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Year 2 OBGYN > Management of the newborn > Flashcards

Management of the newborn Flashcards

1
Q

is there a correlation between DM severity and perinatal outcome?

A

yes

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2
Q

what are the effects of DM on the fetus?

A
  • macrosomia

- small for gestational age

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3
Q

macrosomia is defined by what parameter? what can it lead to? what is the cause?

A
  • defined by gestational age
  • can lead to birth trauma
  • caused by insulin which is a growth factor in utero
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4
Q

what is the cause for small size for gestational age? what is the prevalence?

A
  • maternal renovascular insufficiency

- occurs in 20% of pregnancies

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5
Q

what are the signs of a fetus born to a mother with DM?

A
  • sacral agenesis
  • femoral hypoplasia
  • heart defects
  • cleft palate
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6
Q

what are the effects on the newborn born to a diabetic mother?

A
  • hypoglycemia (MOST COMMON)
  • hypocalcemia
  • hypomagnesemia
  • polycythemia
  • hyperbilirubinemia
  • RDS
  • hypertrophic cardiomyopathy
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7
Q

what is the cause of hypoglycemia in a baby born to a diabetic mother? what are the symptoms?

A
  • hyperinsulinism secondary to maternal glucose
  • poor feeding
  • poor tone
  • jittery
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8
Q

what is the prevention for hypoglycemia in a baby born to a diabetic mother?

A

early and frequent feeding

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9
Q

what is the treatment for a hypoglycemia in a baby born to a diabetic mother?

A

feeding and D10 IV

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10
Q

prolonged rupture of membrane is rupture lasting for longer than what time period? what is the greatest risk?

A
  • 18 hours

- greater risk for infection

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11
Q

women with prolonged rupture of membrane are at risk for infection from what pathogen?

A

group B strep

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12
Q

screening for ROM occurs at what time?

A

35-37 weeks

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13
Q

what are the symptoms of a baby with group B strep?

A
  • poor temperature control
  • respiratory distress / apnea / hypoxemia
  • poor color
  • poor feeding
  • excessive jaundice
  • decreased tone
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14
Q

early onset disease occurs in what timeframe?

A

within first week

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15
Q

meningitis is associated more with early or late onset disease?

A

late onset

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16
Q

late onset disease occurs in what timeframe?

A

from 1 week to 3 months

17
Q

late onset disease has an increased risk of what infection?

A

meningitis

18
Q

mothers who are group B strep positive receive what? what is the mother’s status is not known?

A
  • IV PCN or ampicillin at least 4 hours prior to delivery

- IF group B strep status is not known then abx for the mother are recommended from PROM or maternal fever

19
Q

if a baby is symptomatic following group B strep exposure, what is the workup?

A

begin lab and X ray work up including cultures and begin abx

20
Q

if a baby is asymptomatic following group B strep exposure, what is the workup?

A
  • observe in the hospital for signs or symptoms of illness

- if maternal abx administered under 4 hours prior to delivery observe for 48 hours

21
Q

what is the workup for a fever WITHOUT SOURCE in the neonate under 28 days old after discharge from the nursery?

A
  • CBC, BC
  • UA, UC
  • LP and CSF culture
  • HSV PCR of CSF
  • CXR if cough is present
  • fecal WBC if diarrhea is present
22
Q

what are the pathogens responsible for fever in the neonate less than 28 days old?

A
  • late onset group B strep
  • e. coli
  • listeria monocytogenes
  • HSV
23
Q

what is the treatment for a fever in a neonate under 28 days of age?

A
  • hospitalize until cultures are positive or negative at 48 hours
  • begin abx as soon as cultures are collected
  • cover for group B strep, e. coli, listeria, HSV
  • ampicillin, gentamicin / cefoxamine, acyclovir
24
Q

what are two of the most common features of down syndrome?

A
  • endocardial cushion defect

- mental retardation

25
Q

polyhydramnios is defined as AFI greater than what value? what is AFI?

A

25

amniotic fluid index

26
Q

what is the main association with polyhydramnios?

A

GI abnormalities

27
Q

what is the presentation for GI abnormalities secondary to polyhydramnios?

A

tracheoesophageal fistula:

  • poor feeding
  • excessive secretions
  • respiratory distress
28
Q

what is the most common type of tracheoesophageal fistula?

A

blind esophageal pouch

29
Q

what disorder should you think about with a TE fistula?

A

VACTERL

30
Q

oligohydramnios is defined by what AFI value?

A

AFI under 5

31
Q

what is the potter sequence?

A

fetal compression leading to:

  • fetal growth retardation
  • fetal GU abnormalities
  • pulmonary hypoplasia
  • positional deformities of the fetus
  • flat face, beaked nose, low set ears
32
Q

what is the standard of care for a baby that received late prenatal screening?

A

drug screen

33
Q

what are the consequences of smoking for a fetus?

A
  • IUGR
  • heart defects
  • limb deficiencies
34
Q

when is it appropriate to discharge (in general)?

A
  • drug screen results are in
  • seen social services
  • stable vital signs for over 12 hours
  • urine and stool output one or more times
  • feeding well
  • arranged follow up

Year 2 OBGYN (33 decks)

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