Neonatology Flashcards
Why may neonates require care?
Prematurity Low birth weight Intrauterine growth restriction Congenital malformation Infection Birth asphyxia
When does the CVS develop in utero?
End of the third week
When does the fetal heart start to beat?
Beginning of the fourth week
What is ductus arteriosus?
Small vessel connecting pulmonary artery with aorta
What is the purpose of the ductus arteriosus?
Prevents circulatory overload in lungs
What is the ductus venosus?
Foetal blood vessel connecting umblical vein to IVC
What is normal blood pressure for a full term newborn?
1 hour - 70/44
1 day - 70/42
3 days - 77/49
What is a normal resp rate for a baby?
30-60/min
Periodical so must be assessed over a full minute
What is normal new born heart rate?
120-160
What is considered bradycardia in a full term baby?
<100
What is considered tachycardia in a full term baby?
> 160
How do newborn babies generate heat?
Metabolic production through lipolysis of brown fat
What is the innervation of brown fat?
Sympathetic neurons
How do babies lose heat?
Radiation
Convection - heat loss by moving air
Evaporation
Conduction - heat loss to surface on which baby lies
What should newborn gas partial pressures be?
PaCO2 - 5-6kPa
PaO2 - 8-12kPa
What should tidal volume of a newborn be?
4-6ml/kg
When does physiological jaundice happen?
Day of life 2-3 until 7-10 in term infants and up to 21 in premature
What causes weight loss in newborn babies?
Shift of interstitial fluid to intravascular
Diuresis
What is expected haemoglobin at different stages of a baby’s life?
Born with 15-20
Week 10 - 11.4
Week 20 - 12
What weight is a baby considered to be too small?
Less than 2500g
What are causes of low birth weight?
Hypotrophy
Small for gestational age
Intrauterine growth restriction
What are maternal causes of small for weight?
Maternal smoking
Pre-eclampsic toxaemia
What are foetal causes for low weight?
Trisomy 18 and 21
Infection
What are placental causes of low birth weight?
Placental abruption
Twin pregnancy - Monochorionic monoamniotic - twin-twin transfusion
What are common problems with babies being small?
Perinatal hypoxia Hypoglycaemia Hypothermia Polycythaemia Thrombocytopenia GI problems
What are potential long term problems for small babies?
Hypertension
Reduced growth
Obesity
Ischaemic heart disease
What is considered very low and extremely low birth weight?
Very is <1500g
Extremely is <1000g
What system can be affected by prematurity?
Any
How is respiratory distress syndrome prevented?
Antenatal steroids if concern for prevention
Surfactant after birth
What causes bronchopulmonary dyslasia?
Overstretcg by volu-baro-trauma
How is apnoea treated in preterm?
Caffeine
How is intraventricuar haemorrhage prevented?
Antenatal steroids
What happens as a result of permanent ductus arteriosus?
Overperfusion of lungs - lung oedema
Systemic ischaemia due to pulmonary circulation stealing from systemic
How is necrotising enterocolitis treated?
Surgical intervention
Antibiotics
Parenteral nutrition
