Conditions of Foetus/Baby

Question 1

What is classified as a preterm delivery?

Answer 1

Delivery before 37 weeks gestation

Question 2

What is the definition of small for gestational age?

Answer 2

Estimated fetal weight or abdominal circumference below the 10th centile

Question 3

Is an obese mother more likely to have a large or small baby?

Answer 3

Small

Question 4

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?

Answer 4

Symmetrical = genetic
Asymmetrical = placental

Question 5

How is a baby classified as large for dates?

Answer 5

• Symphyseal-fundal height >2cm for gestational age

* Baby is consistently measuring over the 90th centile

Question 6

What is fetal macrosomia?

Answer 6

Fetus that is significantly larger than average (>90th centile)

Question 7

What is polyhydramnios?

Answer 7

Excess amniotic fluid

Question 8

What is the most common cause of polyhydramnios?

Answer 8

Maternal diabetes

Question 9

What can you feel on examination of an abdomen with polyhydramnios?

Answer 9

A tense, shiny abdomen and an inability to feel fetal parts

Question 10

What does polyhydramnios put you at risk of?

Answer 10

• Premature rupture of membranes

Preterm labour

• Cord prolapse
• Malpresentation
• PPH

Question 11

What is persistent pulmonary hypertension of the newborn?

Answer 11

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)

Question 12

What are the symptoms of persistent pulmonary hypertension of the newborn?

Answer 12

• 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

Question 13

What is transient tachypnoea of the newborn?

Answer 13

A benign, self-limited condition caused due to delay in clearance of fetal lung fluid after birth

Question 14

What are symptoms of transient tachypnoea of the newborn?

Answer 14

• Breathing rate > 60 breaths per minute
• Respiratory distress
• Grunting /
  Flaring of the nostrils /
  increased work of breathing / intercostal recessions

Question 15

What is the classic risk factor for transient tachypnoea of the newborn?

Answer 15

C-section

Question 16

What is respiratory distress syndrome in the newborn?

Answer 16

Surfactant deficiency

Question 17

What is the main risk factor for respiratory distress syndrome in the newborn?

Answer 17

Prematurity

Question 18

What are the symptoms of respiratory distress syndrome?

Answer 18

o Tachypnoea

o Grunting

o Intercostal recessions

o Nasal flaring

o Cyanosis

(worst at day 2-4 then improvement)

Question 19

What does a CXR of a newborn with respiratory distress syndrome look like?

Answer 19

Ground glass appearance (lungs not as black as you’d expect them to be)

Question 20

What drug taken by the mother can cause neonatal hypoglycemia?

Answer 20

Labetalol

Question 21

Neonatal hypoglycaemia is caused by maternal diabetes - true or false?

Answer 21

False - maternal diabetes doesn’t cause neonatal hypoglycaemia. Illness, hypothermia or a mother using labetalol can

Question 22

How do you treat neonatal hypoglycaemia?

Answer 22

Keep them fed and warm

Question 23

What causes physiological jaundice?

Answer 23

Fetal haemoglobin breaks down – conjugating pathways are immature – unconjugated bilirubin (haemoglobin breakdown product) rises

Question 24

What is the ductus arteriosus?

Answer 24

A vessel connecting the trunk of the pulmonary artery to the proximal descending aorta

Question 25

What is the main risk factor for patent ductus arteriosus?

Answer 25

Prematurity

Question 26

What happens to blood when a patent ductus arteriosis is present

Answer 26

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.

Question 27

What heart murmur is present in patent ductus arteriosis?

Answer 27

A continuous “machine-like” murmur