Neonatal checks Flashcards
When should neonatal checks be carried out
Within 72 hrs by a qualified professional
Purpose of neonate examination
To screen for congenital abnormalities that will benefit from early intervention
To make referrals for further tests or treatment as appropriate
To provide reassurance to the parents
Microcephaly
Head that is smaller than expected for age and sex. May be associated with reduced brain size or atrophy.
Macrocephaly
head that is larger than expected for age and sex. It may be normal, but may be associated with hydrocephalus, cranial vault abnormalities or genetic abnormalities.
Cranial moulding
Abnormal head shape as a result of the pressure applied during birth usually resolves in a few days
Caput succedaneum
diffuse subcutaneous fluid collection with poorly defined margins (often crossing suture lines) caused by the pressure on the presenting part of the head during delivery
Resolves after a few days
Cephalhaematoma
Subperiosteal haemorrhage (1-2% infants) bound by the periosteum, therefore, the swelling does not cross suture lines
Most commonly caused by instrument delivery and can result in jaundice
Investigation and management of cephalhaematoma
CT Scan
Dependent on size:
Monitor
Drain. RARE as risk of infection and abscess
If severe infant may need a blood transfusion
Subgaleal haematoma
Clinically differentiated from cephalhaematoma as it crosses the suture lines
Can lose up to 80% of blood volume to that space resulting in hypovolaemic shock, anaemia, coagulapathy and death.
Commonly associated with vacuum assisted, forceps delivery or caesarean delivery.
Sign of subgaleal haematoma
- The scalp is mobile relative to the skull bones underneath.
- There is fluid moving freely between the scalp and skull and
- This fluid is not contained by the suture lines.
