pre-term infant Flashcards
define pre term
born <37 weeks
define post term
born >42 weeks
risk factors for pre-term delivery
smoking/drinking/illicit drugs maternal age disadvantaged circumstances >2 pre-term deliveries uterine malformation <6 months between pregnancies IVF
causes of pre-term birth
spontaneous delivery (most common) multiple pregnancy pre-term pre-labour rupture of membranes pregnancy associated hypertension IUGR antepartum haemorrhage cervical incompetence
why should you pause before clamping cord in pre-term babies
allows placental transfusion - remember to keep warm
best way to keep pre-term baby warm
don’t dry
put in plastic bag under radiant heater
resp complications of prematurity
respiratory distress syndrome
apnoea prematurity
bronchopulmonary dysplasia
what is respiratory distress syndrome
surfactant deficiency and structural immaturity leading to alveolar damage and inflammation
clinical features of RDS
tachypnoea grunting intercostal recessions nasal flaring cyanosis
management of RDS
maternal steroid
surfactant
ventilation (be careful not to over-inflate lungs)
what is intraventricular haemorrhage
intracranial haemorrhage - bleeding into germinal matrix
presentation of intraventricular haemorrhage
usually in 1st day of life, always < 72 hours of life
can be asymptomatic
general deterioration
investigation if suspected intraventricular haemorrhage
USS
preventative measures of intraventricular haemorrhage
antenatal steroids
most common neonatal surgical emergency
necrotising enterocolitis
what is necrotising enterocolitis
widespread necrosis in small and large intestine
presentation of necrotising enterocolitis
after recovering from RDS lethargy and gastric residuals bloody stools temp instability apnoea bradycardia
what may be seen on abdo xray in severe necrotising enterocolitis
gas and abscesses in bowel
common eye disease of new born
retinopathy (6-8 weeks after delivery)
metabolic diseases of newborn
hypoglycaemia
hyponatraemia
osteopenia
complications of prematurity in later life
impaired cognition, motor deficits, vision and hearing loss chronic medical poor growth effect on adult health conditions cerebral palsy
