Neonatal/Infant 2

Question 1

What are the symptoms and signs of Infant respiratory distress syndrome (IRDS)?

Answer 1

• Preterm delivery
• Increased work of breathing
• Respiratory distress symptoms soon after birth
• Rapidly progress to fatigue, apnoea and hypoxia

Question 2

What is respiratory distress?

Answer 2

• Tachypnoea (> 60/min)
• Expiratory grunting
• subcostal & intercostal retractions
• Diminished breath sounds
• Cyanosis
• Nasal flaring

Question 3

What are the risk factors of IRDS?

Answer 3

• Premature delivery.
• Male infants.
• Infants delivered via caesarean section without maternal labour.
• Hypothermia.
• Perinatal asphyxia.
• Maternal diabetes.
• Family history of IRDS.

Question 4

What is the main cause of infant respiratory distress syndrome?

Answer 4

A deficiency of alveolar surfactant

Question 5

What is transient tachypnoea of the newborn (TTN)?

Answer 5

• A respiratory problem that can be seen in the newborn shortly after delivery.
• Consists of a period of rapid breathing (higher than the normal range of 30-60 times per minute).

Question 6

What is the likely cause of TTN?

Answer 6

It is likely due to retained lung fluid.

Question 7

When is TTN most often seen in terms of gestational age and type of delivery?

Answer 7

It is most often seen in 35+ week gestation babies who are delivered by caesarian section without labor.

Question 8

Chest x-ray shows:
- Hyperinflation of the lungs including prominent pulmonary vascular markings,
- Flattening of the diaphragm, -Fluid in the horizontal fissure of the right lung
What is the diagnosis?

Answer 8

Transient tachypnoea of the Newborn

Question 9

What is neonatal sepsis and when is it more common?

Answer 9

Neonatal infection of a bacterial blood stream infection.

More common in premature babies.

Question 10

What are the risk factors for early-onset neonatal sepsis?

Answer 10

• Prolonged rupture of membrane > 18 hours
• Maternal infection (GBS, E.coli, listeria), pyrexia, chorioamnionitis, UTI
• Mother known carrier of GBS from vagina or urine, or previous infant affected by it
• Perterm labour
• Fetal distress
• Breaks in neonatal skin or mucosa

Question 11

What are the risk factors in late-onset neonatal sepsis?

Answer 11

• Central lines and catheters
• Congenital malformations e.g.: spina bifid a
• Severe illness
• Malnutrition
• Immunodeficiency

Question 12

What are the common organisms in early-onset neonatal sepsis?

Answer 12

• GBS
• E.coli
• Listeria
• Herpes simplex
• Chlamydia trachomatis
• Anaerobes
• H. influenza

Question 13

What are the common organisms in late-onset neonatal sepsis?

Answer 13

• Staph. aureus
• E.coli
• coagulase-negative staphyocci (s. epidermidis)
• fungi

Question 14

How are neonatal sepsis categorised?

Answer 14

• Early onset (within 48h birth)

- Late onset

Question 15

What is hypoxic-ischaemic encephalopathy (HIE)?

Answer 15

Clinical syndrome of brain injury secondary to a hypoxic-ischaemic insult.

Question 16

What are the causes of HIE?

Answer 16

• Cord prolapse
• Placental abruption
• Maternal hypoxia causes
• Inadequate postnatal cardiopulmonary circulation

Question 17

What are the presentation of HIE?

Answer 17

• Respiratory depression at birth
• A need for resuscitation, including intermittent partial pressure ventilation (IPPV)
• pH soon after birth <7
• Base excess > -12