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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
Q

Normal Physiology of Respiration after birth

25
Q

Etiology of Asphyxia Neonatorum

26
Q

Etiology of Asphyxia Neonatorum

  • CNS Failure
27
Q

Etiology of Asphyxia Neonatorum

  • Peripheral Failure
28
Q

Complications of Asphyxia Neonatorum

29
Q

Dx of Asphyxia Neonatorum

A
  • APGAR Score
  • Clinical Picture
30
Q

Def of APGAR Score for Asphyxia Neonatorum

A

Clinical score to assess degree of neonatal asphyxia & effectiveness of resuscitation

31
Q

APGAR Score for Asphyxia Neonatorum

  • Technique
A
  • 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
Q

APGAR Score for Asphyxia Neonatorum

  • Scoring
33
Q

APGAR Score for Asphyxia Neonatorum

  • Time
A

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
Q

APGAR Score for Asphyxia Neonatorum

  • Interpretation
A
  1. Score of 7-10: Good condition.
  2. Score of 4-6: Moderate asphyxia.
  3. Score < 4: Severe asphyxia.
35
Q

CP of Asphyxia Neonatorum

36
Q

CP of Asphyxia Neonatorum

  • Asphyxia Livida
37
Q

CP of Asphyxia Neonatorum

  • Asphyxia pallida
38
Q

Compare between Asphyxia livida & Asphyxia Pallida

39
Q

Prevention of Asphyxia Neonatorum

A
  • Antenatal
  • Intranatal
40
Q

Prevention of Asphyxia Neonatorum

  • Antenatal
A

Proper ANC to high-risk cases.

41
Q

Prevention of Asphyxia Neonatorum

  • Intranatal
42
Q

TTT of Asphyxia Neonatorum

43
Q

TTT of Asphyxia Neonatorum

  • Airway
44
Q

TTT of Asphyxia Neonatorum

  • Breathing
45
Q

TTT of Asphyxia Neonatorum

  • Cardiac Massage
46
Q

TTT of Asphyxia Neonatorum

  • Drugs
47
Q

Drugs in TTT of Asphyxia Neonatorum

  • NaHCO3
A

To correct metabolic acidosis.

48
Q

Drugs in TTT of Asphyxia Neonatorum

  • Epinephrine
A
  • 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
Q

Drugs in TTT of Asphyxia Neonatorum

  • Naloxone
A

0.1 mg/kg 1 M or IV as an antidote to pethidine or morphine.

50
Q

Drugs in TTT of Asphyxia Neonatorum

  • Ca Gluconate
A

To stimulate cardiac contractility.

51
Q

Drugs in TTT of Asphyxia Neonatorum

  • Glucose
A

To prevent or treat hypoglycemia.

52
Q

Drugs in TTT of Asphyxia Neonatorum

  • Volume Expanders
A

Ringer’s lactate or normal saline can be given to correct hypovolemia.

53
Q

Drugs in TTT of Asphyxia Neonatorum

  • Antibiotics
A

To guard against pulmonary infections.

Y4R2 - Obstetrics I 🤰 (59 decks)

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