Normal Term and Preterm Infant Flashcards
what is the definition of extremely preterm
23 weeks to 27 weeks
what is the definition of very preterm
28 weeks to 31 weeks
what is the definition of preterm
32 weeks to 36 weeks
i.e. anything before 37 weeks gestation
what is the definition of term
37 weeks to 42 weeks
what is the definition of post term
anything after 42 weesk
what is important about the 3rd trimester for the baby
daily weigh again of about 7g of fat per day
about 24g by end of the semester
what is transferred via the placenta in the 3rd trimester
iron, vitamins, calcium, phosphate & antibodies
what is the normal weigh range for a baby
2.5kg - 4kg
> 4kg is large for gestational age
< 2.5kg is small for gestational age
what type of environment is the baby faced with during contractions and how does it try deal with this
hypoxic environment
- fetal Hb helps release O2
what happens in the first few minutes after a baby is born
first breath/cry
alveolar expansions
decreased pulmonary arterial pressure
change from fetal to newborn circulation
increased PaO2
what is a normal APGAR score
8/10 or greater
what are the 5 categories of the APGAR score
HR Resp Responsiveness Tone Colour
what is Haemolytic Disease Newborn
alloimmune condition
- the IgG antibodies passed from mother to foetus attack the red blood cells causing haemolysis
- range of severity
- can cause anaemia and a reticulocytosis
what vaccinations do infants get
Hepatitis B at birth
BCG first month
Routine vaccinations 8 weeks
what is caput succedaneum
oedema, of a newborn’s scalp soon after delivery
appears as a lump or a bump
should disappear after a few days
what is moulding
the shape of the infant head to the shape of the mothers birth canal
what are Ebsteins pearls
small white or yellow cystic vesicles often seen in the median palate
what are the characteristics of fetal alcohol syndrome
epicanthal folds small eye openings flat mid face upturned nose smooth philtrum thin upper lip
what are the hip examinations preformed on a new born baby
barlow manoeuvre
- screens for DDH,
- dislocates the hip
ortolani
- relocated the hip
what puts a baby at high risk of being born premature
maternal smoking/alcohol/drug use
abnormally shaped uterus
multiple pregnancy
interval of < 6 months between pregnancies
conceiving through in vitro fertilisation
maternal poor nutrition
what are causes of preterm birth
spontaneous preterm multiple pregnancy preterm prelabour rupture of membrane pregnancy associated HTN IUGR antepartum haemorrhage cervical incompetence
what is the difference between a preterm infant and a term infant
Get cold even faster
Have more fragile lungs
Don’t breathe effectively
Have fewer reserves
what are examples of conditions caused by system immaturity
respiratory distress syndrome
patent ductus arteriosus
intraventricular haemorrhage
nectrotising enterocolitis
neonatal sepsis can be split into two types
early onset (EOS) - mainly due to bacteria acquired before and during delivery
late onset (LOS) - acquired after delivery
what organisms commonly cause neonatal sepsis
Group B streptococcus (GBS)
Gram negative organisms:
Klebsiella, Escherichia coli, Pseudomonas, and Salmonella
Gram positive organisms:
Staphylococcus aureus, Coagulase negative staphylococci (CONS), Streptococcus pneumoniae, Streptococcus pyogenes
what is important to remember when using incubators
incubators increase infection
what are resp complications of prematurity
RDS
Apnoea of prematurity
Bronchopulmonary dysplasia
several pathologies can cause RDS - what are the primary pathology
Surfactant deficiency
Structural immaturity
several pathologies can cause RDS - what are the secondary pathology
Alveolar damage
Formation of exudate from leaky capillaries
Inflammation
what are features of RDS
Tachypnoea
Grunting, Nasal flaring
Intercostal recessions
Cyanosis
Mx of RDS
maternal steroid
surfactant
ventilation [invasive/non-invasive]
what are the cardiovascular concerns in the preterm infant
PDA
Systemic hypotension
what happens in PDA
Duct does not respond to “close” signals
Leads to symptoms of congestive heart failure
Oxygen requirements are high
Exacerbates RDS
what type of murmur is heard in PDA
machine like murmur
what is an Intraventricular Haemorrhage
a form of intracranial haemorrhage that occurs in preterm infants, which begins with bleeding into the germinal matrix.
Risk factors for IVH
prematurity
RDS
when does IVH commonly present
most occur within first day of life or within 72 hours
how does IVH present
Diminished/absent Moro reflex. Poor muscle tone. Sleepiness. Lethargy. Apnoea.
Mx of IVH
preventive measures
- antenatal steroids
what is NEC
widespread necrosis in the small and large intestine
usually after recovering from RDS
Sx of NEC
lethargy bloody stool temperature instability aponea bradycardia abdominal extension
what are long term potential complications of prematurity
cerebral palsy
what is the HR range expected in a newborn
120-140/min
what is the RR range expected in a newborn
40-60/min
what type of infections do new borns get
Septicaemia
CNS - meningitis
Respiratory - pneumonia
GU – UTI
what is the most common bacterial cause of septicaemia
group B strep
what is transient tachypnoea of the newborn (TTN)
presents in the neonate as tachypnoea for the first few hours of life, lasting up to one day.
The tachypnoea resolves by two days.
