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Human Development 2 > Perinatal Pathology > Flashcards

Perinatal Pathology Flashcards

1
Q

what are markers of population health

A
  • Maternal wellbeing during pregnancy

- Conditions into which babies are born

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2
Q

what are markers of healthcare effectiveness

A
  • Maternity services

- Neonatal care

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3
Q

what is miscarriage

A
  • Pregnancy loss less than 24 weeks
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4
Q

what is a still birth

A
  • Baby born greater than 24 weeks with no signs of loss
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5
Q

what is a neonatal death and what is the difference between early and late neonatal death

A
  • Baby born live but dies in the frist 28 days of life
  • Early neonatal – 0-7 days
  • Late – 7-28 days
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6
Q

what is infant death

A
  • Death in the first year of life
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7
Q

How do you measure still births

A
  • Number of still births per 1000 total births (live and still births)
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8
Q

how do you measure the perinatal mortality rate

A

number of stillbirths and early neonatal deaths per 1000 total births

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9
Q

how do you measure the neonatal mortality rate

A

number of neonatal deaths (early and late) for each 1000 live births

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10
Q

How do you measure the infant mortality rate

A

number of infant deaths for each 1000 live births

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11
Q

what are the international factors that contribute to differences in death of babies

A 
Maternal health
Nutrition
Access to services
Income
Family size
Birthweight
Prematurity
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12
Q

List what can cause neonatal and perinatal mortality

A
  • prematurity
  • congenital abnormalities

Immediately after delivery

  • asphyxia
  • infections
  • unexplained still brith
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13
Q

describe how prematurity can lead to neonatal death and perinatal mortality

A
  • Surfactant deficiency
  • Periventricular haemorrhage
  • Infection
  • Necrotising enterocolitis
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14
Q

what can you give to treat surfactant deficiency

A

antenatal corticosteroids

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15
Q

What can you give to treat periventricular haemorrhage

A

antenatal corticosteroids in order to reduce the chance of a periventricular haemorrhage

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16
Q

when are the luges developed enough for oxygen breathing

A

37 weeks

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17
Q

list some congenital abnormalities that can occur

A
  • Heart disease
  • Neural tube defects
  • Chromosomal abnormalities
  • Usually detected antenatally – usually terminated babies that are not going to survive to adulthood
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18
Q

when can you develop infections and when can this lead to perinatal death

A
  • Congential
  • Acquired
  • Intrapartum
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19
Q

what is an unexplained still birth likely due to

A
  • cord accidents

- likely placenta dysfunction

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20
Q

what are the most causes of perinatal mortality

A
  • Preterm associated problems
  • Intrapartum related events
  • Sepsis and pneumonia
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21
Q

when is sudden infant death most common

A
  • More common in the infant period and not the neonatal death
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22
Q

what are the causes of still birth

A
  • Unexplained
  • Umbilical cord complications
  • Infection - not common in the UK
  • Placental abruption
  • Placental insufficiency
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23
Q

what are the foetal causes of still birth

A
  • lethal congenital anomaly
  • infection acute v chronic
  • non-immune hydrozoan
  • immunisation
  • foetal/maternal haemorrhage
  • twin to twin transfusion
  • foetal growth restriction - probably attributed to the placenta not supplying baby with enough oxygen
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24
Q

what is non-immune hydrozoan

A
  • this is when there is a material mismatch due to rhesus D

- anti D can build an antibody response to the baby and attack the baby

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25
Q

what type of genetic condition is mocked Gruber syndrome

A

autosomal recessive

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26
Q

What is mocked-gruber syndrome

A

Meckel-Gruber syndrome is a rare and lethal autosomal recessive disorder characterized by occipital encephalocele, postaxial polydactyly and bilateral dysplastic cystic kidneys

27
Q

What can also cause still brith

A
  • congenial acquired penumbra

- CMV

28
Q

name some still brith causes

A
  • umbilical cord
  • placental causes
  • amniotic fluid
  • uterus
29
Q

what are umbilical causes of death

A
  • Prolapse – gets cold and then no longer supplies the baby
  • Loop or knot – restriction of oxygen and blood supply to the baby
  • Velamentous insertion - inserted on the periphery of the placenta, when the waters break the cord tears of from the placetna and this stops the babies blood supply
30
Q

What is. velamentous insertion

A

inserted on the periphery of the placenta, when the waters break the cord tears of from the placetna and this stops the babies blood supply

31
Q

What are placental causes still birth of death

A
  • Abruption
  • Praevia – placenta covering the neck of the womb, placetna will bleed out if contractions where this takes place
  • Placental insufficiency
32
Q

what are amniotic fluid causes of still birth death

A
  • Chorioamnionitis - infction usually from the maternal gential tracts and infects the water around the baby
  • Oligohydramnios – too little, cant develop the lungs and other organs
  • Polyhydramnios
33
Q

what are uterus causes of still birth death

A
  • Rupture

- Uterine abnormalities

34
Q

List the maternal causes of still birth

A
  • diabetes
  • hypertensive disorder
  • lupus
  • APS
  • cholestasis
  • drug misuse
35
Q

How does diabetes, hypertensive disorder, lupus, and APS cause still birth

A

– poor vascular, poor implantation of the placenta and increase clot forming in the placenta, reduction oxygen supply to the baby

36
Q

How can cholestasis cause still birth

A
  • this is a genetic condition when less bile is filtered out of the maternal blood and this can kill the baby
37
Q

What is drug misuse

A
  • this is when drug can cross the placenta
38
Q

what are intrapartum causes of still birth

A
  • Birth trauma

- Asphyxia

39
Q

what are the two types of stillbirth

A
  • actue

- chronic

40
Q

describe acute still brith

A
  • acte occurs within hours
  • Causes – placenta abruption, cord accident
  • Baby well growth
  • No maceration – not been dead for long
  • Normal placenta
41
Q

what causes acute still birth

A
  • Causes – placenta abruption, cord accident
42
Q

describe chronic still brith

A
  • Days to several weeks
  • Causes – diabetes, hypertension, maternal disease
  • Baby; IUGR – moderate to severe maceration
  • Placenta; small
43
Q

what are the causes of chronic stillbirth

A
  • Causes – diabetes, hypertension, maternal disease
44
Q

what are the contributing factors to perinatal mortality

A
  • Specific disease and conditions
  • Birthweight and gestation
  • Utero-placental function
  • Country of birth
  • Social class
  • Maternal age and parity
  • Access to healthcare
45
Q

How can we reduce the rates of perinatal mortality

A
  • Health care services – detecting placental problems, intrapartum care, effective treatment of neonates
  • Immunisation
  • Maternal education
  • Reduce child poverty
  • Improve housing
  • Breastfeeding promotion
46
Q

what does SUDI stand for

A

sudden unexpected death in infancy

47
Q

What does SIDS stand for

A

sudden infant death syndrome

48
Q

what is SUDI

A
  • This is a sudden unexpected death in infancy, it is when the infant dies when they are less than 1 year of age
49
Q

what situations are classed as SUDI

A
  • Baby found death in cot
  • Baby dies in parents’ arms; instantaneous
  • Rapid death due to illness
50
Q

what can cause SUDI

A
  • Low birth weight and prematurity
  • Birth injury and difficult labour
  • Sepsis
  • Congenital anomalies
  • Haemolytic disease of the new-born
  • Conditions of placenta and cord
51
Q

what are cot causes of death

A
  • Congenital heart disease
  • Respiratory infection
  • CNS infection
  • Seizure disorder
  • SIDS
  • Suffocation
52
Q

what causes rapid death due to recognised illness

A
  • Respiratory infection
  • CNS
  • Fastrogtneritis
  • Reyes syndrome
53
Q

every infant who dies by SUDI has to ..

A

undergo a post mortum

54
Q

what do you try to establish in a post mortar in someone who dies from SUDI

A
  • Establish whether death was natural or not
  • Provide basis of counselling
  • Try to prevent reoccurance
  • Epidemiology and research
55
Q

what is the definition of SIDS

A
  • Sudeen unexpencted death of an infant under 1 year of age which remains unexplained after a thorough investigation including post mortern and reiveiw of history and examination of the death scene
56
Q

what are the risk factors of SIDS

A
  • Placed on front to sleep
  • Smoking
  • Sleeping on softer or co sleeping
  • Most common in 1st 6 months of babies life
57
Q

what weeks is SIDS typically found in

A
  • Commonest between 4 and 20 weeks

* Commoner in winter

58
Q

What is the suggestion to the cause of SIDS

A
  • Delayed developing in arousal, cardio-respiratory control and thermal regulation happens between 2 and 4 months
  • Laryngeal spams – suggested that in these babies don’t have these autoregulatory functions and perhaps this is why they are dying as they failure to auto resuscitate from apnoea
59
Q

What is the triple risk theory of SIDS

A

Idea that these 3 factors can lead to the development of SIDS

  • Vulnerable infant – low brith weight twins
  • Outside stressors – single mothers, smokers, city livers
  • Critical developmental period
60
Q

What are external stressors leading to SIDS

A
  • Minor URTI
  • Prone position
  • Bed sharing
  • Overheating
61
Q

what are external finings of SIDS

A
  • Body well developed and nourished
  • Frothy fluid around nose
  • Cyanosis of lipids and nail beds
62
Q

what are internal findings of SIDS

A
  • Large thymus
  • Empty bladder
  • Full expansion of lungs
  • Petechiae in pleura and epicardium (haemorrhages consist with oxygen deprivation)
63
Q

SIDS and suffocation have…

A

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Human Development 2 (34 decks)

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