Pre-term Infant Flashcards

1
Q

What is a preterm birth?

A

Before 37 weeks

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2
Q

What is extreme preterm?

A

Before 28 weeks

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3
Q

What is very preterm?

A

28-32 weeks

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4
Q

What is moderate to late preterm?

A

32-37 weeks

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5
Q

What are risk factors for preterm delivery?

A

Previous preterm delivery
Multiple pregnancy
Smoking/drug use in pregnancy
Under/over weight in pregnancy

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6
Q

What is RDS?

A

Respiratory distress syndrome

Insufficient surfactant produced by type 2 pneumocytes in the lungs

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7
Q

What is function of surfactant?

A

Increases the surface tension so prevents the alveoli collapsing

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8
Q

What gestation does surfactant begin to be produced?

A

28 weeks

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9
Q

What are signs of RDS?

A

Tachypnoea >60
Laboured breathing
Expiratory grunting

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10
Q

How is RDS managed?

A

Antenatally = steroids

Postnatally = exogenous surfactant + ventilatory support

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11
Q

What is CLD?

A

Chronic lung disease

Requiring oxygen post corrected 36 weeks

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12
Q

What is CLD also known as?

A

BPD - bronchopulmonary dysplasia

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13
Q

What is premature apnoea?

A

Short periods where the infant stops breathing

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14
Q

What causes premature apnoea?

A

Immature central respiratory control

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15
Q

How is premature apnoea managed?

A

Caffeine

Ventilatory support

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16
Q

What is PDA?

A

Patent ductus arteriosus

Failure of the ductus arteriosus to close

17
Q

What is the function of the ductus arteriosus in utero?

A

Shunt between the pulmonary artery and aorta to bypass the lungs

18
Q

What problem can a PDA cause?

A

Shunt can reverse from right->left to left->right as aortic pressure increases

This results in increase blood flow to the lungs -> pulmonary oedema

19
Q

How is PDA managed?

A

Ibuprofen

Surgical ligation

20
Q

What is IVH?

A

Intraventricular haemorrhage

21
Q

Why do IVHs occur?

A

Underdeveloped ventricular system
Highly vascular choroid

Very delicate and susceptible to damage

22
Q

What problem can an IVH cause?

A

Large bleed/clot can block the ventricles and impair CSF drainage

Leads to hydrocephalus

23
Q

How are IVHs screened for?

A

Preterm infants get cranial ultrasounds

24
Q

What is PVL?

A

Periventricular lecuomalacia

Ischaemic damage to periventricular white matter

25
Q

Why do preterm infants have feeding problems?

A

Immature gut

Do not develop ability to suckle and swallow until ~34 weeks

26
Q

How are preterm feeding problems managed?

A

NG feeding

Parental nutrition

27
Q

What is NEC?

A

Necrotizing enterocolitis

28
Q

What causes NEC?

A

Impaired blood flow to gut = ischaemic injury
+
microbial growth

29
Q

What are the features of NEC?

A

Bilious vomiting
Bloody diarrhoea
Abdominal distension

30
Q

What are the x-ray features in NEC?

A

Distended bowel loops
Intramural gas
Portal venous tract gas

31
Q

How is NEC managed?

A

NBM
Antibiotics
Surgery - resect bowel

32
Q

What is ROP?

A

Retinopathy of prematurity

Proliferation of new blood vessels in an area of relative ischaemia in a developing retina

33
Q

What is the cause of ROP?

A

Higher oxygen levels outside of uterus

34
Q

How is ROP screened for?

A

Preterm infants screened by ophthalmologist

35
Q

How is ROP managed?

A

Keeps sats 92-96
Anti-VEGF
Laser ablation