neonatology Flashcards
categories of term admission
sepsis
resp
cardio
hypoglycaemia
hypothermia
jaundice
birth asphyxia
surgical problems
neonatal abstinence syndrome
symptoms of sepsis in the neonate
- pyrexia or hypothermia
- poor feeding
- lethargy or irritable
- early jaundice
- tachypnoea
- hypo/hyperglycaemia
- floppy
- asymptomatic
risk factors for sepsis in the neonate
premature rupture of membranes
maternal pyrexia
maternal GBS carriage
management of presumed neonatal sepsis
- admit NNU
- partial septic screen - FBC, CRP, blood cultures and blood gas
- consider CXR, LP
- IV penicillin and gentamicin 1st line
- add medronidazole if surgical/abdo concerns
- fluid management and treat acidosis
- monitor vital signs and support resp and CVS system as required
commonest causes of neonatal sepsis
- group B strep
- e coli
- listeria
- coag -ve staphylococci (if lines in situ)
- haemophilus influenzae
onset of GBS sepsis
early onset: birth - 1wk
late onset/recurrence - up to 3mths
difficulties w/ GBS sepsis
may be non-specific sepsis
may have no risk factors
complications of GBS sepsis
meningitis
DIC
pneumonia and resp collape
hypotension and shock
causes of congenital infection - TORCH
toxoplasmosis
other - syphilis, VZV
rubella
CMV
HSV
what is a congenital infection
infections acquired transplacentally or in utero
typically occurs when a woman contracts an infection w/ one of the responsible organisms for the 1st time during pregnancy and the foetus then becomes affected
what can congenital infections result in
IUGR
brain calcifications
neurodevelopmental delay
visual impairment
recurrent infections
signs and symptoms associated w/ congenital infection
how common is resp distress in neonates
one of the most common reasons for admission to NNU
causes of resp problems in neonates
sepsis
TTN - transient tachypnoea of the newborn
meconium aspiration
how common is TTN
self limiting and commonest cause of resp distress in term neonate