Illness in full term baby Flashcards
What is perinatal asphyxia
Oxygen deprivation on birth (greek for pulseless)
Another name for perinatal asphyxia
Hypoxic- ischaemic encephalopathy
What are the consequences in the tissue from hypoxic-ischaemic encephalopathy
Hypoxaemia
Ischaemia
Metabolic acidosis
`What are the warning for hypoxia-ischaemia
Decreased fetal movement
Sentinel events
What sentinel events give warning for hypoxia-ischaemia
Placental abruption
Uterine rupture
Cord prolapse
What structures are preserved in redistribution of blood supply
CNS
Myocardium
Adrenals
What structures are left vulnerable due to redistribution of blood supply
Kidneys
GI tract
Liver
Muscle
What does encephalopathy in new born refer to (4)
- Abnormal neurologic function and conciousness
- Abnormalities of tone and reflexes
- Autonomic dysfunction
- Seizures
What brain injury is most common after HIE
Cerebral palsy
Describe the sequence of events that occur after fetal hypoxia
Primary neuronal injury Primary energy failure Derangement of cellular function Secondary energy failure Secondary neuronal injury, further necrosis and apoptosis
What causes secondary neuronal death
Cerebrovascular dysfunction Glutamate releasde Free radicals Calcium entry Apoptosis
Name some mechanisms of brain injury in hypoxia-ischaemia
Glucose and oxygen deprivation Energy depletion Glutamate receptor activation Accumulation of intracellular calcium Free radicals Lipid peroxidation Oligodendrogial death Apoptosis
Why may inducing hypothermia be neuroprotective
Reduces cerebral metabolism Reduced energy use Reduced accumulation of excitotoxic aa reduced NO synthetase activity Reduced free radical activity
When do newborns acquire serious infections
Passage through birth canal and from outside environment
What infections do newborns suffer
GBS
E. coli
Name 3 groups of newborns which have higher rates of infection/ high mortality from infections
Infants requiring intensive care
Preterm infant
Newborns in developing world
What is the onset of early onset sepsis
Within 48 hours
What causes early onset sepsis
Microbes acquired from mother before/ during passage through birth canal
What condition may early onset group b streptococcus mimic
Perinatal hypoxia-ischaemia
What are the features of early onset GBS
Apnea Severe hypoxia Cardio resp failure Hypotension Metabolic acidosis Tachycardia Poor perfusion
What does a full blood count show in GBS
Neutropenia
Predisposing factors to GBS
Evidence of chorioamniotis
Prolonged labour
Prolonged rupture of membrane
Low birthweight
What brain related complication can result from E. coli infection
Meningitis
What is the time period for late onset sepsis in the newborn
> 48 hours after birth
Name 2 organisms often responsible for late onset sepsis
Coagulase negative staph
Staph aureus
