Preterm birth Flashcards
define preterm birth
<37 weeks
antenatal risk factors
multiple pregnancies fetal growth maternal factors- PIH, diabetes APH PROM/SROM, chorioamnioitis fetal distress
why can neonates not control their temperature
large surface area to body weight ratio and immature skin with absence of fat
- neonates don’t shiver and non-shivering thermogenesis is impaired
what is the cut off for viability
24 weeks- at this point the alveoli and vascularisation are complete
examination findings with patent ductus arteriosus
prominent pulses with systolic/diastolic murmur
- USS dopplers may show absent or reversed diastolic flow in mesenteric artery
treatment for PDA
ibuprofen/indomethacin followed by surgical ligation
what is necrotising enterocolitis characterised by
inflammation and necrosis of the intestine with a predilection for terminal ileum
typically in 2nd-3rd week of life of prem baby
risk factors for nec
prematuriy asphyxia polycythaemia PDA enteral/artificial feeds
clinical manifestations of nec
- intolerance to feeds
- distended tender abdomen
- signs and symptoms of sepsis
- vomiting, diarrhoea, delayed gastric emptying, ileus
- systemic signs: apnoea, lethargy, shock, CVS collapse
Diagnosis of Nec
AXR- fixed distended bowel loops
Treatment of nec
stop enteral feeds
initiate broad spec abx
some evidence for probiotics
what is retinopathy of prematurity
disorder of retinal vascularisation primarily occurs at extremely low birthweight insants
when does retinal vascularisation begin and when is it complete
begins at 14 weeks from optic disc to periphery and becomes fully mature at term
risk factors for ROP
prematurity
hyperoxia- downregulates VEGF causing blood vessels to constrict
-fluctuation in oxygenation
Mx of ROP
Avoid o2 sats >95%
screen by examination of peripheral retina if <32weeks
can undergo cryo/laser therapy to prevent retinal detachment
