Neonatology Flashcards
list some functions of the placenta
gas exchange
waste product and nutrient transport
acid base balance
transport of IgG
list the three shunts in the foetus and what they are called when closed or patent
foramen ovale - becomes persistent foramen ovale
ductus arteriosus becomes ligamentus arteriosus
ductus venosus beceoms ligamentus teres
describe persistent pulmonary hypertension of the newborn and presentation
failure to move from foetal to neonatal circulation after birth
pulmonary hypertension causing hypoxia secondary to left-to-right shunting of blood at ductus arteriosus
what are the 3 most important regulatory mechanisms a newborn must do
thermoregulation
glucose homeostasis
nutrition
why is thermoregulation so difficult in newborns
high surface area to volume ratio, a lot of heat is lost through their head
what are the methods of keeping a newborn warm
hats, skin to skin, heated blankets, incubators
why is glucose homeostasis difficult for newborns to manage
switch from basal enteral nutrients from the placenta to bolus oral milk every couple of hours
what is colostrum
the first round of breast milk a mother produces, thick and very antibody rich compared to foremilk and hindmilk
list some causes of physiological jaundice
breakdown of foetal Hb
conjugating pathways not matured yet
increase in circulating unconjugated bilirubin
a premature baby is born before how many weeks
37
a post term baby is born after how many weeks
41
post term babies are at risk of what conditions
still birth and cerebral palsy
what is the normal birth weight for a baby
2.5-4kg
which trimester has the largest weight gain for baby
3rd trimester
list some perinatal adaptions a newborn baby must do
alveolar expansion - first cry
decrease in pulmonary arterial pressure
increase in PaO2
what is apgar score used for
measure effectiveness of perinatal adaption
describe the components and scoring of APGAR scoring
measures heart rate, respiratory rate, responsiveness, tone and colour
each component gets a max of 2 points - normal scoring >8
describe haemorrhagic disease of the newborn
rare clotting disorder causing spontaneous bleeding which untreated can lead to intracranial haemorrhage
what is given to prevent haemorrhagic disease of the newborn
IM vitamin K - especially important in breast fed babies as breast milk lacks it
what screening tests are carried out as part of newborn baby checks
universal hearing screening hip screening - clinical and USS CF haemoglobinopathies thyroid function tests metabolic disorders
list common causes of death in neonate
prematurity pneumonia birth trauma neonatal sepsis congenital abnormalities
what is the normal heart rate for newborn
120-140 bpm
what is the normal respiratory rate for newborn
40-60/min
where are common sites of infection in neonates
CNS - meningitis
resp - pneumonia
GI
all can lead to sepsis
list common bacterial pathogens in neonatal infections
group B strep
E. coli
listeria
staph aureus and epidermidis
what is transient tachypnoea of the newborn
self-limiting condition where there is delay in clearance of the fluid from lungs - can cause ineffective gas exchange and tachypnoea
what is the presentation of transient tachypnoea of the newborn
tachypnoea nasal flaring grunting intercostal retractions crackles on auscultation
what are some of the causes of hypoglycaemia in neonates
reduced reserves eg low birth weight
related to maternal disease eg diabetes mellitus
what are the reasons for more preterm babies
increased maternal age
increase rate of complications during pregnancy
increased rate of fertility treatments
more C-sections before term date
causes of preterm births
spontaneous preterm labour
multiple pregnancy
preterm prelabour eg rupture of membranes
pregnancy associated hypertension
list risk factors for preterm births
>2 more previous preterm deliveries abnormally shaped uterus multiple pregnancies <6months between pregnancies smoking, alcohol and drugs during pregnancy poor nutrition
list complications for the baby of preterm birth
poor temperature control sepsis respiratory distress syndrome patent ductus arteriosus intraventricular haemorrhage necrotising enterocolitis
which organisms are most likely to cause neonatal sepsis
group B strep
gram negatives
what is respiratory distress syndrome
deficiency of surfactant causing re-inflation of the lungs on each breath leading to respiratory failure
most common in premature babies
what is the treatment for respiratory distress syndrome
maternal betamethasone if high risk
give surfactant
non-invasive ventilation
