preterm infant

Question 1

what is the most common cause of preterm birth?

Answer 1

spontaneous preterm labour
other common causes are multiple pregnancy, membrane rupture & pregnancy associated hypertension

Question 2

what are some risk factors for preterm birth?

Answer 2

more than 2 previous preterm births, multiple pregnancy, <6 months between pregnancies, IVF, smoking, alcohol & drugs, multiple miscarriages / abortions

Question 3

how do you keep preterm infants warm?

Answer 3

put them in a plastic bag immediately after birth and putting them under a radiant heater with a hat on

Question 4

what are the common problems of prematurity?

Answer 4

temperature control
feeding/nutrition
sepsis
system immaturity/dysfunction - RDS, PDA, IVH, necrotising enterocolitis (NEC)

Question 5

why is thermal regulation ineffective in preterm infants?

Answer 5

low basal metabolic rate
minimal muscular activity
almost no subcutaneous fat insulation
high ratio of surface area to body mass

Question 6

what is the difference between early and late onset neonatal sepsis?

Answer 6

EOS is due to bacteria acquired before or during delivery
LOS is due to bacteria acquired after delivery

Question 7

what organisms cause early onset neonatal sepsis?

Answer 7

group b strep
gram negatives

Question 8

what organisms cause late onset neonatal sepsis?

Answer 8

coag -ve staph
gram -ves
staph aureus

Question 9

what is the management of neonatal sepsis?

Answer 9

preventions
hand washing
antibiotics
super vigilant and infection screening

Question 10

what are the respiratory complications of prematurity?

Answer 10

RDS
apnoea of prematurity
bronchopulmonary dysplasia

Question 11

what is the primary pathology of RDS?

Answer 11

surfactant deficiency
structural immaturity

Question 12

what is a secondary cause of RDS?

Answer 12

alveolar damage- formation of exudate from leaky capillaries

Question 13

what are the clinical features of RDS?

Answer 13

respiratory distress
tachypnoea- grunting, intercostal recessions, nasal flaring, cyanosis

Question 14

what is the management of RDS?

Answer 14

maternal steroid
surfactant
ventilation

Question 15

what are the classifications of intraventricular haemorrhage?

Answer 15

Grade 1- 4 classification and outcome:

Grade 1 and 2 : Neurodevelopmental delay up to 20%
-Mortality 10%

Grade 3 and 4: Neurodevelopmental delay up to 80%
-Mortality 50%

Question 16

what are other complications of prematurity?

Answer 16

retinopathy (6-8 weeks after delivery)
early metabolic- hypo/hyperglycaemia
late metabolic- osteopenia of prematurity