Introduction (Chap 9 and 94)

Question 1

Perinatal period

Answer 1

28th wks AOG until day 7 of life

Question 2

Neonatal period

Answer 2

First 28 days after birth.

It is divided into 3:
Very early - birth to <24hrs (highest mortality)
Early - birth to <7days
Late - 7 days to less than 28days

Question 3

Major causes of neonatal mortality (3)

Answer 3

Prematurity
Low birth weight
Congenital anomalies

Question 4

Low birth weight

Answer 4

LBW = to 2500g

VLBW = 1500g
ELBW = 1000g

Question 5

T or F: Elective delivery should be delayed until >/=39wks AOG

Answer 5

True

Question 6

Infectious antecedents ormf preterm delivery

Answer 6

Maternal UTI
Chorioamnionitis
Bacterial vaginosis
Upper and lower GUT infections

Question 7

Adverse neurodevelopmental sequelae of prematurity

Answer 7

Cerebral palsy
Seizures
Hydrocephalus requiring a shunt
Blindness
Deafness
Cognitive impairment

Question 8

Average term NB birth weight

Answer 8

3.4kg (7.5lbs)

Range 2500g-4000g

Boys slightly heavier than girls

Question 9

Average length at birth

Answer 9

50cm

Question 10

Average head circumference at birth

Answer 10

35cm

Question 11

How long does the first alert-awake period last?

Answer 11

Approximately 40min

Followed by a period of somnolence. This period maybe affected by maternal analgesics, anesthetics or fetal hypoxia

Question 12

Neonates have inborn preference for faces. They are also near-sighted with a fixed focal length of ____.

Answer 12

~8-12inches (approximate distance from breast to mother’s face)

Question 13

T or F: In newborns, hearing is well-developed.

Answer 13

True. And they preferentially turn towards a female voice.

Question 14

What are the 6 behavioral states of newborns?

QADAFC

Answer 14

Quiet sleep
Active sleep - habituation (e.g. progressively less reaction to a repeated heel stick)
Drowsy - pain will cause fussiness or crying
Alert - fixate on objects or faces and follow horizontally (1st) and then vertically (within a month). Turns to a novel sound.
Fussy
Crying

Question 15

First official visit should be in ____ after discharge.

Answer 15

In 1-2weeks except for those who:

• early discharge
• purely breastfeeding
• risk for jaundice

They should be seen 1-3days after discharge

Question 16

When to perform initial and 2nd examination in NB?

Answer 16

Initial exam - performed as soon as possible after delivery
2nd exam - more detailed; performed within 24hrs of birth

• Take PR (nv: 120-160bpm) and RR (nv: 30-60bpm)
• Take BP if NB appears ill or has a heart murmur