Prematurity Flashcards
What counts as preterm?
Before 37 weeks
What % of newborns require full intestive care
3%
Cardiovascular changes after utero
Closure of foetal shunt Perfusion of the lungs Falling pulmonary artery pressure Increasing systemic blood pressure Increase in cardiac output Foetal lung fluid removed
Respiratory changes after birth
Lungs filled with air, surfactant released, gas exchange
Which cells release surfactant
Type II alveolar epithelial cells, also called pneumocytes, which differentiate between 24 and 34 weeks of gestation in the human
When does implantation occur
Weeks 1 to 2 following missed period
When does the embryo fully form?
Up to 8 -9 weeks by the end of this stage you are fully formed
When is movement felt by the mother?
From 12 to 16 weeks
What happens in the last 4 to 6 weeks of pregnancy
All growth
Mainly fat
What weight is a very low birth weight?
1500g
What weight is an extremely low birth weight?
1000g
What weight is an incredibly low birth weight?
750g
When do alveoli develop
From 24 weeks
What is chronic lung disease of prematurity?
general term for long-term breathing problems in premature babies. It is also called bronchopulmonary dysplasia (BPD).
What is apnoea of prematurity
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
When does the brain stem fully myelinate?
32 to 34 weeks
What is the pathophysiology for apnoea of prematurity
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.
What are the symptoms of apnoea of prematurity
Forget to breathe
Bradycardia
Made worse by sepsis
What is the treatment of apnoea prematurity
Physical - NCPAP Nasal continuous positive airway pressure aims to establish and maintain lung volume, stimulation.
Drugs - caffeine
Infant benefits of breast feeding
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
Maternal benefits of breastfeeding
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
Because prems can’t suckle for breastfeeding what is the alternative
IV/ parental nutrition
Small volumes of expressed breast milk
Monitor growth
When does suck and swallow start?
32 to 34 weeks
Causes of premature jaundice
In
