Born Too Small Too Early Flashcards

1
Q

What weight is classed as too small?

A

<2500g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Types of “small for dates”

A

Small for Gestational Age (SGA)
Intra-Uterine Growth Restriction (IUGR)
Hypotrophy (symmetric and asymmetric)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is classed as severe IUGR

A

<0.4th centile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Causes for being small for dates

A

Maternal:

  • Smoking
  • Maternal Pre-Eclamptic Toxaemia

Foetal:

  • Chromosomal (Eg Edwards Syndrome)
  • Infection (Eg CMV)

Placental:
-Eg placental abruption

Other:
Twin pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Common problems that occur when too small for dates

A
Perinatal hypoxia
Hypoglycaemia
Hypothermia
Polycythaemia
Thrombocytopenia
Hypoglycaemia
Gastrointestinal problems (feeds, Necrotizing enterocolitis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Long term problems caused by being small for dates

A

Hypertension
Reduced growth
Obesity
Ischaemic heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Define preterm and extremely preterm?

A

Preterm <37 weeks

Extremely preterm <28 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Define low birth weight, very low and extremely low

A

Low b/w <2500g
Very low <1500g
Extremely low <1000g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What happens to a preterm’s respiratory system

A

Respiratory distress syndrome

Broncho-pulmonary Displasia (BPD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Prevention of RDS in preterm

A

Antenatal steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Treatment for RDS

A

Surfactant
N-CPAP
Minimal ventilation (low tidal volume and good inflation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is and what causes Broncho-pulmonary dysplasia?

A

Chronic lung disease of newborns

Caused by :
-Overstretch by volu-baro-trauma

Leads to:

  • Atelectasis (collapse)
  • Infection via endotracheal tube
  • O2 toxicity
  • Inflammatory changes
  • Tissue repair causing scarring
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Treatment of BPD

A

Patience
Nutrition and growth
Steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Preterm minor respiratory problems that can occur?

A

Apnoea
Irregular breathing
Desaturations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Treatment of preterm minor respiratory problems

A

Caffeine

N-CPAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Neuroloigcal problems that can occur in preterm

A

intra-ventricular haemorrhage

Peri-ventricular leucomalacia (96% adverse outcome)

Post-haemorrhagic hydrocephalus

17
Q

How to prevent intraventricular haemorrhage

A

Steroids

18
Q

Treatment of IVH

A

Sympthomatic

Drainage

19
Q

Circulation problems that can occur in preterm

A

Patent Ductus arteriosus

20
Q

Patent ductus arteriosus presentation

A

Additional blood to pulmonary circulation:
-Lung oedema

Steal from systemic circulation:
-Systemic ischaemia

21
Q

Consequences of PDA

A

Worsening of respiratory symptoms
Retention of fluids (low renal perfusion)
GI problems (GE ischaemia)

22
Q

Preterm gastrointestinal presentation

A

Necrotising Entero-Colitis

23
Q

What is Necrotising Entero-colitis

A

Ischaemic, inflammatory changes and necrosis of bowel

24
Q

Treatment of Necrotising Entero-colitis

A

Surgical intervention may be required

Antibiotics and parenteral nutrition

25
Q

Outcome of extreme prematurity

A

1/3 die
1/3 normal life or mild disability
1/3 have moderate or severe disability for lifetime

Deterioration between year 2 and year 6