CLIPP 1 - SGA Flashcards
Adverse effects of maternal tobacco use (1)
-low birth weight
Adverse effects of maternal alcohol use (2)
- Fetal alcohol syndrome (facial abnormalities, growth deficiency, CNS dysfunction)
- cognitive disability and learning problems
- there is no “safe” amount of alcohol
adverse effects of maternal marijuana use (1)
-no distinctive effects have been identified
adverse effects of maternal heroin/opiate use (2)
- fetal growth restriction, placental abruption, fetal death, preterm labor, intrauterine passage of meconium
- neonatal abstinence syndrome
adverse effects of maternal cocaine/stimulant use (2)
- placental insufficiency and low birth weight
- deficits in cognitive performance, information processing, and attention to tasks
SGA vs IUGR
- SGA is a diagnosis made at birth
- IUGR is noted during pregnancy
Etiologies for SGA at birth (4)
- maternal factors
- fetal factors
- medications and other exposures
- uterine and placental abnormalities
Risk factors for early onset GBS disease (4)
- prolonged ROM
- prematurity
- intrapartum fever
- previous delivery of infant who developed GBS disease
Management of babies born to GBS+ moms
- ill-appearing: sepsis workup + IV abx
- well-appearing: CBC + blood cx or just observation
APGAR
Appearance (skin color) Pulse Grimace (reflex irritability) Activity (muscle tone) Respiration
Symmetric vs asymmetric IUGR
- symmetric: head, length, and weight are decreased proportionately (congenital infections)
- asymmetric: length/weight decreased without affecting head circumference (poor nutrient delivery)
Risks for SGA newborns (3)
- hypoglycemia (decreased glycogen stores, heat loss, possible hypoxia, decreased gluconeogenesis)
- hypothermia (cold stress, hypoxia, hypoglycemia, increased surface area, decreased subcutaneous insulation)
- polycythemia (chronic hypoxia, maternal-fetal transfusion)
Newborn resuscitation steps (5)
- universal precautions
- warm and dry infant/remove wet linens
- stimulate infant to elicit vigorous cry
- suction amniotic fluid from nose and mouth
- initiate further resuscitation if required
Rooting primitive reflex
newborn turns head toward finger when cheek touched
Sucking primitive reflex
newborn suck on finger when roof of mouth touched
Startle (moro) primitive reflex
newborn flexes thighs and knees, fans and clenches fingers, throws out arms and then brings together when head position drops
palmar and plantar grasps primitive reflexes
newborn grasps finger when palm or plantar foot surfaces stroked
asymmetrical tonic neck response
turning newborn’s head to one side causes extension of arm toward direction of infant’s faze with contralateral arm flexion (fencer)
stepping response primitive reflex
newborn’s legs make a stepping motion when held vertically above table with dorsum of foot against table edge
causes of absent red reflex (5)
- cataract
- opacified cornea
- inflammation of anterior chamber
- developmental anomalies of the ye
- retinoblastoma
Treating neonates to prevent vertical transmission of Hep B
- hep B vaccine + hepB immune globulin within 12 hours of delivery
- routine vaccine series starting at 1 month
- test for anti-HBs and HBsAG at 9-18 months
Routine newborn medications (3)
- vitamin K
- hepatitis B vaccine
- erythromycin
maternal prenatal lab screening tests (10)
- maternal blood type, Rh, and antibody screen
- Rubella IgG
- Hepatitis B Surface antigen
- HIV antibody
- RPR or VDRL
- UA
- Urine NAAT for chlamydia and gonococcus
- urine or vaginal culture for GBS
- Hep C antibody (women with IVDU hx)
- TST (women with HIV or who liovein a household with someone with active TB)
