Neonatology Flashcards
What are the components of the ToRCHH screen
Toxoplasmosis Rubella CMV HIV HSV
Risk factors for hypoglycaemic neonate
- Diabetic mother
- Haemolytic disease of the newborn
- Preterm
- Inborn errors of metabolism
Treatment for hypoglycaemic neonate
40% dextrose gel
usually self-revolving
What causes haemolytic disease of the newborn
Transplacental passage of maternal antibodies –> immune haemolysis of foetal RBC
Due to ABO incompatibility/ rhesus alloimmunisation
Presentation of haemolytic disease of the newborn
Hydrops foetalis,
Jaundice <24h
When does pathological jaundice occur in a newborn
Within first 24h
Explain why physiological jaundice occurs
Higher rate of RBC breakdown in neonates due to
- shorter RBC lifespan
- higher conc of RBC
Where does neonatal jaundice first occur
Face and forehead
What investigations should be done to identify cholestatic (obstructive jaundice in a child)
o USS
o Hepatobiliary iminodiacetic acid radionuclide scan
o Liver biopsy
o Laparotomy
When does breastmilk jaundice occur
3 days,
peaks by 5-15 days,
Resolves by 6 weeks (latest 4 months)
Conservative management of breast milk jaundice
Increase feeds
leads to increased bowel movements, increased excretion of bilirubin
What causes neonatal respiratory distress syndrome
Inadequate production of lung surfactant
What causes neonatal respiratory distress syndrome
Inadequate production of lung surfactant
How to reduce risk of neonatal respiratory distress syndrome
Antenatal corticosteroids
- Accelerates foetal surfactant production
- Accelerates lung maturation
Why is transient tachypnoea of the newborn common in babies from C section
Lung fluid doesnt get squeezed out like in vaginal birth
Does large or small airways obstruction occur first
Large airways
Complications of large airway obstruction from meconium aspiration
- reduced lung compliance
- atelectasis
- hypoxaemia
- hypercapnea
- respi acidosis
Complications of small airway obstruction from meconium aspiration
- Inflammation
- pulmonary oedema
- vaso and bronchoconstriction
- collapse of airways
- inactivation of surfactant
What heart rate is concerning in neonatal sepsis
> 160bpm
What respi rate is concerning in neonatal sepsis
> 60 breaths/min
What O2 sats is concerning in neonatal sepsis
<90%
What temperature is concerning in neonatal sepsis
> 38 or <36C
Empirical antibiotics for neonates
IV benzylpenicillin +
Gentamycin
Antibiotics for suspected meningitis in neonates
Empirical +
Ampicillin/ amoxicillin +
Cefotaxime
Antenatal risk factors for hypoxic ischaemic encephalopathy in neonates
- Maternal diabetes
- Pre-eclampsia
- Congenital infections
- Cardiac disease
- Placental insufficiency
- Drug, alcohol abuse
- Severe foetal anaemia
Labour risk factors for hypoxic ischaemic encephalopathy in neonates
- Excessive placental bleeding
- Very low maternal BP
- Umbilical cord accidents
- Prolonged labour
- Abnormal foetal position
- Rupture of placenta/ uterus
- Amniotic fluid embolism
Postnatal risk factors for hypoxic ischaemic encephalopathy in neonates
- Severe cardiac/ pulmonary disease
- Infections
- Severe prematurity
- Low neonatal BP
- Brain/ skull trauma
- Congenital brain malformations
What is given to all newborns to prevent haemolytic disease of the newborn
Vit K
Components of the Apgar score
- Appearance
- Pulse (>100bpm is good)
- Grimace
- Activity (4 flexed limbs that resist extension)
- Respiration
