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HD2 > Low Birth Weight And Prematurity > Flashcards

Low Birth Weight And Prematurity Flashcards

1
Q

Low birth weight

A

Less than 2500g

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2
Q

Very low birth weight

A

Less than 1500g

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3
Q

Extremely low birth weight

A

Less than 1000g

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4
Q

Normal weight at term

A

2500-4200g

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5
Q

Inter uterine growth restriction

A

Fetus with birth weight <10th percentile of those born at same gestational age and displays signs of chronic hypoxia and failure to thrive

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6
Q

How many standard deviations below population mean is considered growth restricted

A

2

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7
Q

What does fetal growth depend on

A

Genetic potential
Substrate supply from placenta

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8
Q

How much weight does the fetus gain a day at 14wks, 20wks, and 33wks

A

5g
10g
30-35g

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9
Q

At what week does fetal growth rate start to decrease

A

35

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10
Q

How is symphysiofindal height measured

A

Pubic symphysis to top of uterus

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11
Q

What affects symphysiofindal height

A

Fetal size
Amniotic fluid volume

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12
Q

Where is abdominal girth measured

A

Level of umbilicus

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13
Q

How much does symphysiofindal height increase per day between weeks 14 and 32

A

1cm

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14
Q

How much does abdominal girth increase per day after 30wks

A

2.5cm

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15
Q

Which type of IUGR is symmetrical

A

1

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16
Q

What causes type 1 IUGR

A

Growth inhibition in early pregnancy - 4-20wks

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17
Q

What causes type 2 IUGR

A

Restriction of nutrient supply in utero

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18
Q

What is the criteria for type 1 IUGR

A

All parameter below 10th percentile for gestational age with normal ratio

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19
Q

What can cause growth inhibition in early pregnancy

A

Genetics
Infection of fetus/amniotic sac
Multiple gestation
Environmental toxins - smoking

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20
Q

What weeks is growth restricted in type 1, type 2, and type 3IUGR

A

1 - 4-20wks
2 - 28+wks
3 - 20-28wks

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21
Q

What causes brain sparing effect/asymmetry in type 2 IUGR

A

Redistribution of CO to brain and heart

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22
Q

Effects of Type 3 IUGR

A

Skeletal shortening
Decr soft tissue mass

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23
Q

What conditions can lead to type 2 IUGR

A

Maternal HT and pre eclampsia
Renal disease
Vasculopathy

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24
Q

What conditions can lead to type 3 IUGR

A

Chronic HT
Lupus nephritis
Maternal vascular disease

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25
Q

Which types of IUGR affect hyperplasia and hypertrophy

A

1 - hyperplasia
2 - hypertrophy
3 - both

26
Q

What Antepartum, Intrapartum, and neonatal Complications are more common with IUGR

A

perinatal morbidity, morality, and still birth
Oligohydramnios
Meconium aspiration
Fetal distress
Hypoxic ischaemic encephalopathy
Fetal circulation insufficiency
Temperature regulation difficulty
Hypoglycaemia
Chronic intrauterine hypoxia
Birth/perinatal asphyxia
Retinopathy of prematurity
Hypocalcemia
Polycythemia/hyperviscocity
Low serum ferritin
Pulmonary haemorrhage
Immunodeficiency
Renal dysfunction
Feed intolerance/necrotising enterocolitis
Persistent pulmonary hypertension

27
Q

Why do babies with IUGR have difficulty regulating temperature

A

Little brown fat
Small body mass to surface area

28
Q

Why is Oligohydramnios more common with IUGR

A

Fetal kidneys not developed

29
Q

Childhood IUGR complications

A

Increased mortality from infections and congenital abnormalities
Cerebral palsy
Impaired cognitive performance

30
Q

Adult IUGR complications

A

Coronary heart disease
Hypertension
T2 diabetes
Dislipidaemia
Stroke

31
Q

IUGR diagnosis

A

Identify at risk mothers
Serial fundal height measurement
Serial abdominal girth measurement
Head circumference
Amniotic fluid volume
Doppler ultrasound - umbilical artery, middle cerebral artery, cerebral/placental ratio

32
Q

What lag in fundal height suggests IUGR

A

4wks
6wks = severe IUGR

33
Q

What ratio between MCA and umbilical artery is normal

A

Below 1
1.1= brain sparing

34
Q

IUGR management

A

Treatment of underlying cause
Bed rest in left lateral position
Maternal oxygen therapy
Delivery
Antenatal steroids

35
Q

Why are mothers with IUGR on bed rest in left lateral position

A

Increases uteroplacental blood flow

36
Q

Main cause of infant deaths

A

Congenital defects and chromosomal disorders

37
Q

preterm birth

A

Born Before 37 weeks

38
Q

Deficiency of what nutrient increases pre term births

A

Vitamin D

39
Q

Peripheral inserted central catheter

A

IV used for medications and replacing fluids

40
Q

How is a pre term baby’s airways kept open in an incubator

A

SIPAP or CPAP

41
Q

Orogastric tube function in preterm baby

A

Aid feeding
Remove air from stomach

42
Q

What causes respiratory distress syndrome

A

Structural and functional immaturity of lungs - underdeveloped parenchyma and surfactant insufficiency

43
Q

Why do antenatal steroids decrease respiratory distress syndrome

A

Stimulate maturation of type 2 pneumocytes to produce surfactant

44
Q

Intra ventricular haemorrhage

A

bleeds into ventricles and brain tissue

45
Q

Periventricular leukomalacia

A

White matter softens and dies around lateral ventricles leaving fluid filled cysts due to interventricular haemorrhage

46
Q

What causes retinopathy of prematurity

A

Abnormal fragile blood vessels grow across retina and leak scarring and detaching retina causing reduced vision or blindness

47
Q

When in gestation does the eye start developing

A

Week 16

48
Q

Why do pre term baby’s have temperature control problems

A

Large SA:volume
Less subcutaneous and brown fat
Inadequate thermal response
Skin may be thinner and may not be fully keratinised
Poor capillary response

49
Q

Why might premature babies need Parenteral infusion of fluids, nutrients and vitamins

A

GI system usually immature and unable to process enteral feeds

50
Q

Why do pre mature babies have lower energy requirements than term babies

A

Less activity and movement

51
Q

Why do premature babies need more protein, calcium, and phosphorus

A

Muscle and bone growth

52
Q

Necrotising enterocolitis symptoms

A

Milk aspirated from stomach
Bile stained vomit
Distended abdomen
Bloody stools
Shock
Distended bowel loops, thickened bowel wall, and intramural gas on x ray
Bowel perforation

53
Q

What causes necrotising enterocolitis

A

Bacterial invasion of ischemic bowel wall

54
Q

What condition is more likely in babies fed cows milk

A

Necrotising enterocolitis

55
Q

Necrotising enterocolitis treatment

A

Stop oral feeding
Broad spectrum antibiotics
Surgery to remove perforated bowel

56
Q

Why is fluid and electrolyte balance monitored

A

Prevent dehydration, fluid overload, electrolyte balance, fluid loss

57
Q

What can fluid overload lead to

A

Congestive heart failure
Necrotising enterocolitis
Mortality

58
Q

How is fluid loss through the skin minimised in preterm babies

A

Humidified incubators
Skin emollients

59
Q

Why is sodium restricted in pre term babies

A

Immature Nephrons not equipped to handle large amounts of sodium

60
Q

Why are premature babies often given iron supplements for 6 months corrected age

A

Anaemia of prematurity

HD2 (23 decks)

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