6.3. Neonatology - Born too Small / Too Early Flashcards
What is the Definition of being Born too Small?
2500g (5lb 8oz)
What are the Different Categories of being Small for Dates?
- Small for Gestational Age (SGA)
- Intra-Uterine Growth Restriction (IUGR) - <10th Centile
- Hypotrophy - Symmetric / Asymmetric
Note - Severe IUGR - <0.4th Centile
What are the Causes for being Small for Dates?
- Maternal - Smoking / Blood Pressure
- Foetal - Chromosomal / Infection
- Placental - Abruption
- Twin Pregnancy
What are Common Problems with being Small for Dates?
- Perinatal Hypoxia
- Hypoglycaemia
- Hypothermia
- Polycythaemia
- Thrombocytopenia
- Gastrointestinal Problems
What are the Common Long-Term Problems for being Small for Dates?
- Hypertension
- Reduced Growth
- Obesity
- Ischaemic Heart Disease
What is the Definition of Preterm?
< 37 weeks
What is the Definition of Extremely Preterm?
<28 weeks
What is the Definition of Low Birth Weight?
< 2500g (5lb 8oz)
What is the Definition of Very Low Birth Weight?
<1500g (3lb 5oz)
What is the Definition of Extremely Low Birth Weight?
<1000g (2lb 3oz)
What are the Common Respiratory Problems of Preterm Babies?
- Respiratory Distress Syndrome (RDS)
- Bronchopulmonary Dysplasia
- Minor Problems - Apnoea / Irregular Breathing / Desaturation
With Regards to Respiratory Distress Syndrome What is the:
- Prevention?
- Early Treatment?
- Antenatal Steroids
- a) Surfactant (and then as little as possible)
- b) Non-Invasive Support (CPAP)
- c) Minimal Ventilation
What is the Treatment of Bronchopulmonary Dysplasia?
- Patience
- Nutrition / Growth
- Steroids
What is the Treatment of Minor Respiratory Problems?
- Caffeine
2. N-CPAP
What are the Common Brain Problems of Preterm Babies?
- Intraventricular Haemorrhage (Grades I-IV)
- Peri-Ventricular Leucomalacia
- Post-Haemorrhagic Hydrocephalus
What is the Treatment of Intraventricular Haemorrhage?
- Prevention - Antenatal Steroids
2. Symptomatic
What is the Common Circulatory Problem of Preterm Babies?
Persistent Ductus Arteriosus
What is the (Patho)Physiology of Persistent Ductus Arteriosus?
- Pressure in the Aorta > Pulmonary Artery causing a Left-Right Shunt
- Additional Blood goes to Pulmonary Circulation causing:
- a) Over-Perfusion of Lungs
- b) Lung Oedema
- c) Systemic Ischaemia
What are the Consequences of Persistent Ductus Arteriosus?
- Worsening of Respiratory Symptoms
- Retention of Fluids (Low Renal Perfusion)
- Gastrointestinal Problems (GE Ischamia)
What is the Common Gastrointestinal Problem of Preterm Babies?
Necrotising Entero-Colitis
What are the Features of Necrotising Entero-Colitis?
- Ischaemia and Inflammatory Changes
2. Necrosis of Bowel
What is the Treatment of Necrotising Entero-Collitis?
- Conservative Management sometimes Possible - Antibiotics and Parenteral Nurtrition
- Surgical Intervention often Required
What is the Significance of Nutrition in Preterm Babies?
- Enormous Nutritional Requirements
2. Triple their size during Hospital Stay
What is the Outcome of Prematurity?
- 1/3 die
- 1/3 have Moderate / Severe Disability
- 1/3 have Normal Life / Mild Disability
