Care of the newborn Flashcards
How many neonates end up on NICU?
10%
How many childhood deaths in 1st year of life?
25%
How many mums Rhesus neg?
10%
Placenta and Ig
IgG from mum to fetus
HbF has what?
gamma instead of beta chains
shifts oxygen curve to LEFT
Blood transfer from mum to baby 3 factors
Mum oxygen levels higher than fetes
HbF has a higher affinity of oxygen than HbA
Fetal blood doesn’t bind DPG easily (can carry more o2)
Umbilical vein
blood placenta to fetus
oxygenated
umbilical artery
fetus to placenta
deoxygenated
First breath
contraction
beta adrenaline
oxygenation
respiration
umbilical vein becomes
ligamentum teres
liver
umbilical artery becomes
constricted as the bladder starts working
ductus venosis
constricts and all the blood pases the hepatic sinusoids
ductus arteriosus becomes
ligamentum arteriosis
Cephalhaematoma
blood under periosteum
from operative delivery
or prolonged labour
erythema toxicum
common
lasts days- week
central papule surround by erythema
baby is usually well (if not well think staph)
cornelia de lange
low birth weight delayed growth developmental delay microcephaly long eyelashes and thick eyebrows
club foot
talipes
swelling of dorsum of foot
turners
noonans
early onset haemorrhagic disease of the newborn
a few days
vit K deficiency
late onset haemorrhagic disease of the newborn
4-6 weeks
Neonatal jaundic within
24 hours
Biblrubin brain damage
kernicterus
dyskinetic CP
Breast milk contains
macrophages lymphocytes IgA IgG Lysozymes Lactoferrin Lipase Prebiotics Hormones
Contraindications for breast feeding
HIV
Anti-psychotics
Chemo/Radio therapy
Heroin/Methadone
Heb B/C and breast feeding
should still breast feed
How many breast feed in UK at birth?
81%
How many breast feed at 6 months
25%
Benefits to mum for breast feeding
decrease breast cancer
decrease ovarian cancer
bone protection
macrosomia
> 4500mg
LBW
<2500
vlbw
<1500
Extremely! LBW
<1000mg
Shivering and newborns
they can’t do it
Resp support for the newborn
O2 CPAP intubation surfactant methyl xanthine
NGT and newborns
introduce food SLOWLY!
delay for 48 hours
other name for necrotising enterocolitis
pneumotosis intestinalis
Avoid sats over:
95%
Retinopathy of prematurity
Fundoscopy screening for
all under 32 weeks and vlbw
repeat 2 weekly until complete vascularisation
treatment for retinopathy of prematurity
ablate vessels
they will lose their peripheral vision
SGA definition
<10th percentile
SGA at risk of (immediately)
still birth
intrapartum hypoxia
neonatal hypoglycaemia
polycythemia
SGA at risk of later in life
T2DM, hyperlipid, hypertensive, ischaemic heart disease.
APGAR stands for
Activity, Pulse, Grimace, Appearance, Resps
Activity in APGAR
2: moves around, flexed, flaccid
1: rigid
0: none
Pulse in APGAR
2: over 100
1: under 100
0: absent
Grimace in APGAR
2: sneeze, cough, pull away
1: flexed
0: absent