Normal Term + Pre-Term Infant Flashcards
Definition of extremely preterm
23-27 weeks
Definition of very preterm
28-31 weeks
Definition of preterm
32-36 weeks
ie. anything before 37 weeks gestation
Definition of term
37-42 weeks
Definition of post-term
anything after 42 weeks
Why is the 3rd trimester important
Daily weight gain of 7g fat
3.5% fat at 28 weeks, 15% fat at term
what is transferred via the placenta in the 3rd trimester
iron, vitamins, calcium, phosphate, antibodies
normal weight of term baby
2.5kg-4.0kg
>4kg = large for gestational age
<2.5kg = small for gestational age
what type of environment occurs during labour? How does baby cope with this?
Hypoxic environment
Foetal Hb helps release oxygen
what is perinatal adaptation
the response of the baby to the post partum environment
what happens has part of perinatal adaptation
First breath/cry Alveolar expansion Change from foetal to newborn circulation Decreased pulmonary arterial pressure Increased PaO2
What are the 5 categories of an APGAR score
HR RR Responsiveness Tone Colour
Normal APGAR score
8 or more out of 10
what is haemorrhagic disease of the newborn
Autoimmune condition
The IgG antibodies passed from mother to foetus attack the red blood cells causing haemolytic
Can cause anaemia + reticulocytosis (increase in immature RBC’s)
what is given to prevent haemorrhagic disease of the newborn
IM vitamin K
what is moulding
the shape of the infants head changes to fit the shape of the mothers birth canal
what is caput succedaneum
Oedema of the newborns scalp soon after delivery
Appears as a lump- should disappear after a few days
characteristics of fetal alcohol syndrome
Epicanthal folds (skin of upper eye lid covers inner eye) Small eye openings Upturned nose Smooth philtrum Thin upper lip
hip examinations performed on a new baby
barlow- tries to dislocate the hip
Ortolani- tries to relocate the hip
causes of pre-term birth
spontaneous multiple pregnancy Rupture of membranes IUGR Antepartum haemorrhage Cervical incompetence IVF
Differences between term + preterm infant
Get cold faster
More fragile lungs
Don’t breathe as effectively
Examples of conditions caused by system immaturity in pre-term infants
Respiratory distress syndrome
Patent ductus arteriosus
Intraventricular haemorrhage
Nectrotising enterocolitis
why do preterm infants have trouble keeping warm
low BMR
Minimal muscular activity
Low levels of fat
High ratio of surface area to body mass
two types of neonatal sepsis
Early onset- due to bacteria acquired before + during delivery
Late onset- acquired after delivery
Organisms that cause early onset neonatal sepsis
Group B strep
Gram -ve: klebsiella, E.Coli, Pseudomonas, Salmonella
Organisms that cause late onset neonatal sepsis
Gram +ve: Staph.Aureus, Strep Pneumoniae, Strep. Pyogenes
what is important to remember about the use of incubators
they increase infection
Respiratory complications of preterm
RDS
apnoea of prematurity
Bronchopulmonary dysplasia
pathology behind RDS
Surfactant deficiency + structural immaturity
Leads to alveolar damage, inflammation + exudate formation from leaky capillaries
Features of RDS
Tachypnoea Grunting Nasal flaring Intercostal recessions Cyanosis
Management of RDS
Maternal steroid
Ventilation
Cardiac concerns with preterm delivery
Patent ductus arteriosis
Systemic hypotension
what type of murmur is heard in PDA
machine like murmur
connection between aorta and pulmonary artery remains open
what is an intraventricular haemorrhage
A form of intracranial haemorrhage that begins with bleeding into germinal matrix
How does an intraventricular haemorrhage present
within first 72 hours Diminished/absent moro reflex Poor muscle tone sleepiness lethargy apnoea
management of intraventricular haemorrhage
Preventative measures (antenatal steroids)
what is necrotising enterocolitis (NEC)
Widespread necrosis in the small and large intestine
Symptoms of NEC
lethargy bloody stool temperature instability apnoea bradycardia Abdominal distension
Long term complication of prematurity
cerebral palsy
Normal HR for a newborn
120-140 BPM
Expected RR for a newborn
40-60 breaths/min
What is transient tachypnoea of the newborn
presents as tachypnoea for first few hours of life, lasts up to 1 day and resolved by day 2
Most common bacterial cause of septicaemia in neonates
Group B strep
