Newborn examination Flashcards
What is a stillbirth classified at?
Foetus birth with no signs of life >24 weeks of pregnancy
What is perinatal mortality rate classified as?
stillbirths + deaths within the 1st week per 1000 live births and stillbirths
What is neonatal mortality rate classified as?
deaths of live-born infants within the first 4 weeks after birth per 1000 live births
What is a neonate classified as?
infant ≤28 days old
What is preterm birth classified as?
– gestation <37 weeks of pregnancy
What is term delivery classified as?
Term – 37–41 weeks of pregnancy
What is post-term delivery classified as?
gestation ≥42 weeks of pregnancy
What is
- low birthweight
- very low birthweight
- extremely low birthweight
- low birthweight : <2500g
- very low birthweight : <1500g
- extremely low birthweight : <1000g
What is assessed with a head-to-toe systematic examination for a new born? (7)
- Birthweight
- General observation
- Head
- Chest + thorax
- Femoral pulse + pelvis
- Muscle tone, back + spine + legs + feet
- Primitive reflexes
What is included in general observation as part of the head-to-toe routine newborn exam?
Appearance
Posture
Movements
Plethoric or pale
Jaundice
Rashes
What is included in Head circumference as part of the head-to-toe routine newborn exam?
Head circumference (macrocephaly)
Fontanelle
Facies
Eyes (red reflex)
Palate
Clavicles
What is a cephalohematoma?
Benign
in margins of skull sutures
Resolves over a few months
Start day 2-3 of life
What is Caput Succedaneum?
Crosses suture lines
Resolves over a few days
Starts at birth
What is a subaponeurotic / subgaleal haemorrhage?
Diffuse, boggy swelling
Can lead to hypovolaemia and shock
What to do if a baby presents with tense fontanelle at birth?
Raised ICP
Can be because of caput succedaneum or cephalohaematoma
-> Cranial USS
What does a depressed fontanelle suggest?
Dehydrated
What to check for when looking at a baby’s thorax and chest at birth?
Breathing
chest wall movement
HR
cord to fall off by day 40
Hernias
pectus
What to check for with with pelvis in a newborn exam?
Femoral pulses
Genetalia
(testes in scrotum, hypospadias, clitroromegaly)
Anus patency
What to check for in back spine and lower limb in a newborn exam?
Muscle tone
Whole of back and spine
- DDH
- Club feet
- fully dorsiflex the foot to touch lower leg to check for true talipes equinovarus
What primitive reflexes are checed?
Moro
Stepping
Asymmetric tonic
Palmar
Babinski
What biochemical screening occurs at 7 days old?
Congenital hypothyroidism
SCD
CF
6 inherited metabolic disease
What is the 1st line hearing exam done for all babies?
Evoked otoacoustic emission testing
If not normal move onto 2nd line
What is the 2nd line hearing exam for babies?
Automated auditory brainstem response audiometry
Symptoms of foetal alcohol syndrome?
Microcephaly
Absent philtrum
Cardiac abnormalities
Reduced IQ
IUGR
Small upper lip
