Cephalhaematoma and haemolytic disease of newborn Flashcards
1
Q
what is a cephalhaematoma?
is it unilateral or bilateral?
A
- bleeding between the cranium and periosteum
- unilateral, does not cross midline
2
Q
what might make infection likely in cephalohaematoma?
A
- if the overlying skin is broken
3
Q
what are the risk factors for cephalohaematoma?
what complications may occur?
A
- Forceps delivery
- Large baby
- first pregnancy
- difficult and prolonged labours
- exacerbated jaundice
4
Q
what is the treatment of cephalohaematoma?
A
- most resolve within 3 months
- if infections occur then this can be drained
5
Q
How does haemolytic disease of the newborn occur?
A
- maternal IgG crosses placenta and reacts with antigen of foetal RBCs
- in the 2nd pregnancy these antibodies cross placenta and destroy RBCs
6
Q
how is it usually picked up antenatally ?
What kind of symptoms will babies have?
A
- antenatally with direct Coombs test
- jaundice
- pallor
- hepatosplenomegaly
- hydrops foetalis
- polyhydramnios
7
Q
what tests can you do antenatally to check for haemolytic disease of the newborn?
A
- Indirect coombs at 1st antenatal visit for Rh -ve, if +ve then monitor
- AN ultrasound: look for hydrops
- FBS: If doppler scan finds anaemia then can take blood from HV or cord insertion
- FBC: anaemia, reticulocytes, DIC
- Biochemistry: hypoglycaemia, hyperinsulinaemia
8
Q
How can you manage haemolytic disease in utero?
A
- blood samples confirm anaemia, transfusion with O -ve blood at 18 weeks by umbilical vein
- early delivery (32-38 weeks)
9
Q
how is it managed after delivery?
A
- 50% of babies have normal Hb, and bilirubin, but transfuse if needed
- they may need phototherapy if jaundice
- 25% need ICU
10
Q
how can haemolytic disease of the newborn be prevented?
A
- Anti-D Immunoglobulin should be given to all rh -ve women
- can be given at 24 and 28 weeks
