Neonatology Flashcards
when is a baby at term?
after 37 weeks completed gestation
when is a baby considered post term?
after 41 weeks completed gestation
what is a normal weight for babies?
2.5-4.0 kg
what is a baby considered to be if they weigh over 4kg?
large for gestational age
what is a baby considered to be if they weight under 2.5kg?
small for gestational age
when is the third trimester of pregnancy?
from 28 weeks onwards
what hormones increase during labour to help the baby adapt to postnatal life?
cortisol
adrenaline
what score is used to assess a babies perinatal adaptation?
APGAR score
what is a normal APGAR score?
8 or more
what is given to prevent haemorrhagic disease of the newborn?
vitamin K
preferably via IM route
why is giving vitamin K especially important in breastfed babies?
their milk is not fortified with vit K like formula is
higher risk of bleeding if not given vit K
what is done if a mother has active hep B?
immediate vaccination on the day of birth
what is given to particularly high risk babies who’s mothers have active hep B?
hep B immunoglobulin IV
can mothers with hep C breastfeed?
yes
as long as hep C RNA level is low
can mothers with HIV breastfeed?
only if their viral load is undetectable
when would babies be offered the BCG vaccine?
if their family is high risk for TB
what vaccines should mother’s to be receive to prevent illness in their baby?
pertussis
influenza
when does the routine vaccination schedule start?
8 weeks
what vaccines can be given early if the baby is high risk?
hep B
BCG
when is a baby considered to be preterm?
born before 37 weeks gestation
what should be delayed if a baby is born preterm?
clamping the umbilical cord
how should preterm babies be kept warm?
in a plastic bag
under a radiant heater
wear a hat
what do preterm babies need to help their lungs adn why?
lungs are more fragile
PEEP to gently inflate the lungs
how is there an increased risk of nutritional compromise in a preterm baby?
limited nutrient reserves
gut immaturity
immature metabolic pathways
increased demands to meet growth needs
what nutrition do some preterm babies who cannot feed receive?
total parenteral nutrition
what are the two types of neonatal sepsis?
early onset
late onset
what causes early onset sepsis?
bacteria acquired before or during delivery
what causes late onset sepsis?
bacteria acquired after delivery
name some causative organisms of early onset sepsis
group B strep
gram negatives
name some causative organisms of late onset sepsis
coagulase negative staph
gram negatives
staph aureus
what risks associated with prematurity increase likelihood of sepsis?
immature immune system
ICU environment - indwelling tubes and lines
how is neonatal sepsis prevented?
hand washing
care of cord
infection screening
how is neonatal sepsis managed?
antibiotics
supportive care measures
what causes primary RDS?
surfactant deficiency and structural immaturity of the lungs
what causes secondary RDS?
damage to the lungs causes by things like intubation or ventilation
which babies are more high risk for RDS?
preterm
what clinical signs may be seen in a baby with RDS?
tachypnoea grunting intercostal recessions nasal flaring cyanosis
what is the natural history of RDS like?
gradual worsening for 2-4 days
gradual improvement
what can be given to prevent RDS?
maternal steroids
name two steroids given to mothers to prevent RDS
dexamethasone
betamethasone
what treatments can be given to a baby with RDS?
surfactant replacement
ventilation
name four things that are screened for on the blood spot card
cystic fibrosis
hypothyroidism
haemoglobinopathies
metabolic diseases
name five metabolic diseases screened for on the blood spot card
PKU MCADD IVA GA1 HCU
name two other screening tests done in newborns
hearing screening
hip screening
when is the newborn examination carried out?
before/around 24 hours old
name the 7 things looked at/for in the newborn examination of the head
OFC sutures fontanelles marks moulding cephalohematoma caput succedaneum
what is OFC?
occipital frontal circumference
what is the importance of OFC?
ensures the baby has grown appropriately
what can cause overlapping sutures?
moulding
what can cause marks on a babies head during birth?
forceps
ventouse
what causes moulding of a babies head?
being born
it is normal
what is cephalohaematoma?
bleeding between the bone periosteum and the epicranial aponeurosis
where is cephalohematoma often found?
the parietal bones
limited by suture lines
what is caput succedaneum?
swelling and oedema in the outer layer of the skin
how long does it take for caput succedaneum to settle?
no more than 48 hours normally
name the 5 things assessed in the eyes in the newborn examination
size red reflex subconjunctival haemorrhage squints iris abnormality
name the 5 things assessed in the ears in the newborn examination
position EAM patency tags/pits folding family history of hearing loss
name the 7 things assessed in the mouth during the newborn examination
shape philtrum tongue tie palate neonatal teeth ebsteins pearls sucking reflex
what can a smooth philtrum be a sign of?
foetal alcohol syndrome
what is looked for when looking at the palate of a baby?
cleft palate
what are ebsteins pearls and where are they found?
white, pearly collections of skin cells
joint of the palate and the hums
what two things are looked for in the face during the newborn examination?
facial palsy
dysmorphism
what are some signs of respiratory distress in a neonate?
nasal flaring
grunting
tachypnoea
in-drawing
name 5 things assessed in the newborn examination of the heart
saturations pulses apex beat thrills and heaves heart sounds
when do babies get a detailed heart scan?
20 weeks
