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Pediatrics > Perinatal Period > Flashcards

Perinatal Period Flashcards

1
Q

Pertern gestation

A

< 37 weeks

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2
Q

Term gestation

A

37 - 42 wks

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3
Q

Post-term gestation

A

> 42 wks

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4
Q

Neonatal period

A

First 28 days of life.

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5
Q

Perinatal period

A

from 20 wks gestation to one month after birth.

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6
Q

Ductus Venosus

A

Connects umbilical vein to inferior vena cava.

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7
Q

Ductus arteriosus

A

Channel of communication btw main pulm artery and aorta.

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8
Q

Foramen Ovale

A

Opening btw two atria or fetal heart.

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9
Q

What is the last system to develop in utero?

A

Respiratory system. Surfactant production in 3rd trimester.

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10
Q

What does it mean if a neonate loses weight after birth?

A

It is a normal loss of water weight. baby should return to birth weight by 2 wks of age.

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11
Q

Symmetric SGA

A

Early pregnancy complications

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12
Q

Asymmetric SGA

A

Implies late pregnancy complications.

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13
Q

Causes of LGA

A

Infant of diabetic mother (IDM)

Erythroblastosis fetalis

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14
Q

IDM

A

Infant of Diabetic Mother.
Need to be screened for hypoglycemia.
At 3 hrs, normal-term babies BG normalizes at 50-80

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15
Q

IUGR

A

Intrauterine Growth Restriction

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16
Q

RDS

A

Respiratory Distress Syndrome.
Results form inadequate surfactant production.
70% chance of RDS at 28-30 wks gestation

17
Q

RDS Mgmt

A

O2 therapy, ABG’s
CPAP
Mech ventilation if needed
Artificial surfactant

18
Q

Meconium aspiration syndrome (MAS)

A

Meconium enters amniotic fluid and is aspirated.

Common in post-maturity and fetal distress.

19
Q

MAS CXR findings

A

Fluffy infiltrates.
Pneumothorax.
Flattened diaphragm.

20
Q

MAS Mgmt

A

Suctioning.
Chest phyisiotherapy.
CPAP.
Abx.

21
Q

Persistent Pulmonary HTN of Newborn (PPHN)

A

AKA persistent fetal circulation.
Pulm HTN and R to L shunting.
Sustained elevation in Pulm vascular resistance.

22
Q

Transient tachypnea of the newborn (TTN)

A

Retained fetal lung fluid. typically happens in term infants.
CHR of perihilar streaking
Resolution occurs in 12-24 hrs

23
Q

What can cause jaundice?

A

Any process that increases excess destruction of RBC’s or interferes with bile excretion.

24
Q

Physiologic Jaundice

A

Neonates have increased RBC’s and increased destruction, inadequate liver clearance resulting in jaundice. Occurs in first wk of life.

25
Q

How does physiologic jaundice progress?

A

Head to toe. Clears in 10-12 days. Starts after 24 hrs of life.

26
Q

At what serum bilirubin level does jaundice appear?

A

Total bili levels of 3-5

27
Q

Do jaundiced infants have high levels of direct or indirect bilirubin?

A

Indirect, it has not been conjugated by the liver.

28
Q

Physiologic Jaundice Tx

A

Feed every 2-3 hrs.
Stay properly hydrated (6-8 wet diapers/day).
Consider phototherapy.

29
Q

Indirect coombs tests for?

A

ABO compatability

30
Q

Kernicterus

A

Can occur when unconjugated bilirubin reaches high levels.

Neurotoxicity in the brain.

31
Q

Dangerous levels of bili = ?

A

20 - 25 mg/dl

32
Q

Factors suggesting pathologic jaundice?

A

Levels above 17mg/dl.
Onset in first 24 hrs.
Conjugated bili levels rise.

33
Q

ABO hemolytic dz

A

Common, not severe.

Can occur in 10% of pregnancies.

34
Q

Rh Hemolytic Dz

A

Much less common, but more severe.
Can accompany any pregnancy where mom has Rh negative blood.
SYmptoms in first 24 hrs

35
Q

Rhogam

A

Immunoglobulin that will prevent Rh hemolytic dz.

36
Q

Breast milk jaundice

A

Uncommon dz that occurs in healthy thriving newborns and lasts 3 wks to 3 months.
Peaks at 10-15 days of age.
Treat by not nursing for 1-2 days.

37
Q

BIlirubin level estimation.

A

Face: 5
Upper chest: 10
Abdomen: 12
Palms and soles > 15

38
Q

Sudden Infant Death Syndrome (SIDS)

A

Unexplained death <1 yr of age.
Peak at 2-4 minths of age
Risks: sleeping position, bottle feeding, smoking, overheating.

Pediatrics (8 decks)

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