Lecture 2 Flashcards
What are neonatologists?
Paediatric specialists whose expertise is looking after newborn infants or those born prematurely and their families
What is the neonatal period? What happens?
First 4 weeks of the child’s life, the most dramatic physiologic changes that occur during human life
What makes neonataology a unique speciality?
High level of skill required to undertake technical procedures on newborn infants combined with the ethical and emotional support that is essential
What is the spectrum of clinical condition care?
Care required from critically ill preterm babies in the NICU, to the care of well term babies on the postnatal ward
Can you name some facts from the WHO?
- 13.4 million babies were born preterm in 2020, before 37 weeks of gestation
- Preterm birth complications are the leading cause of death among children below 5 years, responsible for approximately 900 000 deaths in 2019
- 3/4 of these deaths could be prevented with current, cost effective interventions
- Across countries, the rate of preterm birth ranges from 4-16% of babies in 2020
Name and list the specturms of term birth
Extremely preterm - less than 28 weeks
Very preterm - 28 to 31 weeks
Moderately preterm - 32 to 33 weeks
Late preterm - 34 to 36 weeks
Early term - 37 to 38 weeks
Full term - 39 to 40 weeks
Post term - equal or more than 42 weeks
What percentage of preterm births, the actual cause of early delivery as well as possibilities of prevention remain unknown?
50%
Name the risks and preventions of preterm birth, what are the influences?
Care of infections - infections
Healthy lifestyles - stress, smoking, alcohol, obesity, drugs, excessive physical work, undernutrition
Preconception & antenatal care - genetic predisposition, conception by in-vitro fertilisation, shorter inter - pregnancy intervals, multiple pregnancies, maternal age less than 18 and above 35 years, low economic status
Care of chronic diseases - maternal diseases eg. High blood pressure, diabetes
Name the levels of neonatal care units
Special care baby unit (SCBU)
Local Neonatal Unit (LNU)
Neonatal Intensive Care Unit (NICU)
Transition Care (TC)
For the SPCU, what care does this include?
Monitoring their breathing or heart rate
Giving them more oxygen
Treating low body temperature
Treating low blood sugar
Helping them feed, sometimes by using a tube
Helping babies who become too unwell soon after
For the LNU, what care is provided?
Breathing support given through their windpipe
Short term intensive care
CPAP or high flow therapy for breathing support
Feeding through a drip in their vein
Cooling treatment for babies who have had difficult births or are unwell soon after birth ( before being transferred to NICU)
Helping babies who become unwell soon after birth
For the NICU, what care do they provide?
Care for babies with the highest need for support
Need breathing support given through their windpipe
Have severe disease affecting their breathing (respiratory disease)
Need or have just had surgery
For TC, what does care is provided?
Mother and baby stay together in hospital whilst the team care for the baby
Some babies born between 32 and 37 weeks of gestation
Babies with mild jaundice or feeding problems
Neonatal care is family centred, what elements are important to ensure this is the priority through the chain of care?
Capacity and patient flow, repatriation, discharge planning and outreach, follow-ups
National guidance and pathways, data and audits, health information, research and innovation, education and workforce
Equity, well-being, quality improvement
How many deaths for children occur in their first year of life? What are the risk factors?
Over half of deaths
Maternal age, smoking, disadvantaged circumstances
