preterm babies and associated complications Flashcards
hypothermia management
- deliver baby in room at 26 degrees
- wrap baby appropriately (plastic bag, towel)
- place in incubator (watch as independent risk factor for infection)
hypothermia complications
- increased work of breathing
- hypoxia
- hypoglycaemia
respiratory distress syndrome cause
- develops due to surfactant insufficiency resulting in collapse of alveoli with each breath
- this increases the work of breathing, causing exhaustion and respiratory failure leading to hypoxia, leading to reduced cardiac output, acidosis and death
respiratory distress syndrome risk factors
- male
- maternal diabetes and hypertension
- IGUS under 29 weeks
- sepsis
- hypothermia
- delivery by c-section
- second twin
- more common in premature babies
respiratory distress syndrome presentation
- tachypnoea (under 60), increased work of breathing (grunting, nasal flaring, intercostal recession)
- onset of symptoms from minutes to 4 hours after birth
- symptoms don’t resolve after 24 hours like transient tachypnoea of newborn
respiratory distress syndrome diagnosis
- O2 low
- chest x-ray showing ground glass appearance
respiratory distress syndrome management
- surfactant and ventilation
- invasive is intubation, non-invasive is CPAP
apnoea of prematurity cause
breathing centres in the brain not being fully developed, which results in the baby forgetting to breathe
apnoea of prematurity presentation
gaps between breaths of > 20 seconds
apnoea of prematurity management
may require ventilation due to risk of hypoxia
necrotising enterocolitis pathophysiology
- inflammatory necrosis of the intestine thought to be associated with gut immaturity
- when pre-term babies begin to eat, the bowel isn’t mature enough to deal with this, which results in transmural necrosis and ultimately bowel necrosis
necrotising enterocolitis risk factors
- formula feeding
- IGUR
- umbilarla arterial insertion
necrotising enterocolitis presentation
- poor feeding, mucous and blood-stained diarrhoea, abdominal distension and tenderness
- if perforation: shock and disseminated intravascular coagulation
- typically couple of weeks after birth
necrotising enterocolitis diagnosis
abdominal x-ray
- asymmetrical dilated loops of bowel
- bowel wall: oedema and pneumatosis intestinalis (air cysts in bowel wall)
necrotising enterocolitis management
- conservative: stop feeding, supportive care, antibiotics especially benpen
- interventional: surgical removal of affected part of bowel
