Pretem Delivery Flashcards
RDS pathophysiology
Surfactant deficiency>increase surface tension in aveoli>alveolar collapse >impaired ventilation
Main problems in RS in preterms 4
RDS
Pneumothorax
Apnoea ,bradycardia,desaturation
Bronchoplum dysplasia
Can it occurred in term babies RDS,
In who
Yes in diabetic moms babies
Treatments to prevent RDS
Steroids to mom
Surfactant via et tube to baby’s lungs
When will RDS symptoms present
Immediately O within 4hrs of birth
What are the RDS sympt
Tchypnea >60
Distress features
Cyanosis
Expiratory grunting
X ray findings 3 in RDS
Ground glass appearance
Obliterated heart border
Airbronchogram
RDS treatment methods 3
Oxygen
Cpap
Artf ventilation
What is Pulmonary interstitial emphysema
From over distended alveoli air leaks in to interstium in RDS
How does pneumothorax occur in Preterms
Mechn ventilation
How to prevent pneumothorax
Use minimum ventilatory pressure adequate
Avoid ventilating against respiration
Why bradycardia in preterms 2
Prolonged apnoea
Breathing through closed glottis
Underlying causes for bradycardia in preterms
Sepsis Hypoxia HF hypoglycaemia Elec imbalances
Treatment method for bradicardia
Stimulate respiration(caffein,physically) Cpap
PDA symptoms and signs
Apnoea
Bradycardia
Increase ox demand
Difficult to wean off ventila
Bounding pulses
Prominent apex
Murmurs
Treatment methods2 in PDA
Drug - prostaglandin synthatase inhibitor (ibuprofen ,indomethacin)
Surgical ligation
Why the heat loss is more in preterms 4
Increase body surface area
Thin skin cause transdermal heat loss
Less fat poor insulator
Inability to shiver and crawl
Complications of hypothermia 4
Increase metabolic rate cause Hypoxia Hypoglycaemia Reduce wt gain Death
What’s neutral temperature range?
The temperature range at which the babies energy consumption is lowest
Methods of temp control 4
Drying
Covering
Incubators
Heaters
Nutrition methods and food type for 35-36 wk Less <1.5kg Extreme preterm o very ill
Breast milk sucking
Breast milk via NG
Breast milk with supplementary ca,phosp
Formula via PICC
Why iron supplements necessary 3
Iron transfer in 3rd trimester
Blood loss
Erythropoietin less action
Causes for preterm infections 3
Only IgG transfer in 3rd trimester
Maternal infections esp cervical
Nosocomial infections
Infections contributes to what2
Bronchi plum dysplasia
Periventr leucomalacia
Preterm brain injury types2
Haemorrages-
Germinal layer
Parenchal
Ventricular
Periventr leucomalacia
Risk factors for haemorrage2
RDS
pneumothorax
Which if these causes cp
Germinal layer bleed
Intra ventricular large bleed
Large parenchymal bleed
Last two
Complication of a large intra ventricular hge
Hydrocephalus
Peri ventricular white matter injury happens following what 2
Inflammation
Ischemia
PVLM uss brain feature
Multiple cystic lesions bilaterally around ventricals
Complication of PVL
CP
Pathophysiology of NEC
Preterm asphyxia>bowel ischemia >bacteria invasion>infection > necrosis> perforation
NEC risk high with which feeding
Cows milk
Symptoms present when and what4 in NEC
Within first few weeks Bile stained vomiting Refusing feeds Abdo dissension Fresh blood in stools
X ray findings of NEC4
Distended bowel loops
Thickens bowel walls
Intramural gas
Gas in portal tract
Complications of NEC acute 2and long term 2
Severe pain and abdo distention causing shock
Perforation of bowel
Stricture
Malabsorption
Management of NEC
NBM Iv fluids Broad spect antibiotics Artificial ventilation Ax for perforation
ROP Pathophysiology
Revival ischemia>affects developing blood vessel as at the vascular and avascular junction>proliferation of blood vessels >retina detachment>fibrosis and blindness
Risk factor main for ROP
Oxygen toxicity
Treatment for rROP
Laser tx
What’s bronchopulm dysplasia
Ox dependency at 36weeks
Causes 3 for BPD
Artificial ventilation
Ox toxicity
Infection
X-ray findings in BPD
Diffuse lung opasities with cystic changes
Treatment for BPD
Prolonged artificial ventilatin >cpap>prolong ox
Steroid shirt courses
Complication of BPD3
Recurrent infections(RSV , pertussis ) Pulmoney hypert
