Child health- prematurity Flashcards
why is blood in the ventricles in premature babies a concern?
fontanelles not fixed- there can be a lot of blood in the brain and NOT in the systemic circulation
can cause brain death and organ damage
what are the principles of foetal development?
growth
movement
heartbeat
what is a risk factor for cystic periventricular leukomalacia
chrorioamniotis
define prematurity
birth before 37 weeks gestation
more premature = worse outcomes
when should resuscitation in a preterm baby be carefully considered
babies under 500 grams or under 24 weeks gestation
what are the different classifications of prematurity
Under 28 weeks: extreme preterm
28 – 32 weeks: very preterm
32 – 37 weeks: moderate to late preterm
what are risk factors associated with prematurity
Social deprivation
Smoking
Alcohol
Drugs
Overweight or underweight mother
Maternal co-morbidities
Twins
Personal or family
history of prematurity
what is the best thing to do if there is possibility of preterm labour?
KEEP THE BABY INSIDE
each added week to gestation improves outcomes for the baby
what are the options for trying to delay birth?
Prophylactic vaginal progesterone: putting a progesterone suppository in the vagina to discourage labour
Prophylactic cervical cerclage: putting a suture in the cervix to hold it closed
what is offered if preterm labour is suspected
Tocolysis with nifedipine: nifedipine is a calcium channel blocker that suppresses labour
Maternal corticosteroids: can be offered before 35 weeks gestation to reduce neonatal morbidity and mortality
IV Magnesium sulphate: can be offered before 34 weeks gestation and helps protect the baby’s brain
Delayed cord clamping or cord milking: can increase the circulating blood volume and haemoglobin in the baby
what are issues in early life experienced by preterm babies
Respiratory distress syndrome
Hypothermia
Hypoglycaemia
Poor feeding
Apnoea and bradycardia
Neonatal jaundice
Intraventricular haemorrhage
Retinopathy of prematurity
Necrotising enterocolitis
Immature immune system and infection
what are long term effects experienced by preterm babies
Chronic lung disease of prematurity (CLDP)
Learning and behavioural difficulties
Susceptibility to infections, particularly respiratory tract infections
Hearing and visual impairment
Cerebral palsy
when during gestation is there transfer of IgG antibodies across the placenta?
last three months of gestation
