PRETERM BIRTHS AND COMPLICATIONS

Question 1

PRETERM BIRTHS

Answer 1

One million

Question 2

Preterm neonate - is one delivered before ______ completed weeks of gestation.

Classification based on gestational age
Extreme preterm- <______weeks GA
Early preterm - ____-<____ weeks GA Moderate preterm – ____-<____ weeks GA Late preterm – _____-__________ weeks GA

Answer 2

37

28weeks GA
- 28-<32 weeks GA
– 32-<34 weeks GA
— 34-36+6days weeks GA

Question 3

Classification based on weight for age
Preterm ______________________ (preterm AGA).
Preterm ______________________ (preterm SGA).
Preterm ______________________

Answer 3

appropriate for gestational age
small for gestational age
large for gestational age

Question 4

Tools to diagnose gestational age

LMP
USS
Dubowitz/ ________ score

Answer 4

Ballard

Question 5

THE NEW BALLARD’S SCORE

Answer 5

Bb

Question 6

CHARACTERISTICS OF THE PRETERM INFANT

Answer 6

reddened ; thin

fine hairs ; back.

floppy ; Large

smooth : flat.

34 weeks ;Weak ; absent

Question 7

Characteristics of preterm infant

Genitals: in boys the testes may not be _____________ and the scrotum may be small with __________;

Answer 7

descended ; no ruggae;

large ; anterior

Question 8

FACTORS ASSOCIATED WITH PRETERM DELIVERY.

Answer 8

16yr ; > 35yr

Question 9

FACTORS ASSOCIATED WITH PRETERM DELIVERY

Answer 9

Multiple ; Polyhydramnios

Question 10

PROBLEMS OF PREMATURITY

Answer 10

PROBLEMS OF PREMATURITY

immature

suboptimal function

Question 11

PROBLEMS OF PREMATURITY
Respiratory:
Small _________, weak respiratory muscles and _________ thoracic cage
_________ breathing - irregular
Apnoea – Immature _____________
Respiratory distress syndrome – insufficient ___________

Answer 11

airways ; compliant

Periodic ; respiratory centre

surfactant

Question 12

Problems of prematurity

RESPIRATORY

Aspiration pneumonia – unable to _______________________________, poor ________ action- easy ________

Chronic lung disease – lung injury, _______ exposure and abnormal repair
Subglottic stenosis

Answer 12

coordinate sucking and swallowing

sphinteric ; regurgitation

exposure

Question 13

PROBLEMS OF PREMATURITY
Temperature regulation:
They are prone to _________________________
_________ temperature regulatory centre
Increased heat loss – reduced ____________ , _______ surface area to body weight, non flexed posture
Impaired heat production (__________________________)

Answer 13

both hypo and hyperthermia

Immature ; subcutaneous fat

large ; non-shivering thermogenesis

Question 14

Prematurity problems

Temperature

↓ ________ fat (found in the interscapular, paraspinal and perirenal areas- develops after 26-28 wks of gestation), poor muscular activity,

Answer 14

brown

Poor

Question 15

PROBLEMS OF PREMATURITY
Haematologic:
Anaemia – _________ deficiency, shortened _________, inadequate production, iatrogenic losses,

Jaundice - ↑ _________ production due to ↓ _________, ↓ capacity of the liver to conjugate, ↓ bilirubin excretion, ↓ excretion via bile,

Increased risk of _________- ↓ serum albumin, hypothermia, acidosis, permeable blood brain barrier.

Answer 15

iron ; RBC life span,

bilirubin production; rbc lifespan

kernicterus

Question 16

PROBLEMS OF PRETERM INFANTS

Answer 16

risk for infection

hypoxia; haemorrhage

hypotension ; patent ductus arteriosus (PDA)

Question 17

PROBLEMS OF PRETERM INFANTS

Answer 17

suck ; ~32-34 wks

stomach capacity ; motility,

hypoglycemia ; hypocalcemia

retinopathy

Question 18

MANAGEMENT OF THE PRETERM INFANT

Answer 18

2 doses of steroids

lung maturity

Question 19

MANAGEMENT OF THE PRETERM INFANT

Answer 19

oxygen ; CPAP; surfactant,

neutral ; incubator

hypoglycemia; Gavage feeding

handling