Neonatal Presentations Flashcards
What conditions are tested for in NEONATAL BLOOD SPOT SCREENING?
- Congenital hypothyroidism
- Cystic Fibrosis
- SIckle cell disease
- Phenylketonuria
- Medium chain acyl - CoA dehydrogenase deficiency (MCADD)
- Maple Syrup Urine Disease
- Isovaleric acidaemia
- Gluatric aciduria type I
- Homocystinuria ‘
Presents at 5-9 days of life
What is TRANSIENT TACHYPNOEA of the NEWBORN?
Commonest cause of respiratory distress in the newborn period - delayed resorption in the lungs.
Most common following caesarean sections as lung fluid isn’t squeezed out during birth.
CXR: Hyperinflation of the lungs, fluid in horizontal fissure
May need supplementary O2 and normally settles in 1-2 days
What is CAPUT SUCCADENEUM?
Oedema of the scalp at the presenting part of the head, typically vertex
Usually due to prolonged delivery or secondary to ventouse delivery
Resolves within days
Features:
- Soft, puffy swelling due to localise oedema
- Crosses suture lines
What is a CEPHALOHAEMATOMA?
Swelling on the newborn head that typically delivers several hours after delivery - due to bleeding between periosteum and skull
Commonly parietal region - doesn’t cross suture lines
Jaundice may develop as a complication
Can take up to 3 months to resolve
What is SURFACTANT DEFICIENT LUNG DISEASE?
aka ‘Respiratory Distress Syndrome’
Caused by insufficient surfactant production and structural immaturity of the lungs. 50% risk of birth at 26-28w, 25% at 30-31w
Risk Factors: Male sex, diabetic mothers, Caesarean sections, second born of twins (premature)
Symptoms: Tachypnoea, intercostal recession, expiratory grunting/cyanosis. ‘Ground-glass’ appearance + indistinct heart border
Management: Oxygen, assisted ventilation, exogenous surfactant given via endotracheal tube.
Prevention during pregnancy -> Give maternal corticosteroids to induce foetal lung maturation
What causes CYANOSIS in the neonatal period?
Use nitrogen washout test: Infant is given 100% oxygen for 10minutes, then ABGs taken. A pO2 of <15kPa indicates cyanotic congenital heart disease
What are the most common congenital infections?
Rubella, Toxoplasmosis and Cytomegalovirus
Cytomegalovirus is the most common congenital infection in the UK, whereas maternal infection is usually asymptomatic
What are the characteristic features of RUBELLA?
- Sensorineural deafness
- Congenital cataracts
- Congenital heart disease (PDA)
- Glaucoma
- Growth retardation
- Hepatosplenomegaly
- Purpuric skin lesions
- Salt and pepper chorioretinitis
- Microphthalmia
- Cerebral palsy
What are the characteristic features of TOXOPLASMOSIS?
- Cerebral calcification
- Chorioretinitis
- Hydrocephalus
- Anaemia
- Hepatosplenomegaly
- Cerebral palsy
What are the characteristic features of CYTOMEGALOVIRUS?
- Growth retardation
- Purpuric skin lesions
- Sensorineural deafness
- Encephalitis/seizures
- Pneumonitis
- Hepatosplenomegaly
- Anaemia
- Jaundice
- Cerebral palsy
What are the features of CLEFT LIP and PALATE?
Cleft lip results from the failure of fronto-nasal and maxillary processes to fuse, whereas cleft palate results from the failure of the palatine processes and the nasal septum to fuse
- Polygenic inheritance
- Maternal antiepileptic use increases risk
What is the management of CLEFT LIP and PALATE?
Repair cleft lip before cleft palate, with practices varying from repair in the first week of life to three months
Typically repaired between 6-12 months of age
