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HD CC > Perinatal and childhood mortality > Flashcards

Perinatal and childhood mortality Flashcards

1
Q

Miscarriage

A

Pregnancy loss <24 weeks

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2
Q

Stillbirth

A

Baby born >24/40 showing no signs of life

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3
Q

Neonatal death

A

Baby born alive but dies in first 28 days of life

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4
Q

Early neonatal death

A

Death 0-7 completed days

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5
Q

Late neonatal death

A

Death 7-28 days

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6
Q

Infant death

A

All deaths within first year of life

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7
Q

Post-neonatal death

A

Deaths 28 days–>1 year

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8
Q

Rates

A

Stillbirth + Perinatal mortality rate –> per 1000 total births (live and stillbirths)
Neonatal + infant mortality rate- per 1000 live births

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9
Q

Factors that contribute to Stillbirth

A

Maternal health
Access to maternity care
Uteroplacental function

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10
Q

Factors that contribute to Early Neonatal death

A

Uteroplacental function
Perinatal infection
Neonatal resuscitation
Effective neonatal care

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11
Q

Factors that contribute to Late Neonatal death

A

Effective neonatal care

Postnatal infection

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12
Q

Factors that contribute to Postneonatal infant death

A

Postnatal infection

SIDS

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13
Q

Prematurity

A

Surfactant deficiency
Periventricular haemorrhage
Necrotising enterocolitis
Infection

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14
Q

Congenital abnormalities

A

Congenital heart disease
Chromosomal
Neural tube
Diaphragmatic hernia

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15
Q

Asphyxia

A

Before or during labour

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16
Q

Infections

A

Congenital
Intrapartum
Acquired

17
Q

Unexplained stillbirth

A

Probably a major contribution from impaired placental function

18
Q

Sudden infant death

A

Mostly neo-natal deaths

19
Q

Stillbirth causes

A 
Unexplained
Congenital anomaly
Antepartum haemorrhage
Maternal disorder
Pre-eclampsia
Infection
20
Q

Meckel-Gruber syndrome

A

Autosomal recessive
42 weeks
Characterised by CNS malformations, renal cystic dysplasia, pulmonary hypoplasia etc.

21
Q

Funisitis

A

Infection of connective tissue of umbilical cord

22
Q

Stillbirth Baby- Acute

A 
Well grown
Absence of maceration <12h
Traces meconium
Petechiae on serosal surfaces
Liquid blood
23
Q

Stillbirth baby- chronic

A

Moderate to severe/advanced maceration

IUGR

24
Q

SIDS

A

Sudden unexplained death under 1 year

Autopsy doesn’t reveal anything

25
Q

Baby found dead in cot

A 
CHD
Resp. infections
CNS infections
Septicaemia
Intoxication
Seizure disorders
SIDS
Suffocation and NAI
26
Q

SIDS facts

A

Commonest 4-20 weeks
Winter
Sleep

27
Q

SIDS RFs

A 
Social Class IV or V
Co-sleeping
Male baby
Maternal smoking
Low birth weight
28
Q

SIDS triple risk hypothesis

A 
Vulnerable infant (physiologic responses)
Critical Developmental period (age)
Exogenous stressor (environment)
29
Q

Vulnerable infant

A

Males 60%
Abnormality of serotoninergic network
Slower responses to changes (increase in HR or breathing)
Alterations in heart ion channels

30
Q

SIDS external findings

A

Body well developed and nourished
Frothy fluid around nose (often blood tinged)
Cyanosis of lips and nail beds

31
Q

SIDS internal findings

A 
Large thymus with petechiae
Petechiae in pleura
Epicardial petechiae
Full expansion of lungs
Liquid heart blood
Empty bladder
Prominent LN + Peyer's patches
32
Q

SIDS microscopic findings

A

Pulmonary congestion + oedema
Mild inflammation of URT
Focal fibrinoid necrosis of vocal cords
Persistent haemopoiesis in liver

33
Q

Reducing Pneumonia

A

Breastfeeding promotion

Haemophilius influenzae type b and pneumococcal vaccines

34
Q

Reducing diarrhoea

A 
Improved water and sanitation
Rotavirus vaccine
Zinc supplementation
ORS
Community case management
35
Q

Reducing malaria

A

Insecticide treated bed, nests
Intermittent preventive treatment in pregnancy
Artemisin based combination therapy

36
Q

Reducing Neonatal deaths

A

Improved labour and delivery management

37
Q

Preterm birth outcomes

A

Antenatal steroids

Kangaroo care

38
Q

Critical developmental period (age)

A 
Developmental immaturity
Rapid changes between 2-4 months
Delayed development of arousal, CR control or CV control + thermal regulation
Laryngeal spasm with GOR
Failure to auto-resuscitate from apnoea

HD CC (22 decks)

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