Common postnatal problems Flashcards
What are the types of problem of skin?
Colour
Rashes
Birthmarks
What is the common colour change in babies?
Jaundice
When is jaundice pathological?
Always in 1st 24 hours
>2 weeks, investigate
What are the causes of jaundice in the 1st 24 hours?
Haemolysis
Congenital infection
What are the causes of jaundice from 2 days to 3 weeks?
Physiological- gone after 1 week normally Breast milk Sepsis Polycythaemia Cephalohaematoma Haemolysis
What are the causes of jaundice from 3 weeks on?
Can be breast milk
Hypothyroid
Pyloric stenosis
Cholestasis
What is the problem of high bilirubin?
Can lead to kernicterus
What is the management of jaundice?
Hydration Blue light Treat underlying cause Exchange transfusion Igs
What is and causes plethora?
Red baby
Polycythaemia
What could cause central jaundice?
Congenital heart defects
What us erythema toxicum?
Maculopapular rash, common in term infants
Fades in about a week, no treatment required
What types of birth marks are common?
Capillary haemangiomas Mongolian blue spots Port wine stains Stork marks Giant melancytic nave Cafe au lait spots Strawberry mark
What are Mongolian blue spots?
Blue-grey pigmentations often of lower back and buttocks
Caused by accumulation of melanocytes, often in races with pigmented skin
What are stork marks?
Flat, pink lesions
Present at birth
Normally on forehead, eyelids, back of neck
Gradually fades
What are the risk factors for hypoglycaemia?
Premature
Perinatal stress
Hyperinsulinaemia
Increased glucose utilisation- large, small, hypothermia, sepsis
What are the symptoms of hypoglycaemia in neonates?
Jittery Temperature instability Lethargy, hypotonia, vomiting High pitched, weak cry Seizures
What are the risk factors for hypothermia?
Low birthweight
Prolonged resus
Heat loss factors
What are tongue ties?
Short +/- thickened frenulum attached anteriorly to base of tongue
What is the management of tongue ties?
Normally none
Frenotomy if
-restriction of tongue protrusion, heavy grooving of tip of tongue, feeding affected
What is the most common reason for NNU admission?
Resp distress
What should be evaluated on res distress?
RR
Effort- grunting, retractions, nasal flaring
Colour
Oxygen sats
What oxygen sat would suggest a cardiac issue?
Not 100% sats on 100% O2
What is cleft palate?
Maxillary and medial nasal processes fail to merge usually around 5 weeks
Can be uni or bilateral, usually left uni
70% also have cleft palate
What problems can cleft lip cause?
Resp
Feeding
Associated anomalies
Why are red reflexes checked?
Cataracts
Retinoblastoma
What can spinal dimples be a sign of?
Normally nothing
Spina bifida- esp if tuft or hair or can’t see bottom
Kidney problems
The should spinal dimples be investigated?
Off centre Large, red Higher up Pigmented Tender Accompanied by fluid
What are cephalohaematomas?
Localised soft translucent swelling over one or both sides of head reaching max size at 3-4 days of life
What are the complications of cephalohaematomas?
If v large, can cause jaundice when they break down
No association w intracranial bleed
What is caput?
Only shaped head from being pushed through birth canal
Normally resolves in a few days
How can physiological and pathological talipes be differentiated?
Physiological can normally straighten by moving
