pre-maturity Flashcards
Define prematurity
Neonate born prior to 37W
What is the limit of viability
22W
According to WHO, what defines extreme pre-maturity
<28W
According to WHO, what defines very pre-term
28-32W
According to WHO, what defines moderate-late pre-term
32-37W
When are majority of pre-maturity complications seen
Prior to 32W
What are risk factors for pre-mature delivery
- Previous pre-term delivery
- PROM
- Multiple pregnancy
- Maternal illness
- Cervical incompetence
- Intra-uterine bleed: placenta abruption
What are general complications of pre-maturity
- Hypothermia
What are cardiac complications or pre-maturity
- Patent DA
- Anaemia
What are 2 respiratory complications of pre-maturity
- RDS
- Bronchopulmonary dysplasia
What are 2 CNS complications of pre-maturity
- Retinopathy of pre-maturity
- Intra-ventricular haemorrhage
What are 3 GI complications of pre-maturity
Necrotising enterocolitis
Poor suck
Poor milk tolerance
What are liver complications of pre-maturity
Jaundice
What are immune complications of pre-maturity
Immunocompromised
What are 4 late complications of pre-maturity
NAI
Neurodevelopment delay
Sudden infant death syndrome
Behavioural problems
What is given antenatally if 23-35W
two doses IM corticosteroids 12-24h apart
When should a senior obstetrician be present
All deliveries <28W
How long is cord clamping delayed if pre-mature
3-minutes
What should a pre-mature baby be placed in after birth
Food exchange bag under radiant heater to maintain temperature
If under 27W what is often required
Intubation and endotracheal corticosteroids
Why are antenatal corticosteroids given
Reduces mortality in pre-mature infants by 40%
What 3 conditions does antenatal corticosteroids decrease risk of
- RDS
- Intraventricular haemorrhage
- Necrotising enterocolitis
What % of infants under 23W will have no or minor disability
5