Neonatology Flashcards
Essential Newborn Care
Immediate Drying
Uninterrupted skin to skin contact
Delayed cord clamping after 1-3 mins
Non separation of mother and baby
Heat energy to cooler surrounding air
CONVECTION
Heat to colder materials touching the infant
CONDUCTION
Transfer of heat to nearby cooler objects
RADIATION
Looses from skin and lungs (respiration)
EVAPORATION
Low Birth Weight
< 2500 g
Very Low Birth Weight
< 1500 grams
Extremely Low Birth Weight
< 1000 grams
Known as INTRA-UTERINE GROWTH RETARDATION (IUGR)
BW < 3rd percentile for calculated gestational age
Small of Gestational Age (SGA)
Associated with POOR maternal nutrition or with late onset or exacerbation of maternal vascular disease
WEIGHT affected > length
HEAD continues to grow
fetus affected in LATE gestation
Postnatal catch up growth is good
ASYMMETRIC IUGR
Associated with GENETIC and METABOLIC conditions
Associated with diseases that seriously affect fetal cell number
weight, height, HC equally affected
fetus affected early in gestation < 18 weeks
SYMMETRIC IUGR
Birth weight >90th percentile for gestational age
at risk for HYPOGLYCEMIA and POLYCYTHEMIA
Large for Gestational Age
Large for gestational age babies are at increased risk for
hyperbilirubinemia birth injuries RDS congenital cardiac defects lumbosacral agenesis
APGAR SCORING SYSTEM!!
assesses neonates in need of resuscitation
Activity Pulse Grimace Appearance Respiration
SEVERELY DEPRESSED - 0-3
MODERATELY DEPRESSED - 4-6
EXCELLENT CONDITION - 7-10
Disorders associated with LARGE ANTERIOR FONTANEL
hypothyroidism achondroplasia hydrocephaly IUGR prematurity osteogenesis imperfecta Congenital rubella syndrome Trisomies 13, 18 and 21 hypophosphatasia Kenny syndrome
The target temperature for newborn
36.5 -37.5
The reason why room temperature should be set at 25-28 C
Convection
Hypothermia may cause
Acidosis
Hypoglycemia
Hypoxemia
At point of contact
Can EXTEND across sutures
Maximal size and firmness at birth
Resolves in 48-72 hr
Caput Succedaneum
Usually over PARIETAL bones
Does NOT CROSS sutures
Distinct margins;initially firm more fluctuant after 48 hr
may cause JAUNDICE
Cephalhematoma
Beneath epicranial aponeurosis
May extend to orbits, nape of neck
Firm to fluctuant; ill defined borders
May have crepitus or fluid waves
May be MASSIVE especially if there is an associated coagulopathy
SUBGALEAL HEMORRHAGE
Estimated birth anthropometrics (Lt, Wt, HC)
Lt: 50 cm
Wt; 3.5 kg
HC: 33-35 cm
SGA
BW <3rd percentile for calculated gestational age
LGA
BW >90th percentile for calculated gestational age
APGAR score that is valid predictor of neonatal mortality
5 minute score
MCC of congenital hypothyroidism
Thyroid dysgenesis
Physiologic weight loss in during the 1st 10 days for term and 2 weeks for preterm
5-10%
SINGLE BUBBLE SIGN
Hypertrophic pyloric stenosis
Pyloric stenosis
DOUBLE BUBBLE SIGN
Duodenal atresia
Annular pancreas
Malrotation
TRIPLE BUBBLE SIGN
Jejunal atresia
Apnea is cessation of breathing for
> 20 seconds or any duration if accompanied by cyanosis and bradycardia
MCC of apnea
Idiopathic apnea of prematurity
Ground glass appearance
(+) air bronchograms
Respiratory Distress Syndrome
Prominent pulmonary vascular markings
Fluid lines in fissure
Transient Tachypnea of the Newborn
“Bubbly lungs”
Bronchopulmonary dysplasia
Coarse streaking granular pattern
Meconium Aspiration Syndrome
Perihilar streaking
Neonatal pneumonia
Jaundice visible on 2nd-3rd day, peaks ar 5-6 mg/dL on the 2nd-4th fay and decrease to below 2 mg/dL b/w 5-7 days of life
Physiologic jaundice
Jaundice that appears on 24-36 hrs of life
Rises faster than 5 mg/dL/24 hrs, persists after 10-14 days
Pathologic jaundice
MCC of hemolytic disease of the newborn
ABO incompatibility
Undescended testes should be treated surgically NOT later than
9-15 mos