Fetal Growth Disturbances & Prematurity Flashcards
What is SGA?
Major differences between preterm and SGA babies
What are the external features assessed on the clinical assessment of maturity - scoring system (New Ballard score, modified from Dubowitz)?
Neurological assessment (relative flexor tone of 4 limbs)
[New Ballard score, modified from Dubowitz]
Don’t use this scoring for neurologically abnormal baby
What is Intrauterine Growth Restriction?
SGA is statistical term
Assessment of foetal growth must be based on statistics from that ethnicity
Yellow: IUGR (initially normal, but gets worse = look at the course)
Red: SGA (small from the start)
What is the consequence of reduce growth support?
% reduction in organ weight in SGA baby compared to normal counterparts
Pathological factors associated with slow foetal growth
What are fetal and placental factors?
What are embryopathies?
What. areconstitutional and genetic factors causeing slow feotal growth>
Idiopathic causes for SGA
History, ultrasound, p/e
Special problems of SGA babies
Lower reserve
Glucose disturbance in SGA babies
Hypothermia in SGA babies
CBC issue in SGA babies
Cardiorespiratory problems in SGA babies
What are some primary causes of SGA in babies?
- Hepatosplenomegaly
- Hearing loss
- Intracranial calficiations
- Blueberry muffin baby
Management of SGA babies
What must be done during resuscitation of SGA baby?
Dextrose gel may be used before mother can breastfeed
Search for underlying cause
Future growth and development of SGA babies
- Catch up growth
- Neurodevelopmental sequalae
Long-term implications of SGA babies
I.e. blood will be diverted to brain, instead of gut, liver, pancreas = in adulthood, more prone to adult disease due to poorer development of these organs
Metabolic syndrome risk is greater
Complicatoins of infant of diabetic mother
What is preterm, very preterm and extreme prematurity?
What is associated with spontaneous premature birth?
Foetal and socioeconic factors with spontaneous premature birth
Problems related to prematurity
What is RDS?
Surfactant is made at around 30-32 weeks
Mother with diabetes
Widreslread collapsed membrane in alveoli
Factors predisposing to RDS: Sex, C-section, maternal, familial
Factors predisposing to RDS
What is the usual cord clamping time in labor ward?
~ 1 min, unless there are other causes
Factors protecting against RDS
Clinical diagnosis of RDS
Bilateral lung fields are white-out
Cannot see cardiac border
Air bronchograms (atelectasis)
Reduce no. of ribs = lung voluem diminished
What is done for prevention of RDS?
What are other causes of respiratory distress?
Treatment of RDS
Nasal CPAP or nasal IMV
Prevent lung complications, which may persist into later life
What are neurological complications in RDS?
RF for IVH/PVH
missing slide
Blood clot inside IVH
Management of PVH / IVH
Enlarged lateral ventricels
What is periventricular leucomalcia?
Neuroreduction in
Nutritional management in premature infant
Enteral feeding
What is NEC?
RF for NEC
XXX
DISTENS
CLINIACL EFATURES OF NEC
Prevention of NEC
Breast milk = evidence-based
Treatment of NEC
Late complications related to prematurity
