Care of the Newborn Preterm Infant Flashcards
What is meant by ‘preterm’?
What are the biggest risk factors for this?
A birth that occurs before 37 weeks completed gestation
Maternal age (> 40 or teenage), smoking and disadvantaged circumstances
What is the definition of stillbirth?
A baby born from 24 weeks, dyring before or during birth
What is the definition of neonatal death?
A baby born from 24 weeks, dying within the first 4 weeks of life
Having had two previous preterm delivery increases a mother’s risk of having another one by what?
70%
What is the biggest difference between term babies and preterm babies in terms of their management?
What is the best way to acheive this?
Preterm babies need more help to stay warm
Placing them immediately (while still wet) in a suitable plastic bag under a radiant heater
What problem with regards to thermal regulation is common in preterm infants?
What other problems can this lead to and why?
Which type of acid base balance problem can occur alongside all this?
How is it managed?
Hypothermia
Hypoxia and hypoglycaemia due to increased metaabolism using up stores
Metabolic acidosis
Put the baby in an incubator to keep them warm
Early onset neonatal sepsis is acquired when?
Give some examples of bugs which can cause this?
Late onset neonatal sepsis is acquired when?
Give some examples of bugs which can cause this?
Before or during delivery
Group B strep, gram -‘s
After delivery
Coagulase negative staph, staph aureus, gram -‘s
How does late onset neonatal sepsis with coagulase negative staph tend to present?
What can it be associated with?
In babies with neonatal sepsis, you should try hard to stay away from which antibiotics?
Insidious onset
Lines and other foreign objects
Very broad spectrum ones
What is the primary pathology behind respiratory distress syndrome?
Structureal immaturity
Surfactant deficiency
What are some signs of respiratory distress in a newborn?
Tachypnoea
Grunting
Intercostal recessions
Nasal flaring
Cyanosis
Respiratory distress syndrome will worsen over when?
What is the natural history of this condition?
Minutes - hours
Worsens to a peak at 2-4 days and then has a gradual improvement
What will be the appearance of this condition on x-ray?
What are some management options for respiratory distress syndrome?
Ground glass appearance (can only just make out the heart border, but it is not clear)
Maternal steroids, surfactant, ventilation (ideally non-invasive)
Apart from respiratory distress syndrome, what are some other respiratory complications that can be seen in premature babies?
What is the second option and what is its outcome?
Apnoea of prematurity
Bronchopulmonary dysplasia
Chronic lung disease as a result of having premature lung disease, usually go on to be fine
Patent ductus arteriosus is a condition which is common in premature babies. What is the function of this structure in the foetus?
When should it normally close?
What are some early signs of this in the first year of life?
What can it lead to if left untreated?
Connects the pulmonary artery to the descending aorta (allows blood from RV to bypass the lungs)
Within a few hours of birth
Increased work of breathing and poor weight gain
Congestive heart failure
What is a neurological condition which is common in premature babies and can lead to neurodevelopmental delay or even mortality depending on how severe a case it is?
Intraventricular haemorrhage
