Neonatal Flashcards
What defines prematurity?
<37 weeks
What are some acute problems a premature baby may have?
RDS Necrotising enterocolitis Intraventricular haemorrhage Hypothermia Jaundice Hypoglycaemia Hypocalcaemia Congenital heart defects (PDA) Infection
What happens to the lungs in respiratory distress syndrome?
There is a lack of surfactant so the lungs are non-compliant and stiff. This leads to hypoxia
What are the risk factors for respiratory distress syndrome?
Diabetic mother
C-section
Meconium aspiration
Describe the CXR in respiratory distress syndrome
Ground glass appearance with air bronchograms and an indistinct heart border
How is respiratory distress syndrome managed?
O2
Exogenous surfactant given via ET tube
Dexamethasone to the mother for prevention
How and when does necrotising enterocolitis present?
Within first 2 weeks of life
- Bloody, mucous stool
- Abdominal distention
- Bilious vomiting
- Feeding difficulties
What are the AXR findings in necrotising enterocolitis?
Bowel dilation
Thickened oedematous bowel wall
Gas filled loops and intramural gas
+/- pneumoperitoneum and Riglers sign
How is necrotising enterocolitis managed?
NG tube
Fluids
Gentamicin and metronidazole
What are the complications of necrotising enterocolitis?
Perforation
Sepsis
DIC
Short bowel syndrome
What is short bowel syndrome and how does it present?
Lack of functioning small intestine leads to malabsorption
- diarrhoea
What is the pathophysiology of retinopathy of prematurity?
If O2 is given following an episode of hypoxia then there is proliferation of vessels at the border of vascular and non-vascular retina
- reduced visual acuity
- retinal detachment
When and how does intraventricular haemorrhage present?
Within first few days
- apnoea
- bulging anterior fontanelle
- bradycardia
How is intraventricular haemorrhage diagnosed?
Cranial USS
What are your differentials for neonatal jaundice occurring within 24 hours?
- ABO incompatibility
- Rhesus incompatibility
- G6PD deficiency
- TORCH infections
When are you not worried about neonatal jaundice? What could be the cause within this time frame?
2-14 days
- physiological (fHb breakdown)
- breast milk
What can cause neonatal jaundice occurring after 14 days?
- Biliary atresia
- Congenital hypothyroidism
- Galactosaemia
- Infection eg UTI