neonatologu Flashcards
congenital infection - TORCH screen
toxoplasmosis 'other' (syphilis, chickenpox) rubella cytomegalovirus (CMV) herpes simplex virus (HSV)
congenital infection may result in…
IUGR (intrauterine growth restrictions) brain calcifications neurodevelopmental delay visual impairment recurrent infections
causes of neonate respiratory distress
sepsis
transient tachypnoea of newborn
meconium aspiration
transient tachypnoea of newborn
self limiting and common, presents within 1st few hrs life
delay in clearance of fetal lung fluids
transient tachypnoea of newborn management
supportive
antibiotics
O2
airway support
transient tachypnoea of newborn clinical presentation
grunting
tachynpnoea
o2 requirement
normal gases
TTN findings on x-ray
wet lungs
prominent vascular margins
fluid in horizontal lung fissure
meconium aspiration - risk factors
post dates
maternal diabetes
maternal HTN
difficult labour
meconium aspiration - symptoms
cyanosis inc work of breathing grunting apnoea floppiness
meconium aspiration - investigations
blood gas
septic screen
CXR
meconium aspiration CXR findings
chest hyperinflation
flapping diaphragm
coarse opacities
patchy areas of collapse
meconium aspiration management
suction below cords intubation + ventilation fluids IV antib surfactant NO ECMO
cyanotic congenital cardiac diseases
truncus arteriosus transposition of great arteries tricuspid artresia tertology of fallot TAVPD
hypoglycamia management
monitor blood glc enteral feeds inc fluis start IV 10% glc inc glc concentration glucagon hydrocortisone
hypothermia management
place in incubator
sepsis screen + antib
consider checking thyroid function
monitor glucose
jaundice management
if severe may require admission for intensive phototherapy and/or exchange transfusion
incubator and IV fluids may be required
birth asphyxia
lack of oxygen at or around birth leads to multiorgan dysfunction
causes of birth asphyxia
placental problem long, difficult difficulty umbilical cord prolapse infection neonatal airway problem neonatal anaemia
birth asphyxia stage 1
within mins
cell damage occurs with lack of blood flow and O2
birth asphyxia stage 2
reperfusion injury
days-weeks
toxins released from damaged cells
hypoxic ischaemic encephalopathy
Pattern of brain injury 2nd to birth asphyxia
hypoxic ischaemic encephalopathy management
treat seizures therapeutic hypothermia supportive fluid restriction monitor renal + liver failure resp support cardiac support
surgical problems seen in term neonates
oesophageal fistula/atresia
duodenal atresia
abdo wall defects
diaphragmatic hernia
causes of failure to pass stool
large bowel atresia imperforate anus +/- fistula hirschsprunas disease meconium plug meconium ileus
neonatal abstinence syndrome
withdrawal from physically addictive substances taken by mother in pregnancy
neonatal abstinence syndrome management
comfort
morphine
phenobarbitone
