Newborn conditions

Question 1

Which vitamin is important to the newborn?

Answer 1

Vitamin K

Question 2

What can persistent obstructive jaundice and vitamin K deficiency result in?

Answer 2

Vitamin K deficiency and persistent obstructive jaundice can lead to poor synthesis of vitamin K-dependent clotting factors and subsequent bleeding, which ranges from minor bruises to intracranial haemorrhage

Question 3

Is breast milk or formula milk more rich in vitamin K?

Answer 3

Formula milk is richer in Vitamin K.

Breast-fed babies require 3 oral doses of Vitamin K or IM, at birth, 1 and 6 weeks.

Question 4

What are babies with IUGR at risk of in their first few days of life? Why?

Answer 4

Babies with IUGR are at risk of hypoglycaemia and hypothermia due to low glycogen stores and lack of subcutaneous fat.

Question 5

What are the causes of IUGR?

Answer 5

Multiple pregnancy
Placental insufficiency
Maternal smoking
Congenital infections, such as TORCHS
Genetic syndromes like Down's syndrome

Question 6

Define Asphyxia

Answer 6

Asphyxia is a condition arising when the body is deprived of oxygen, causing unconciousness or death

Question 7

What are the situations that will require immediate resuscitation?

Answer 7

Prematurity
Fetal distress
Thick meconium staining of the liquor
Emergency Caesarean section
Instrumental delivery
Known congenital abnormality
Multiple births

Question 8

What is the cause of Respiratory distress syndrome in neonates?

Answer 8

RDS results from deficiency of surfactant production

Question 9

Who are at risk of RDS?

Answer 9

• Premature neonates
• Infants delivered via Caesarean section without maternal labour
• Maternal diabetes
• Hypothermia
• Perinatal asphyxia
• FHx of RDS

Question 10

What are the signs of the CXR suggesting RDS?

Answer 10

Ground-glass appearance/atelectasis
Hypoinflation
Air bronchogram

Question 11

What is the management of babies with RDS?

Answer 11

Supplementary oxygen via CPAP

Intubation: Endotracheal tube for administration of protein-free synthetic surfactant

Question 12

What is given to pregnant mothers at risk of having a baby with RDS?

Answer 12

Corticosteroids, betamethasone, given 24 hours before delivery

Question 13

What is the cause of transient tachypnoea of the new-born?

Answer 13

TTN is due to delay in foetal lung fluid absorption

Question 14

After how long will TTN usually resolve by itself? What is done if it doesn’t?

Answer 14

TTN usually resolves within 72 hours after birth.

Nasal CPAP if required

Question 15

What are the risk of TTN?

Answer 15

TTN usually presents in mothers with prolonged second stage of labour, or when the baby is delivered by C-section without ROM, maternal asthma and smoking, prematurity.

Question 16

What are the signs of Meconium Aspiration Syndrome?

Answer 16

Meconium Aspiration syndrome can give rise to coarse breath sounds and meconium show during delivery.
CXR reveals irregular infiltrates, hyperinflation and in severe cases, lobar consolidation

Question 17

Why will meconium be passed into the amniotic fluid?

What will this result in?

Answer 17

Meconium is usually passed into the amniotic fluid when there is significant fetal distress or in post-term babies.
This can result in Meconium Aspiration Syndrome

Question 18

What is an important red flag sign indicative of Meconium Aspiration Syndrome?

Answer 18

Meconium in show

Question 19

What does a CXR reveal in a baby with Meconium Aspiration Syndrome?

Answer 19

Irregular infiltrates, hyperinflation, and in severe cases, lobar consolidation

Question 20

What can cause meconium-stained amniotic fluid (MSAF) be aspirated by the infant in utero or during birth?

Answer 20

Deep irregular respiration or gasping, associated with fetal hypoxia either in utero or during labour can cause aspiration of MSAF.

Question 21

Which babies are at higher risk of MAS?

Answer 21

Neonates experiencing significant fetal distress or post-term babies