Pediatrics intro Flashcards
define postmenstrual age
postmenstrual age- age from 1st day of the last menstrual period
gestational age, chronological and corrected ages are more frequently used
define chronological age
chronological age- actual age of the born baby
define corrected age
Corrected age, or adjusted age, is your premature baby’s chronological age minus the number of weeks or months he was born early. e.g. baby born 10 weeks early and now he is 3 month-> 12 completed weeks since being born; out of 12 weeks: 10 weeks of pregnancy and 2 weeks of his age that he would have been born
define gestational age
gestational age- from 1st day of last menstrual period till the day of birth; used for a period of pregnancy till birth; used to describe the age of premature infant e.g. a child born 10 weeks early-> gestational age of 30 weeks (30 out of 40)
list gestational, chronological, corrected and postmenstrual age of a bb that is 10 weeks premature and u see him 3 month after being born
baby has 42 weeks postmenstrual, 42 weeks gestational age, 2 weeks corrected age and 12 weeks chronological age
how old should an infant be to be considered viable?
22 weeks
until what age is GA age used for preterm bbs? why
usually corrected Ga age is used until baby is 2 years-> this is more reflective of possible issues
definitions of different stages of pre-term and pos-term infants
- Preterm:GA<37 weeks at birth
- Extremely preterm: GA<28 weeks at birth
- Very preterm:28-31 6/7 weeks at birth
- Moderately preterm: 32-33 6/7 weeks at birth
- Late preterm: 34-36 6/7 weeks at birth
- Term: GA>37 weeks
- Postterm: 42 to 46 weeks after birth
Birth weight classification
- Microprem: <750g at birth
- ELBW: <1000g at birth
- VLBW : 1000-1499g at birth • LBW : 1500-2500g at birth
- Normal : <2500g at birth
- SGA: < 10th %ile birthweight for GA
- AGA: 10th - 90th %ile birthweight for GA
- LGA: >90th %ile birthweight for GA
what is IUGR?
Intrauterine growth restriction
• Failure of the fetus to achieve normal predicted growth in utero
what are the causes of IUGR?
probably had compromised nutrition while in utero
usually happens early-
before 2 weeks
types and causes of IUGR
Symmetric IUGR: 20-30% of all cases of IUGR
• Weight, length and head circumference less than 10th %ile.
- Indicative of chronic malnutrition
common causes:
- genetic disorder-> smaller potential of growth
may be due infections during
pregnancy
- early onset
Asymmetric IUGR
• Length and head circumference are appropriate but weight is below the 10th %ile. Better head sparing Indicative of an acute insult in nutrition usually in 3rd trimester
characteristic of acute insult- not enough nutrition or oxygen due to placental insufficiency (preeclampsia)
which score is used to assess health at birth?
Apgar
describe APGAR score
Appearance, Pulse, Grimace
Activity, Respiration
- Neonatal health assessment
- Scored out of 10 at 1 min, 5mins and 10 mins
- Provide information on delivery event
- Risk of perinatal depression
when is mid-upper arm assessment is used?
Mid-upper arm: more in community and research setting, reflects malnutrition
when is upper arm and lower limb assessment used?
handicap kids
fenton’s growth chart is used for which kids?
pre-term
fenton vs WHO
who is used for term infants
what are the types of WHO growth curves for brith-24 months babies
- length for age and weight for age
2. head circumference and weight for length
which ages are covered by WHO curves?
- birth-> 24 months
2. 24 month-> 19 yo
what are the types of WHO growth curves for 24 months-> 19yo
- height for age and weight for age
2. BMI for age
is weight or BMI a preferred method of assessment in curves for teens? Why
BMI
teens go through growth spurts at different points-> different weight at the same age
Specialized growth charts are available for the following conditions:
- Prader-Willi syndrome
- Cornelia deLange syndrome
- Turner syndrome
- Trisomy 21 (Down’s syndrome)
- Rubinstein-Taybi syndrome
- Marfan syndrome
- Achondroplasia
Interpreting growth chart
When to be worried?
Plateauing: bb is not growing over time-> sign of chronic malnutrition
Falling off 50th %ile: bb is growing over time, but not fast enough-> sign of chronic malnutrition
Sharp decline: losing weight-> acute malnutrition e.g. trauma
Incline in BMI: child is gaining too much weight