Prematurity And Rubella Flashcards
also known as “German Measles
CRS
Crs is characterized by:
○ Maculopapular rash
○ Lymphadenopathy
○ Fever
CRS Defects are often rare when the infection occurs in the
20th week or after the 20th week of gestation.
If infection occurs 0-28 days before conception
the infant has a 43% chance of being a ected
If the infection occurs 0-12 weeks after conception
the chance increases to 51%
If the infection occurs 13-26 weeks after conception
the chance is 23%
Infants are not generally a ected if rubella is contracted during
The 3rd trimester
Gestational age: 1-8 weeks
Cardiac defect (heart) and hearing impairment, other CRS anomalies (80%)
Gestational age: 9-12 weeks
Hearing impairment and features of CRS (50%)
Gestational age: 13-16 weeks
CRS anomalies (30%), hearing loss is prominent than other features.
Chances of fetal damage are minimal or none
> 20 weeks
Rubella immunoglobulin M (IgM) antibody detected
infants < 6 months old
Sustained rubella immunoglobulin G (IgG) antibody level detected in serum;
present on at least two occasions between 6 and 12 months of age
Any infant < 12 months with suspicion of CRS. The following clinical manifestation should lead to suspicion of CRS:
(1) Congenital heart disease and/or
(2) suspicion of hearing impairment; and/or one or more of the following eye signs: (a) cataract; (b) congenital glaucoma; or (c) pigmentary retinopathy (salt and pepper).
An infant of < 12 months in whom a qualified clinician detects:
At least two of the complications listed in group A or one in Group A and one in group B:
Cataract(s), congenital glaucoma, congenital heart disease, hearing impairment, pigmentary retinopathy
Group A
Purpura, splenomegaly, microcephaly, meningoencephalitis, radiolucent bone disease, jaundi
Group B
An infant who is a suspected case with one condition from Group A and meets laboratory criteria for CRS
Lab confirmed CRS
An infant who does not have group A clinical signs of CRS but who meets the laboratory criteria for CRS is classified as having congenital rubella
CRI
Auditory defect of CRS
sensorineural hearing impairment
Neurologic impairment of CRS
○ Microcephaly
○ Cerebral calcifications
○ Meningoencephalitis
○ Behavioral disorders, mental retardation
Neonatal manifestations of CRS
○ Low birth weight
○ Interstitial pneumonitis
A birth defect where a baby’s head is smaller than expected when compared to babies of the same sex and age.
Microcephaly
There are calcium deposits in the brain and the e ects of that vary depending on the severity and area of the calcification
Cerebral calcifications
Very rare, life-threatening condition simply means you have meningitis and encephalitis at the same time.
Meningoencephalitis
the classic triad of symptoms for CRS are:
1) Sensorineural Hearing Loss
2) Eye Abnormalities
3) Pulmonary Stenosis
observed approximately around 58% of the patients
Sensorineural Hearing Loss
are present among 40% of the patients
eye abnormalities
clouding of the lens in the eye that a ects vision
Cataract
Also called Microphthalmos
- This is developmental disorder of the eye in which
one or both eyes do not fully develop hence they are small
Microphthalmia
The narrowing of the valve between the lower right heart chamber, right ventricle, and the lung arteries (pulmonary artery)
Pulmonary Stenosis
Presents as a characteristic as a “blueberry mu n rash”
- It occurs in organs outside of the bone marrow and it occurs in very diverse condition,
Extramedullary Hematopoiesis
less than 37 weeks gestation is ___ baby
Premature
(37 to 42 weeks gestation) is a ___ baby
Full term
born after 42 weeks gestation is a ___ baby
Post term
A pregnant woman experiences regular contractions that result in the opening of the cervix after week 20 and before week 37 of pregnancy.
Pre term labor
less than 28 weeks
Extremely preterm
28 to 32 weeks
Very preterm
32 to 37 weeks
Moderate to late preterm
AKA induced preterm delivery
- Often recommended by obstetrician and
gynecologist when the mother has usually multiple gestations with complications
Elective
May or may not have an obvious trigger.
Sometimes it could be an infection or placenta abduction.
Spontaneous
Risk Factors for Premature Birth
● Cervical Incompetence/ cervical insu ciency
● Birth defects in the uterus
● History of preterm delivery
● Infection (UTI or infection of the amniotic
membrane)
● Poor nutrition right before during pregnancy ● Pre-eclampsia
● Placenta previa or placental abruption
Means that the muscles and cervix are weak and that’s the reason it opens or the woman experiences painful cervical dilation that often results in preterm delivery.
Cervical Incompetence/cervical Insu ciency
the placenta is located low in the uterus and it may be covering the cervix.
placenta previa,
placenta detaches from the uterus and with this one it has an unknown cause.
Placental abruption
Often caused by deficiency by the pulmonary surfactant this would a ect the breath supply of the infant because this would a ect the breath supply of the infant because the pulmonary surfactant plays an important role in maintaining the integrity of the alveoli and is essential for e cient exchange of gasses.
Respiratory Distress Syndrome
Symptoms: grunting respiration, use of the accessory muscles, nasal flaring
Respiratory distress syndrome
under-developed lung which is a chronic lung disease and is often used by prolonged use of ventilators.
Bronchopulmonary Dysplasia
caused by the immaturity of the neurologic or mechanical function of the RS because of the immaturity of the system. They do not allow non stop breathing
Apnea
High levels of bilirubin in the bloodstream and you will often observe the white part of the eyes or mucous membranes will turn yellow.
Jaundice
a type of brain damage that can result from high levels of bilirubin in the baby’s blood and it is associated with athetoid CP and HL.
kernicterus
It means that you have a “hole” in your heart
- There is an undisclosed hole in aorta and it allows
the blood to skip the circulation to the lungs
Patent Ductus Arteriosus (PDA)
Occurs when the glucose in the blood is too low
Hypoglycemia
tissue of the intestines are inflamed and
causes that part to die or it will form a hole in the
babyʼs intestines
Necrotizing enterocolitis (NEC)
A disorder of movement, muscle tone, or posture that can be caused by an injury in the brain due to infection, inadequate blood flow, or injury to a newborn’s developing brain either early during pregnancy or while the baby is still young.
CP
related to their neurological impairment/cognitive deficits and language impairment,
Impaired learning
preterm delivery interferes with the vascularization process of the eye or the forming of blood vessels in the eye = causing blindness
Retinopathy of Prematurity
perform worse that their age-matched peers on their total language, receptive language, expressive language, phonological awareness, and grammar abilities by early school age
Children born VPT and have very LBW
the associated medical conditions or health
complications amongst premature children that affect the structure and function of the brain.
Biological constraints
the amount of exploration that the child does during the early stages of his life.
Environmental constraints
- While the patient is there, we have to facilitate:
- Facilitates the nutritive sucking process
- Discusses the maturation levels of the nutritive sucking with bottle and breastfeeding
- Train parents on how to facilitate age-appropriate feeding, swallowing, language/ communication skills
- Discuss the red flags in speech-language development and the importance of the early intervention
For early intervention or school-based SLPs it is our duty, if the child comes to us and we have already identified that they have a language deficit or they have a persisting language deficit then it is our responsibility to:
● Determine the cause of the language deficits
● Identify children who needs speech-language therapy
● Identify children who may not qualify for therapy services through traditional standardized testing
● Train teachers to incorporate the therapy techniques in class discussions to enhance the child’s classroom learning
