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REPRO > Preterm Bby > Flashcards

Preterm Bby Flashcards

1
Q

Preterm bby is born before _______

A

37 weeks of gestation

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2
Q

Premature births fell by ______ after ______

A

10%

Smoking Ban

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3
Q

What strongly influences deaths in the 1st year of childhood?

A
  • Pre-term Delivery
  • Low Birth Weight

—other risk factors: Maternal Age, Smoking, poverty, ethnicity

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4
Q

Why are pre-term deliveries rising every year?

A
  • incr. Maternal age
  • incr. rate in pregn.-related complications
  • greater use of INFERTILITY
  • more C-sections before term
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5
Q

What are the top 3 causes of pre-term births?

A
  1. Spontaneous
  2. Multiple pregn
  3. PPROM (preterm prelabour rupture of membranes)
  4. pregn. associated Hypertension
  5. cervical malformation incompetence
  6. anterpartum hemorrhage
  7. IUGR
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6
Q

What are 3 risk factors of pre-term deliveries?

A
  • > 2 pre-term deliveries= incr. risk of another by 70%
  • ABNORMALLY shaped uterus incr. risk by 19%
  • 9x more likely with multiple bbies
  • IVF
  • smoking, drinking, drugs
  • <6 months interval btw pregnancies
  • poor nutrition/multiple miscarriages
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7
Q

What is diff. in managing a pre-term bby vs a term bby?

A
  • needs MORE help with warmth
  • can’t breathe effectively (fragile lungs)
  • fewer reserves
  • DELAY cord clamping !
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8
Q

How is the bby kept warm?

A
  • using PLASTIC bag under a radiant heater
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9
Q

What are common problems with prematurity ?

A
  • T* control
  • feeding
  • SEPSIS
  • system immaturity: RDS (respir. distress $) , PDA, IVH (intraventricular hemorrhage in brain), NEC (necrotising enterocolitis)
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10
Q

What incr. ALL pre-term morbidities?

A

hypothermia !

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11
Q

Why is thermal regulation diff. in a newborn?

A
  • LOW BMR
  • Minimal Muscular activity
  • Preterm: v. low subcutaneous FAt insulation
  • high ratio of S.A to body mass
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12
Q

Name methods/equipment used to keep preterm bbies warm?

A
  • Wraps/bags
  • Skin-to-skin care
  • Transwarmer mattress
  • Prewarmed incubator
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13
Q

Why does a preterm bby have an incr. risk of Nutritional compromise?

A
  • LIMITED nutrient reserves
  • GUT immaturity
  • immature metabolic pathways
  • incr. nutrient demands
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14
Q

What are the 2 types of Neonatal sepsis?

A
  1. Early Onset (EOS) - d.t bacteria acquired BEFORE and DURING delivery
  2. LOS (late onset)- acquired after delivery (community acq.)
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15
Q

Causes of EO Sepsis?

A
  • Gr. B streptococcus

- Gram (-)ves

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16
Q

Causes of LOS?

A
  • Gram (-ves)
  • Coagulase -ve Staph
  • Staph. aureus
17
Q

Why are premature bbies at a high risk of complications?

A
  • immature immune system
  • intensive care env.
  • indwelling TUBES and LINES
18
Q

How do you ensure pre-term bby is not put at risk of other complications?

A
  • handwashing
  • super vigilant and INFECTION screening should be done
  • judicious use of antibiotics
  • supportive measures
19
Q

What respiratory conditions may occur wtih prematurity?

A
  • RDS- respiratory distressed $
  • Apnoea of prematurity
  • Bronchopulmonary Dysplasia
20
Q

What is the pathophysiology of THE RDS?

A
  • Primary: Surfacant deficiency, structural immaturity

> alveolar damage d.t exudate from leaky capillaries> INFLAMMATION and REPAIR

21
Q

How common is RDS in bbies born before 29 wks?

A

75% vs only 10% in those born after 32 wks

22
Q

What are the clinical fts of RDS?

A
  • respir. distress
  • tachypnoea (grunting/nasal flaring/cyanosis/ intercostal recessions)
  • worsening over MINS to HRS
  • Natural hx
23
Q

How to manage RDS?

A
  • maternal steroid
  • surfactant
  • ventilation (invasive/non-invasive ventilation)
24
Q

How to grade intraventricular hemorrhage?

A
  • Grades 1 and 2: neurodevelop. delay up to 20%

- Grades 3 and 4: neurdevelop. delay up to 80% (mortality 50%)

25
Q

How does NEC present as?

A
  • poor feeding
  • bile stained vomitus
  • abdominal distension
  • blood-stained stools
  • +/- explosive diarrhoea
  • respiratory distress with acidosis
  • sepsis
26
Q

Risk factors of NEC?

A
  • premature bby (50-80%)
  • congenital heart disease
  • perinatal asphyxia
  • decr. umbilical flow
27
Q

What are other complications of preterm bby?

A
  • retinopathy of prematurity (6-8wks after delivery)
  • metabolic: Hypoglycemia and hyponatremia –EARLY

osteopenia of prematurity — LATE

REPRO (55 decks)

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