Newborn Assessment Flashcards
What is gestation
Using the method of adding 280 days to the first day of the last menstrual period and giving this as the ‘due date’
Centile chart
• Plot weight (in kgs), length (in cm) and head circumference (in cm) against age
• Below 2nd centile
Neonatal largest organ
Skin
Baby skin
Less melanin
Thinner epidermis
Faster rate of water loss
Less moisture
Baby skin
Less melanin
Thinner epidermis
Faster rate of water loss
Less moisture
Vernix caseosa
Develops from mid term, decreases as gestation increases
composed of sebaceous gland secretions (sebum) and skin cells and is rich in lipids, cholesterol and protein
Lanugo
Downy body hair – fine and unpigmented (from 12 weeks and mostly shed by birth)
Acrocyanosis
Increased blood to extremities seen within 48hrs
Milia/milk spots
small hard white pearly keratin vesicles (1-2mm in size)
Occurs in around 50% of newborn babies
Erythemia toxicum (rash of the newborn)
Rash of yellow papules surrounded by reddened areas
Port Wine Stain (naevus flammeus
Shape/colour, depression of the skin (colour stays the same)
Refer if on head
Blue Spot (Dermal Melanocytes
Present in 90% ethnic babies
Lasts 5-6years
Strawberry haemangioma
Overgrowth of blood vessels – benign tumour
Can be very faint colour at birth, then develops over time to become red, like a strawberry colour
Will disappear on own
Café au lait
Brown areas <3cm diameter
Refer if more than 5
Naevus Simplex (salmon patch - stock mark / angel kiss)
ink, location, goes when gently press skin
Most common birthmark present at birth – 40% of neonates
Fades within a year
Refer if on spine or not on head/neck
Sucking blisters
Resolves in day/two
Document as looks like cigarette burn
Linea nigra
Y
Head
Almost 25% of body mass
33-38cm OFC
Microcephaly <10th centile (fetal alcohol syndrome)
Macrocephaly >90th centile
Caput succedaneum
Seen at birth - crosses suture lines, involves scalp only (soft tissue swelling), resolves spontaneously within 24-48 hours, common cause of jaundice
Cephalhaematoma
Not seen at birth, but can increase in size over the first few days – does NOT cross suture lines, involves bone (subperiosteal hemorrhage)
Pre-auricular sinus/pits
Common congenital malformation
Edwards dyndrome
Low set hypoplastic ears
Red reflex
Absence of red when lights is passed in newborn eye could mean cataract
Epstein pearls in mouth
Small white cysts
Receding mandible/chin
Pierre syndrome
Webbed neck
Webbed neck – folds that extend digitally or taut skin areas. Tend to be linked to syndromes e,g, Turner’s syndrome
Cystic hygroma
v rare 1;12000 worldwide. Watery tumour - re benign but can be disfiguring. It may compress and distort the trachea, causing breathing issues and require aspiration
Anterior fontanelle (bregma)
Posterior fontanelle (lambda)
Sutures
Coronal, lambdoial and frontal
Fetal alcohol syndrome
-short palpebral fissure (small eyes)
•thin upper lip
•smooth philtrum (area between the mouth and nose
Down’s syndromr
Epicanthal folds
Brushfield’s spots (eyes)
Small white or greyish brown spots on periphery of iris
Cardiac-ASD, AVD
Stomach capacity
15-30mls
Gut development
By 24 weeks
