Newborn Complications

Question 1

Define the terms “small for gestational age (SGA), “term”, “large for gestational age (LGA)”, “preterm”, and “postterm” and intrauterine growth restricted (IUGR)

Answer 1

SGA - babies are those who are smaller in size than normal for the gestational age, most commonly defined as a weight below the 10th percentile for the gestational age

LGA - LGA is often defined as a weight, length, or head circumference that lies above the 90th percentile for that gestational age

preterm - is the birth of a baby of less than 37 weeks gestational age

posterm - is the condition of a baby that has not yet been born after 42 weeks of gestation

IUGR - refers to poor growth of a baby while in the mother’s womb during pregnancy. The causes can be many, but most often involve poor maternal nutrition or lack of adequate oxygen supply to the fetus

Question 2

Explore hypoglycemia in new born

Answer 2

Objective data:
Lethargy, apathy, limpness (hypotonia)
Poor feeding/sucking reflex, vomiting
Pallor, cyanosis
Hypothermia or temperature instability
Apnea, irregular respirations, RDS (tachypnea)
Tremors, jerkiness, seizure activity
Weak or high-pitched cry

Question 3

Explore fetal death/sids in new born

Answer 3

Sudden Infant Death Syndrome (SIDS) occurs when a baby dies suddenly while sleeping. SIDS is most likely to occur in babies between 2 and 4 months of age, and the death remains unexplained even after a full autopsy.

Put your baby to sleep on his or her back every time (at night and for naps).

Question 4

Explore ISAM in new born

Answer 4

Infant of a substance abusing mother may be alcohol or drug dependent. The new born may suffer withdraw after birth.

Fetal alcohol syndrom is leading cause of mental retardation.

Question 5

Explore Transient tachypnea syndrome (TTN) in new born

Answer 5

• infants LGA and late preterm may develope this
• caused by asphyxia by oversedation of mom, bleeding, prolapsed cord, breech, or diabetes
• new born fails to clear the airway of lung fluid
• more prevalent in cesarean births
• newborn experiences grunting, flaring, mild cyanosis,

Question 6

Explore meconium aspiration syndrome

Answer 6

Def- Meconium aspirated into the tracheobronchial tree during labor/delivery

Etiology- Asphyxia →increased peristalsis & relaxation of anal sphincter →aspiration at birth

Tx- O2, high pressure ventilation

Question 7

Explore hyperbilirubinemia

Answer 7

cause by hemolytic disease of the newborn

It occurs because their organs aren’t yet able to get rid of excess bilirubin very well. This type of jaundice usually appears about 24 hours after birth. It gets worse until the third or fourth day, and then it goes away in about a week.

In rare cases, jaundice may be caused by other things, such as an infection, a problem with the baby’s digestive system, or a problem with the mom’s and baby’s blood types (Rh incompatibility). Your baby may have one of these problems if jaundice appears less than a day after birth.

signs

• yellow.
• Be sluggish and not suck well.
• Be cranky or jittery.
• Arch his or her back.
• Have a high-pitched cry.

Question 8

Describe the appearance and common problems of SGA, LGA, Preterm, posterm and IDM babies

Answer 8

SGA 
-Small size, decreased fat & muscle mass
poor skin tugor, loss of vernix
Full term nails, dull hair, separate skull bones
Sunken abdomen, small liver
Developed creases & cartilage
Often a thin, meconium stained cord
Alert, wide eyed, developed reflexes

LGA
-Appearance- ↑body fat, macrosomic, ruddy, lg.placenta & cord

Reason for large size- Poorly controlled diabetes, genetics, multiparity, male

PRETERM
-Everything is premature: 
Physical characteristics
Neuromuscular development
Less flexion of extremities
Less square window ability (wrist)
Less recoil of extremities
Scarf sign (elbow past midline)
Less cartilage, few rugae
Amount of lanugo varies
Labia maj. does not cover labia minora
Nipple & areola barely visable
Heel can touch the ear
Less creases on plantar surface

POST TERM
Behavior- wide eyed, alert
Appearance- long & thin, wasting (↓subcutaneous tissue)
Skin- loose, dry, cracking, parchment like, absence of lanugo & vernix
Fingernails long, hair profuse
Meconium stained nails, skin & cord

IDM COMPLICATION

• hypoglycemia
• hypocalcemia
• hyperbilirubinemia
• birth trauma
• polycythemia
• RDS