Prematurity

Question 1

What counts as preterm?

Answer 1

Before 37 weeks

Question 2

What % of newborns require full intestive care

Answer 2

3%

Question 3

Cardiovascular changes after utero

Answer 3

Closure of foetal shunt 
Perfusion of the lungs
Falling pulmonary artery pressure
Increasing systemic blood pressure
Increase in cardiac output
Foetal lung fluid removed

Question 4

Respiratory changes after birth

Answer 4

Lungs filled with air, surfactant released, gas exchange

Question 5

Which cells release surfactant

Answer 5

Type II alveolar epithelial cells, also called pneumocytes, which differentiate between 24 and 34 weeks of gestation in the human

Question 6

When does implantation occur

Answer 6

Weeks 1 to 2 following missed period

Question 7

When does the embryo fully form?

Answer 7

Up to 8 -9 weeks by the end of this stage you are fully formed

Question 8

When is movement felt by the mother?

Answer 8

From 12 to 16 weeks

Question 9

What happens in the last 4 to 6 weeks of pregnancy

Answer 9

All growth

Mainly fat

Question 10

What weight is a very low birth weight?

Answer 10

1500g

Question 11

What weight is an extremely low birth weight?

Answer 11

1000g

Question 12

What weight is an incredibly low birth weight?

Answer 12

750g

Question 13

When do alveoli develop

Answer 13

From 24 weeks

Question 14

What is chronic lung disease of prematurity?

Answer 14

general term for long-term breathing problems in premature babies. It is also called bronchopulmonary dysplasia (BPD).

Question 15

What is apnoea of prematurity

Answer 15

Apnea of prematurity (AOP) is when a premature (or preterm) baby:

pauses breathing for more than 15 to 20 seconds
or
pauses breathing for less than 15 seconds, but has a slow heart rate or low oxygen level

Question 16

When does the brain stem fully myelinate?

Answer 16

32 to 34 weeks

Question 17

What is the pathophysiology for apnoea of prematurity

Answer 17

In a premature baby, the brain is not fully myelinated until 32 - 34 weeks, it controls breathing is not yet mature enough for nonstop breathing. This causes large bursts of breath followed by periods of shallow breathing or stopped breathing.

Apnea of prematurity usually ends on its own after a few weeks. Once it goes away, it usually doesn’t come back. But no doubt about it — it’s frightening while it’s happening.

Question 18

What are the symptoms of apnoea of prematurity

Answer 18

Forget to breathe
Bradycardia
Made worse by sepsis

Question 19

What is the treatment of apnoea prematurity

Answer 19

Physical - NCPAP Nasal continuous positive airway pressure aims to establish and maintain lung volume, stimulation.
Drugs - caffeine

Question 20

Infant benefits of breast feeding

Answer 20

Less infection
Diarrhoea, otitis media, RSV, enhanced vaccine response

Less immune driven/ allergic disease
Reduced NEC, SIDS, GORD, lower risk of childhood inguinal hernia
Higher IQ
Better cognitive development

Question 21

Maternal benefits of breastfeeding

Answer 21

Reduces cancer risk for - breast, uterine, ovarian and endometrial 
Improved health with less - post partum haemorrhage, post natal depression, decrease insulin requirement, osteoporosis, less child abuse 
Promotors post partum weight loss 
Optimum child spacing 
Less food expense 
Less medical expense 
More ecological 
Delays fertility

Question 22

Because prems can’t suckle for breastfeeding what is the alternative

Answer 22

IV/ parental nutrition
Small volumes of expressed breast milk
Monitor growth

Question 23

When does suck and swallow start?

Answer 23

32 to 34 weeks

Question 24

Causes of premature jaundice

Answer 24

In