Neonatal Flashcards
what are the risk factors for a premature baby
> 2 preterm previous deliveries
abnormally shaped uterus
multiple pregnancy
interval of <6 months between pregnancies
IVF conception
smoking, alcohol and illicit drug use
poor nutrition, some chronic conditions, high BP, diabetes, multiple miscarriages and abortion
if the baby is okay and can be kept warm how long should you pause for to allow placental transfusion
one minute
low admission temperature is a dependent or independent risk factor for neonatal death
it is an independent risk factor
how does hypothermia affect preterm morbidities
it increases severity of all preterm morbidities
why is thermal regulation ineffective in the preterm babies
low BMR
minimal muscular activity
subcutaneous fat insulation is negligible
high ratio of surface area to body mass
how can a preterm baby be kept warm
wrap or bags, transwarmer mattress, skin to skin, prewarmed incubator
why is there increased risk of potential nutritional compromise
limited nutrient reserves
immature metabolic pathways
increased nutrient demands
what is gestational correction
adjusts the plot of a measurement to account for the number of weeks a baby was born early
how long should gestational correction be used for
continued until 1 year for infants born 32-36 weeks
2 years for infants born before 32 weeks
how is neonatal sepsis categorised
time of onset
EOS-early onset, mainly due to bacteria acquired before and during delivery
LOS-acquired after delivery
RDS is also known as
hyaline membrane disease
what is the primary and secondary pathology of RDS
primary-surfactant deficiency, structural immaturity
secondary pathology-alveolar damage, formation of exudate from leaky capillaries, inflammation, repair
what are the clinical features of RDS
tachypnoea, grunting, intercostal recessions, nasal flaring, cyanosis
how does RDS tend to progress
worsen over minutes to hours, gradual worsening to a nadir at 2-4 days then gradual improvement
how does failure of PDA closure affect RDS
exacerbates RDS as symptoms of congestive heart failure, oxygen requirements are high which exacerbated RDS
what is an intraventricular haemorrhage
a form of intracranial haemorrhage that begins with bleeding into the germinal matrix
what are the 2 major risk factors for intraventricular haemorrhage
prematurity, RDS
when does intraventricular haemorrhage tend to occur
in the first day of life
name some preventative measures for IVH
antenatal steroids
prompt and appropriate resuscitation
avoid haemodynamic instability
avoid-hypoxia, hypercarbia, hyperoxia and hypocarbia
how is IVH graded
grade1-4
neurodevelopmental delay up to 20% in grade1-2 mortality 10%
grade 3-4 neurodevelopmental delay up to 80% mortality 50%
what is the typical feature of NEC
usually after recovering from RDS
early signs-lethargy and gastric residuals
bloody stool, temperature instability, apnoea and bradycardia
how do you treat NEC
nil by mouth
except for ?probiotics
broad spectrum antibiotics
consult surgeon
what is pathognomic for NEC
pneumatosis intestinalis-gas in the gut wall seen on XR
what is ROP
retinopathy of prematurity
