Neonatal and Newborn Flashcards
Define ‘Neonate’.
Term infants: Birth - 28 days
Pre-term: Birth - 44 postmenstrual weeks of age
True or false: A neonate with jaundice is a cause for concern.
Both.
No cause for concern if:
- Jaundice NOT apparent within first 24hrs
- Infant seems well
- Serum bilirubin not at treatment level
- Faded by 14 days
Otherwise, maybe be pathological cause.
Early jaundice (<24hrs) is ALWAYS pathological.
What might cause a jaundiced neonate in the first 24 hours after birth?
Early jaundice (<24hrs) is always pathological
Sepsis
ToRCH
(toxopasmosis, rubella, CMV, HSV)
Haemolysis
ABO incompatibility
Haemolytic disease of the newborn (HDOTN; Rhesus)
Glucose-6-Phosphate Dehydrogenase Deficiency (G6PDD; Heinz bodies)
Spherocytosis
Haematoma
Maternal autoimmune haemolytic anaemia (SLE)
Gilbert’s syndrome
Crigler-Najjar or Dublin-Johnson (affect bilirubin metabolism)
What causes physiological jaundice in neonates?
In the womb, babies have higher levels of RBCs in order to steal oxygen from mother. Post-partum, they don’t need such high levels and so their bodies break down the excess erythrocytes.
Because their livers are immature, they aren’t able to process the excess bilirubin.
Resolves within 14 days.
Is pyloric stenosis more common in males or females?
Pyloric stenosis is 4 times more common in males.
What is the incidence of pyloric stenosis?
4 per 1000 live births
What are typical features of pyloric stenosis?
Projectile vomiting, typically 30 minutes after feed
Constipation and dehydration may also be present
Palpable mass in may be present in upper abdomen
Hypochloraemic, hypokalaemic alkalosis due to persistent vomiting
How is pyloric stenosis best investigated?
Diagnosis of pyloric stenosis is most commonly made by ultrasound
How is pyloric stenosis managed?
Management is with Ramstedt pyloromyotomy
