Other Neonatal Conditions Flashcards
Causes of Hydrops (6)
immune: rhesus
non-immune:
- CCF
- decreased oncotic pressure
- obstructed lymphatic flow
- turner’s
- haemolysis
Mx of hydrops (5)
Take cord blood:
- FBC, PCV
- bilirubin
- Coomb’s
- blood group
- serum protein
- infection screen
- LFT
high frequency oscillatory ventilation
Mx hypoglycaemia/anaemia
for CCF:
- drain ascites/pleural effusion if severe
- fluid restrict
- IV furosemide
- monitor UO
1mg vit K for bleeding
Presentation of haemolytic disease of the newborn (8)
jaundice
yellow vernix
progressive anaemia
CNS signs
hepatosplenomegaly
CCF-oedema, ascites
bleeding
kernicterus
(due to isoimmunisation in previous pregnancies, can occur in O mother w. A/B babies>may require exchange transfusion even if first born)
(maternal Abs may persist for severe mo)
Mx of haemolytic disease of the newborn
as w. jaundice: phototherapy/exchange transfusion
Prevention of haemolytic disease of the newborn
give anti-D at 28wks and w/i 72hrs of any sensitising events
Pathology of haemorrhagic disease of the newborn
lack of enteric bacteria which produce vit K>decreased clotting factors
Cause and features of early (<24hrs) haemorrhagic disease of the newborn (2)
maternal drugs: sulphonamides, nitrofurantoin
bleeding at sites of injury during birth
Cause and features of classical (1-7d) haemorrhagic disease of the newborn (5)
causes:
- various atenatal maternal drugs
- exclusively breastfed babies
presents with bleeding from:
- GI tract
- mucous membranes
- sites of trauma-prolonged bleeding
Cause, features and presentation of late (2-12wks) haemorrhagic disease of the newborn (3)
caused by undiagnosed cholestasis>malabsorption of vit K
greatest morbidity/mortality
presents w. intracranial haemorrhage>LT cranial disability
Mx of haemorrhagic disease of the newborn (2)
SC vit K stat-IM causes haematoma
severe bleeding/intracranial haemorrhage may require FFP+vit K
(all babies receive vit K at birth)
Features of Meconium aspiration (3)
occurs in term/near term neonates where meconium is passed in utero
can be triggered by foetal distress and advanced age
however most most don’t aspirate meconium
Consequences of meconium aspiration (5)
airway obstruction/collapse
pulmonary vasoconstriction
infection
surfactant dysfunction
chemical pneumonitis
Mx of meconium aspiration (5)
ET suctioning only in children who aren’t vigorous at birth-can>bradycardia
surfactant
ventilation
inhaled NO
Abx
Pathology of neonatal alloimmune ITP
platelets also typed, if foetus +ve and moter -ve, can>immune reaction similar to Rh disease
Dx of neonatal alloimmune ITP
detection of maternal antibodies which cross the placenta
