Post-natal Issues Flashcards
What is plethora?
Red colour of skin
Can be from polycythaemia or twins - problems with blood vessels so one can receive more blood flow
What are skin colour issues seen post-natal?
Plethora, cyanosis, jaundice and birth marks
What is the treatment for jaundice?
Treat underlying cause, hydrate, phototherapy, exchange transfusion and immunoglobulin
What is erythema toxicum?
Maculo-papular rash
30-70% of normal term neonates and rare in pre-term
Rash fades at the end of 1st week
No treatment required
What are Mongolian blue spots?
Blue-grey pigmentation caused by accumulation of melanocytes
Often lower back and buttocks
Very common in races of pigmented skin
What are capillary vascular malformations - stork marks?
Neavus simplex
Light coloured capillary dilation
Commonly at back of neck and maybe midline of face
Gradually fades within 1-2 years
Describe capillary vascular malformation - port wine stain
Neavus flammeus
Present at birth, flat or slightly raised
Caused by dilated, mature capillaries in the superficial dermis
These do not regress
Associations - Sturge Weber and Klippel-Trenaunay
Describe capillary haemangioma - strawberry naevus
Cluster of capillaries which appears within first month of birth
Raised and bright red, with discrete edges and occur any part of body
Usually regresses after 1 year of age
Can be referred for treatment and BB sometimes
What is the energy triangle?
Keep the baby pink, warm and sweet to prevent hypoxia, hypothermia and hypoglycaemia
Describe resuscitation and cold stress
Dry quickly, remove wet linens, use warm towels/ blankets, provide radiant warmer heat and use heated/ humidified oxygen
Who are babies at risk of hypoglycaemia?
Limited glucose supply - premature babies and perinatal stress
Hyperinsulinemia - infants of diabetic mothers
Increased glucose use - hypothermia and sepsis
What is hypoglycaemia?
Blood sugar is les than 2mmol/l
Bedside checking can be inaccurate so check lab sample if there are concerns
What are the symptoms of hypoglycaemia?
Jitteriness, temp instability, lethargy, hypotonia, apnoea, poor feeding, vomiting, high pitched or weak cry, seizures and asymptomatic
What is tongue tie?
Short and possible thickened frenulum
Attached anteriorly - base of tongue
Mostly no treatment is necessary
Frenotomy if restriction of tongue beyond alveolar margins and feeding is affected
What is bilious vomiting until proven otherwise?
Bowel obstruction
What is evaluated in respiratory new born history?
RR (> 60 is tachypnoea)
Increased effort - grunting, retractions (substernal, subcostal, intercostal and supraternal) and nasal flaring
Colour
O2 saturations
What could absent/ weak femoral pulses indicate?
Coarctation of the aorta
Describe cleft lip
Can be incomplete or complete (can continue to nose)
Can be unilateral or bilateral
Maxillary and medial nasal processes fail to merge, usually at 5 weeks gestation
What are issues associated with cleft lip/ palate?
Feeding issues - special bottles and tests
Airway problems
Associated abnormalities - hearing screening and echo
Remember trisomy
Describe ophthalmology examination
Always check red reflexes
Cataracts - lens opacification, can lead to blindness, may need no treatment or may need lens removal/ artificial lens
Retinoblastoma - laser therapy, chemo and surgical removal of the eye
Describe spinal dimples
Can reveal a more severe abnormality involving the spine and/ or spinal cord ex. spina bifida
If dimple is large, off midline, high or with other cutaneous marker - spinal imaging
What are cephalohaematomas?
Localised swelling over one or both sides of head and becomes max. size on day 3 + 4 of life
Soft, non-translucent swelling
Haemorrhage is under the pericranium
No treatment is required and resolution in 3-4 weeks
If large, increased haemolysis can lead to prolonged neonatal jaundice
Describe talipes
Medial or lateral deviation of the foot is often positional and requires no treatment apart from PT
Fixed - manipulation, strapping, casting and possible surgery
Can be more prone to hip problems
What is the treatment of DDH?
Need to relocate the head of femur to acetabulum so hip develops normally
Pavlik harness
Surgical reduction
What are features of trisomy 21?
Dysmorphism - low set ears, upward slanting palpebral fissures, epicanthic folds, single palmar crease and wide sandal gap
Hypotonia, cardiac defects, learning problems, haematological problems and thyroid problems
