Conditions of Foetus/Baby Flashcards
What is classified as a preterm delivery?
Delivery before 37 weeks gestation
What is the definition of small for gestational age?
Estimated fetal weight or abdominal circumference below the 10th centile
Is an obese mother more likely to have a large or small baby?
Small
Out of symmetrical and asymmetrical IUGR, which is more likely to have a genetic cause and which is more likely to have a placental cause?
Symmetrical = genetic Asymmetrical = placental
How is a baby classified as large for dates?
- Symphyseal-fundal height >2cm for gestational age
* Baby is consistently measuring over the 90th centile
What is fetal macrosomia?
Fetus that is significantly larger than average (>90th centile)
What is polyhydramnios?
Excess amniotic fluid
What is the most common cause of polyhydramnios?
Maternal diabetes
What can you feel on examination of an abdomen with polyhydramnios?
A tense, shiny abdomen and an inability to feel fetal parts
What does polyhydramnios put you at risk of?
- Premature rupture of membranes
Preterm labour
- Cord prolapse
- Malpresentation
- PPH
What is persistent pulmonary hypertension of the newborn?
The failure of the normal circulatory transition that occurs after birth
(Hypoxemia secondary to right-to-left shunting of blood at the foramen ovale and ductus arteriosus)
What are the symptoms of persistent pulmonary hypertension of the newborn?
- Asphyxia
- Tachypnea
- Respiratory acidosis
- Loud, single second heart sound (S2) or a harsh systolic murmur (secondary to tricuspid regurgitation)
- Low Apgar scores
- Meconium staining
- Cyanosis
Systemic hypotension
What is transient tachypnoea of the newborn?
A benign, self-limited condition caused due to delay in clearance of fetal lung fluid after birth
What are symptoms of transient tachypnoea of the newborn?
- Breathing rate > 60 breaths per minute
- Respiratory distress
- Grunting /
Flaring of the nostrils /
increased work of breathing / intercostal recessions
What is the classic risk factor for transient tachypnoea of the newborn?
C-section
What is respiratory distress syndrome in the newborn?
Surfactant deficiency
What is the main risk factor for respiratory distress syndrome in the newborn?
Prematurity
What are the symptoms of respiratory distress syndrome?
o Tachypnoea
o Grunting
o Intercostal recessions
o Nasal flaring
o Cyanosis
(worst at day 2-4 then improvement)
What does a CXR of a newborn with respiratory distress syndrome look like?
Ground glass appearance (lungs not as black as you’d expect them to be)
What drug taken by the mother can cause neonatal hypoglycemia?
Labetalol
Neonatal hypoglycaemia is caused by maternal diabetes - true or false?
False - maternal diabetes doesn’t cause neonatal hypoglycaemia. Illness, hypothermia or a mother using labetalol can
How do you treat neonatal hypoglycaemia?
Keep them fed and warm
What causes physiological jaundice?
Fetal haemoglobin breaks down – conjugating pathways are immature – unconjugated bilirubin (haemoglobin breakdown product) rises
What is the ductus arteriosus?
A vessel connecting the trunk of the pulmonary artery to the proximal descending aorta
What is the main risk factor for patent ductus arteriosus?
Prematurity
What happens to blood when a patent ductus arteriosis is present
A portion of oxygenated blood from the left heart to flow back to the lungs by flowing from the aorta, which has a higher pressure, to the pulmonary artery.
What heart murmur is present in patent ductus arteriosis?
A continuous “machine-like” murmur
