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Year 4 > Preterm Infant > Flashcards

Preterm Infant Flashcards

1
Q

extreme pre-term?

A

<28 weeks

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2
Q

very preterm?

A

28-32 weeks?

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3
Q

late preterm?

A

32-37 weeks?

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4
Q

what increases risk of infant mortality?

A 
<32 weeks
twins
poverty
older mum
smoking etc
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5
Q

majority of neonatal deaths are due to what?

A

pre-term birth

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6
Q

how many births are pre-term?

A

more than 1 in 10 (world wide)

more like 7-8% in scotland

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7
Q

causes of pre-term?

A

spontaneous
multiple pregnancy
rupture of memrbanes
…..

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8
Q

riskf actors for preterm?

A

> 2 preterm deliveries increases risk to 70%>???
<6 months between pregnancies
IVF
smoking, drinking etc

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9
Q

are all pre-term infants in danger?

A

no

34+ weeks generally fine and managed same as term

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10
Q

what pre-term babies should you be worries about?

A

30 weeks and below

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11
Q

general problems in preterm?

A

need help to stay warm
fragile lungs
dont breathe effectively
fewer reserves

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12
Q

how to keep baby warm?

A

plastic bag under heater

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13
Q

delayed cord clamping in preterm?

A

yes

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14
Q

general approach to managing preterm infant?

A

delayed clamping and assess baby > keep baby warm (pastic bag, heater and hat) > gentle lung inflation (PEEP important) > use saturation monitor (to make sure not doing too much)

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15
Q

what resp problems might you anticipate in preterm?

A

resp distress syndrome
lack of surfactant
TTN
apnoea

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16
Q

what cardio problems might you anticipate in preterm?

A

PDA

hypotension

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17
Q

what GI problems might you anticipate in preterm?

A

necrotising enterocolitis

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18
Q

other problems anticipated?

A 
jaundice
poor feeding
cerebral palsy risk
hypoglycaemia 
sepsis
hypothermia
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19
Q

what neuro problems might you anticipate in preterm?

A

intraventricular haemorrhage

20
Q

hypothermia risk in preterm?

A

independent risk factor for neonatal death

increases severity of all preterm morbidities

21
Q

why is temp control poor in preterm?

A

low BMR
minimal muscle activity
s/c fat insulation is negligable
high surface area to body mass ratio

22
Q

what can hypothermia lead to?

A

hypoglycaemia
hypoxia
(can cause each other?)

23
Q

methods to keep baby warm?

A

wrap/bag
transwarmer matress
pre-warmed incubator
skin to skin

24
Q

why is there an increases risk of nutritional compromise in preterm?

A

limited nutrient reserves
gut immaturity
immature metabolic pathways
increased nutrient demand

25
Q

normal term birth weight?

A

3-4kg (generally)

26
Q

how can nutrition be maintained?

A

TPN often used

mothers milk or donor milk used to help mature the digestive system

27
Q

cause of early onset sepsis?

A

usually bacteria acquired before and during delivery (group B strep common cause)

28
Q

cause of late onset sepsis?

A

acquired after delivery

29
Q

early onset organisms

A

group B strep

gram -ves

30
Q

late onset organisms?

A

gram -ve
staph aureus
commensals???? probs not wtf

31
Q

risks of infection in preterm?

A

///
immature immune system
immature gut etc
what in fucking gods name is going on

32
Q

resp complications in prematurity?

A

RDS
apnoea
bronchopulmonary dysplasia

33
Q

primary pathology in RDS?

A

surfactant deficiency

structural immaturity

34
Q

secondary apthology?

A

due to medical intervention (ventilation, suctioning etc)

35
Q

what happens in RDS?

A

alveolar damage leading to leaky capillaries and exudate leakage causing inflammation and fibrosis from repair

36
Q

clinical features of RDS?

A

resp distress
tachypnoea
worsens over mins - hrs
natural history (grunting, recessions, nasal flaring etc)

37
Q

management of RDS?

A

maternal steroid before birth
surfactant
ventilation (invasive/non-invasive)

38
Q

how is surfactant given?

A

using laryngoscope and catheter while having CPAP support

39
Q

how can IV haemorrhage be seen in preterm?

A

US in anterior fontanelle

40
Q

grade 1-2 IV haemorrhage?

A

neurodevelopmental delay up to 20%

10% mortality

41
Q

grade 3-4 IV haemorrhage?

A

50% mortality

neurodevelopmental delay up to 80%

42
Q

classic features of necrotising enterocolitis?

A

distended, discoloured tummy

child is sick

43
Q

how does necrotising enterocolitis occur?

A

…..

reduced blood flow to gut wall………

44
Q

other complications in preterm ?

A

retinopathy of prematurity (6-8 weeks after delivery)

45
Q

metabolic complications?

A 
early = hypoglycaemia, hyponatraemia
late = osteopenia of prematurity

Year 4 (83 decks)

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