Neonatal medicine

Question 1

Main causes of neonatal deaths

Answer 1

Immaturity
Congenital anomalies
Intrapartum causes/complications
Infection
Sudden infant death

Question 2

What is hypoxic-ischaemic encephalopathy?

Answer 2

Critical reduction in oxygen delivery to the foetus antenatally, during labour and/or delivery, producing lactic acidosis, delayed respiration and possible brain damage or death

Question 3

Grades and description of HIE

Answer 3

Mild - irritable, excessive response to stimulation, staring, hyperventilation, impaired feeding
Moderate - markedly abnormal tone/movements, cannot feed, may have seizures
Severe - no normal movements, prolonged and refractory seizures, multi-organ failure

Question 4

What is one way of preventing brain damage?

Answer 4

Mild hypothermia (cooling by 3-4 C) can reduce brain damage (if started withing 6 hours of birth)

Question 5

Prognosis for HIE?

Answer 5

Mild - complete recovery
Moderate - full recovery unlikely if abnormalities persist beyond 10 days, otherwise good prognosis
Severe - 30-40% mortality, 80% have neurodevelopmental disabilites (particularly cerebral palsy)

Question 6

Caput succedaneum?

Answer 6

Bruising and oedema of the presenting part, extending beyond the margin of the skull bones
Resolves in a few days

Question 7

Cephalhaematoma?

Answer 7

Heamatoma from bleeding below the periosteum, confined within the margins of the skull sutures.
Usually involves parietal bone
Resolves over several weeks, and is occasionally associated with a linear skull fracture

Question 8

Chignon?

Answer 8

Oedema and bruising from Ventouse delivery

Question 9

Subaponeurotic haemorrhage?

Answer 9

Heamorrhage below the aponeurosis of the skull, but above the skull bones.
Results in diffuse, boggy swelling of the scalp and may be accompanied by serious blood loss

Question 10

Another term for respiratory distress syndrome?

Answer 10

Hyaline membrane disease

Question 11

Treatment for RDS?

Answer 11

Surfactant therapy