Neonatal Lectures Flashcards
Small for gestational age (SGA) is classified as a size under ___% for gestational age
under 10%
can be symmetric (early)
or
asymmetric (late, after 28 weeks)
large for gestational age (LGA) is classified as weight above ___% for GA
90%
Gestational diabetes increases the infants risk of…
LGA
Hypoglycemia
Increased risk of DM
Maternal HTN increases infants risk of…
Asymmetric SGA
Maternal chronic medical conditions increases the infants risk of…
Thyroid issues
DM
Mental health issues
Maternal smoking increases risk of…
IUGR (intra uterine growth retardation)
SGA (small for gestational age)
SIDS!
IUGR
SIDS risk
Vascular infarcts
..risk is all increased with?
maternal cocaine use
Maternal hx important!
Must get meconium and urine collection
Sx scoring with Finnegan scores (feeding concerns, discomfort)
Neonatal Abstinence Syndrome
37-42 weeks gestational age
Term
34-36 weeks gestational age
Late preterm
under 37 weeks gestational age
Premature
birth weight under 2500 g =?
birth weight under 1500 g=?
under 2500g= low birth weight
under 1500g= very low birth weight
Shoulder dystocia increases risk of…
Fx clavicle
Erb’s Palsy
Breech increases risk of…
Hip dystocia
What are the TORCH maternal infections/exposures that can be passed to baby?
- *T**oxoplasmosis,Treponema
- *R**ubella
- *C**MV
- *H**erpes
What are other maternal infections/exposures (other than TORCH) can be passed to baby?
Hep B, C
HIV
Parvovirus B19
Gonorrhea, Chlamydia
Varicella
Group B strep
Occurs from maternal exposure to cats, raw meat, or immunosuppression
Sxs:
hydrocephalus
intracranial calcifications
chorioretinitis
jaundice
HSM
fever
Tx: pyrimethamine plus sulfadiazine
Toxoplasmosis
(TORCH)
Maternal testing with RPR
Sx: prematurity, anemia, neutropenia, pneumonia, thrombocytopenia, HSM
late sx: snuffles, rash, keratitis
really late sx: Hutchinson teeth , bone abnormalitites
Tx: Penicillin
Syphilis
Viral infection in unvaccination mom
Sx:
IUGR
Microcephaly
Eye issues, deafness
HSM, Jaundice
Blueberry muffin rash
B and T cell deficiency
Tx: None. but can prevent with vaccine
Rubella
Caused by maternal STI
Sx:
Sepsis
IUGR
HSM, anemia
Periventricular calcifications
Blueberry muffin rash
Deafness, pneumonia
Dx: maternal urine
CMV
(no tx)
What does Parovirus B19 increase risk of?
Risk of fetal loss
Causes neonatal conjunctivitis and pneumonia
Chlamydia
Causes microophthalmia
Eye and bone issues
Tx= acyclovir
Varicella
MC cause of neonatal sepsis?
Group B strep infections
Occurs from birth to 7 days of life
Caused by: GBS, E Coli, Klebsiella, Listeria
Can cause: premature rupture of membrane (PROM), maternal fever and preterm labor
Early onset sepsis
Occurs in 7-28 days of life
Caused by: H.flu, S.pneumo, N.meningitidis
Can cause: meningitis, osteo, UTI
Late onset sepsis
Ampicillin and Gentamicin can be used to treat..
Neonatal sepsis
Causes:
Jaundice/scleral icterus
kernicterus
*can be indirect or direct
Hyperbilirubinemia
Occurs within first 24 hours of life
Causes:
Extrahepatic obstruction
Persistent intrahepatic cholestasis
Acquired intrahepatic cholestasis
Genetic and metbaolic disorders
Direct hyperbilirubinemia
Occurs after 24 hours of life
Causes:
Physiologic
Hemolytic
Polycythemia
etc.
Indirect hyperbilirubinemia
Has a max score of 10
Is based upon: tone, color, respiratory effort, HR, reflex irritabilit
APGAR score
Normal neonatal HR range?
120-160 bpm
Normal neonatal RR range?
40-60 breaths per min
True or false..
Normal neonatal temp is 36.5-37.5 C (rectally)
TRUE
soft tissue injury
*Edema of the scalp
*CROSSES SUTURE LINES
Caput Succadeneum
Swelling over 1 or both parietal bones
WILL NOT CROSS SUTURES LINES
Cephalohematoma
Ankyloglossia
Tongue tie
