Preterm Baby Flashcards
Extremely preterm
<28 weeks
Very preterm
8-32 weeks
Moderate to late preterm
32-37 weeks
What are the risks factor for premature birth?
uterine abnormalities. fibrosis. hx of preterm births, family hx of preterm births
multiple pregnancy
maternal lifestyle: smoking, drug and/or alcohol abuse
maternal weight: low or high BMI
maternal age: <17, >35
race
maternal conditions: diabetes, preeclampsia
low socioeconomic status
limited pregnancy care
stress
vaginal bleeding during pregnancy
What are the prevention of preterm labour?
- Primary prevention
- Secondary prevention
What is primary prevention?
Smoking cessation
public education
nutritional counseling (underweight/obesity)reduction of workload and stress at workplace
What is secondary prevention?
cervical cerclage
progesterone supplementation
measurement of vaginal pH
cervial length measurement by trans vaginal ultrasonography
What are common complications of preterm birth for newborn?
respiratory problems
metabolic problems
sepsis
seizures
structural organic problems
cerebral palsy
infections
feeding difficulties
hypoxic ischaemic encephalopathy
visual and hearing problems
What are the characteristics of the preterm neonate?
large head an small face
soft skull bones and large fontanelles
skin is red and thin
subcutaneous fat it almost absent and surface veins are prominent
small narrow chest
large abdomen and low-set umbilicus
thin limbs and soft nails
small genitalia
muscle tone poor
normal reflexes may be absent
What type of care is needed?
tertiary - intensive newborn care
secondary - special newborn care
primary - essential newborn care
What innovations are required for the care of preterm babies?
thermal care
kangaroo mother care
CPAP
phototherapy lamps and eye shields
What is the role of the midwife in preterm labour intrapartum care?
- awareness of the relevant medical history
- preparation of the equipment for resuscitation of the preterm infant
- resuscitation
What is the role of the midwife in preterm newborn on postnatal ward?
maintenance of temperature
establishment of feeding
hiperbilirubinemia management
skin care
vital signs monitoring
blood glucose establishment
apnea
discharge home education
What is SGA?
Small for gestational age
weight below the 10th percentile for gestational age as per the population growth charts
What is moderate SGA?
birth weight from third to tenth percentile
What is severe SGA?
birth weight less than the third percentile
What is FGR?
Fetal Growth Restriction
e fetuses with an estimated fetal weight (EFW) <10th centile
What is IUGR?
Intrauterine growth restriction
pathologically small fetus (ie EFW<10th centile, oligohydramnios, abnormal umbilical artery (UA) Doppler and/or poor interval growth velocity and/ or EFW <3rd centile)
What are the clinical features of infants at birth that have IUGR?
large head
long finger nails
loose,dry and easy peel able skin
small/scaphoid abdomen
poor skeletal muscle mass
loose fold of skin in nape of neck
large an thin hands an legs
thin umbilical cord
poor breast bud formation
absence of buccal fat
What are the immediate neonatal complications seen in intrauterine growth restricted neonates?
birth/perinatal asphyxia
retinopathy of prematurity
hypothermia
hypoglycamia/hyperglycemia
polycythaemia/hyperviscosity
intrauterine fetal death
low serun ferritin
pulmonary haemorrhage
immunodeficiency
renal dysfunction
NEC
MAS
PPHN
