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Y4R2 - Obstetrics I 🤰 > L7: Fetal & Neonatal Asphyxia > Flashcards

L7: Fetal & Neonatal Asphyxia Flashcards

1
Q

Def of Fetal Distress (Intrauterine - Fetal Asphyxia)

A
  • State of inadequate oxygenation & inadequate elimination of CO2 that results in metabolic acidosis if persists for long time.
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2
Q

Types of Fetal Distress (Fetal Asphyxia)

A
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3
Q

Etiology of Acute Fetal Distress (Intrapartum Asphyxia)

A
  • Maternal
  • Fetal
  • Placental
  • Cord
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4
Q

Etiology of Acute Fetal Distress (Intrapartum Asphyxia)

  • Maternal Causes
A
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5
Q

Maternal Causes of Acute Fetal Distress

  • Hypoxic Anoxia
A

Due to

  • pulmonary obstruction
  • pulmonary TB
  • bilateral pneumonia
  • prolonged anesthesia
  • convulsive fits.
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6
Q

Maternal Causes of Acute Fetal Distress

  • Stagnant Hypoxia
A

Due to:

  • HF
  • pulmonary edema
  • severe shock.
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7
Q

Maternal Causes of Acute Fetal Distress

  • Anemic Anoxia
A

Due to:

  • severe anemia (from Hge).
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8
Q

Maternal Causes of Acute Fetal Distress

  • Histotoxic Anoxia
A

As in

  • barbiturate poisoning
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9
Q

Causes of Acute Fetal Distress

  • Fetal
A
  • Cerebral edema & ischemia from prolonged labor or difficult forceps (due to ICH or depressed skull fractures).
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10
Q

Causes of Acute Fetal Distress

  • Placental
A
  • Placental insufficiency
  • Placental separation
  • Placental compression
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11
Q

Placental Causes of Acute Fetal Distress

  • Placental Insufficiency
A

Due to:

  • small placenta
  • placental thrombosis
  • multiple placental infarcts
  • placental aging.
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12
Q

Placental Causes of Acute Fetal Distress

  • Placental Separation
A

As in:

  • placenta previa
  • accidental Hge.
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13
Q

Placental Causes of Acute Fetal Distress

  • Placental Compression
A

Due to:

  • Tetanic uterine contraction
  • Prolonged labor after ROM
  • Compression by head in placenta previa type lI posterior.
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14
Q

Causes of Acute Fetal Distress

  • Cord
A
  • Cord prolapses
  • Cord compression
  • Hematoma, True knots, or tight coils of cord around fetal neck.
  • Avulsion of cord
  • Rupture of vasa previa.
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15
Q

Cord Causes of Acute Fetal Distress

  • Cord Prolapse
A

Leading to cord compression & vasospasm of its vessels.

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16
Q

Cord Causes of Acute Fetal Distress

  • Cord Compression
A
  • By uterine contraction after drainage of liquor or by forceps blades.
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17
Q

Dx of Acute Fetal Distress

A
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18
Q

Dx of Acute Fetal Distress

  • AF
A

Meconium-stained liquor in cephalic presentation.

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18
Q

Dx of Acute Fetal Distress

  • FHR
A
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19
Q

Managment of Acute Fetal Distress

A
  • Conservative
  • Active
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20
Q

Managment of Acute Fetal Distress

  • Conservative
A
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21
Q

Managment of Acute Fetal Distress

  • Active
22
Q

Other Names of Asphyxia Neonatorum

A
  • Extrauterine or Postnatal Asphyxia
23
Q

Def of Asphyxia Neonatorum

A
  • Failure of establishment of good pulmonary circulation & respiratory function after birth.
24
Normal Physiology of Respiration after birth
25
Etiology of **Asphyxia Neonatorum**
26
Etiology of **Asphyxia Neonatorum** - CNS Failure
27
Etiology of **Asphyxia Neonatorum** - Peripheral Failure
28
Complications of **Asphyxia Neonatorum**
29
Dx of **Asphyxia Neonatorum**
- APGAR Score - Clinical Picture
30
Def of **APGAR Score for Asphyxia Neonatorum**
Clinical score to assess degree of neonatal asphyxia & effectiveness of resuscitation
31
**APGAR Score for Asphyxia Neonatorum** - Technique
- The scoring system includes 5 items & each item takes 0, 1 or 2 so, full mark is 10/10 (HR, Respiration, Reaction, Color, Tone).
32
**APGAR Score for Asphyxia Neonatorum** - Scoring
33
**APGAR Score for Asphyxia Neonatorum** - Time
Score is done at 1 & 5 minutes. 1. 1 minute score: Correlates well e survival. 2. 5 minutes score: Prognostic index of late CNS damage at 1 year of age.
34
**APGAR Score for Asphyxia Neonatorum** - Interpretation
1. Score of 7-10: Good condition. 2. Score of 4-6: Moderate asphyxia. 3. Score < 4: Severe asphyxia.
35
CP of **Asphyxia Neonatorum**
36
CP of **Asphyxia Neonatorum** - Asphyxia Livida
37
CP of **Asphyxia Neonatorum** - Asphyxia pallida
38
Compare between Asphyxia livida & Asphyxia Pallida
39
Prevention of **Asphyxia Neonatorum**
- Antenatal - Intranatal
40
Prevention of **Asphyxia Neonatorum** - Antenatal
Proper ANC to high-risk cases.
41
Prevention of **Asphyxia Neonatorum** - Intranatal
42
TTT of **Asphyxia Neonatorum**
43
TTT of **Asphyxia Neonatorum** - Airway
44
TTT of **Asphyxia Neonatorum** - Breathing
45
TTT of **Asphyxia Neonatorum** - Cardiac Massage
46
TTT of **Asphyxia Neonatorum** - Drugs
47
Drugs in TTT of **Asphyxia Neonatorum** - NaHCO3
To correct metabolic acidosis.
48
Drugs in TTT of **Asphyxia Neonatorum** - Epinephrine
- 0.1 ml/kg of 1/ 10000 dilution either by slow IV drip or intracardiac through 4th Lt intercostal space if HR doesn't respond < 80 bpm).
49
Drugs in TTT of **Asphyxia Neonatorum** - Naloxone
0.1 mg/kg 1 M or IV as an antidote to pethidine or morphine.
50
Drugs in TTT of **Asphyxia Neonatorum** - Ca Gluconate
To stimulate cardiac contractility.
51
Drugs in TTT of **Asphyxia Neonatorum** - Glucose
To prevent or treat hypoglycemia.
52
Drugs in TTT of **Asphyxia Neonatorum** - Volume Expanders
Ringer's lactate or normal saline can be given to correct hypovolemia.
53
Drugs in TTT of **Asphyxia Neonatorum** - Antibiotics
To guard against pulmonary infections.

Y4R2 - Obstetrics I 🤰 (59 decks)

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