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Preterm infant Flashcards

1
Q

when a baby pre term

A

before 37 weeks

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2
Q

Extremely preterm

A

before 27weeks

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3
Q

very preterm

A

before 31 weeks

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4
Q

What are the risks and factors which contribute to neonatal death

A 
smoking
maternal age
being born before 32 weeks
twins
poor social circumstances
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5
Q

how many deaths occur among babies born at term

A

1 in 3

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6
Q

What are the most common causes for preterm birth

A

Spontaneous
Multiple pregnancy
Preterm rupture of membrane

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7
Q

Name other risk factors for preterm birth

A 
more than 2 preterms before increases the risk of another premature baby by 70 percent
abnormally shaped uterus
multiple pregnancies
short interval between pregnancies (less than 6 months)
IVF
Smoking alcohol and drugs
Nutrition poor
Diabetes and high BP
Multiple miscarriages or abortions
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8
Q

What is the difference between a term and preterm baby

A 
Preterms get cold faster
Most fragile lungs
Don't breathe well
Fewer reserves
Pulse oximetry often indicated
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9
Q

Why are preterm babies not often resuscitated?

A

The need help to transition to air breathing rather than because they are asphyxiated like a term baby might be

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10
Q

Why is cord clamping ‘paused’ in preterms

A

If the baby can be kept warm then pause for a minute to allow placental transfusion and assess baby.

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11
Q

How are preterm babies kept warm

A

A plastic bag under a radiant heater

Immediately

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12
Q

Name problems that can occur in preterms due to system immaturity

A 
Resp distress syndrome
Patent ductus arteriosis
Intraventricular haemorrhage
Nectrotising enterocolitis
Retinopathy of prematurity
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13
Q

Why are preterms not able to thermoregulate effectively

A

Low BMR
Minimal muscular activity
Subcutaneous fat insulation is negligible
High ratio of surface area to body mass

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14
Q

Why might preterms run into problems with growth and nutrition

A

Increased risk of potential nutritional compromise
Limited nutrient reserves
Immature metabolic pathways
Increased nutrient demands

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15
Q

What is gestational correction

A

Adjustemtn of the plot of measurement of growth charts to account for the number of week a baby was born early

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16
Q

When should gestational correction be used until

A

1 year for prems born 32-36 weeks

2 years for prems born before 32 weeks

17
Q

What is early onset neonatal sepsis usually caused by

A

Mainy due to bacteria acquire before or during delivery

18
Q

What is the most common cause of neonatal sepsis

A

Group B strep

19
Q

What is an important risk factor for neonatal sepsis

A

Incubation

Incubators increase infection

20
Q

What causes respiratory distress syndrome

A

Surfactant deficiency or structural immaturity (Primary)

Secondary pathology - alveolar damage, build up of exudate, inflammation, repair

21
Q

How common is RDS

A

75 percent of babies born before 29 weeks

22
Q

what are the clinical features of RDS

A 
Tachypnoea
Grunting
Intercostal recessions
nasal flaring
cyanosis

Worsen over minutes to hours

23
Q

How is RDS managed

A

Maternal steroid before delivery
Surfactant
Ventilation

24
Q

What is a complication of RDS

A

Bronchopulmonary dysplasia (BPD) is a long-term lung condition that can affect some children with NRDS. It develops when the ventilator used to treat NRDS causes scarring to the lungs

25
Q

what are the symptoms of patent ductus arteriosis

A

heart failure - congestive
poor weight gain
exacerbated RDS

26
Q

Where does intraventricular haemorrhage in infants begin

A

germinal matrix

27
Q

what are the two major rsik factors for IVH

A

prematurity

respiratory distress syndrome

28
Q

When do most IVH occur

A

first day of life

29
Q

How can IVH be prevented

A

antenatal steroids

30
Q

What percentage of grade 1-2 IVH will have neurodevelopmental delay or die

A

NDD- up to 20 percent

death- 10 percetn

31
Q

What percentage of grade 3-4 IVH will have neurodevelopmental delay or die

A

NDD- up to 80 percent

mortality- 50 percent

32
Q

What is the most common neonatal surgical emergency

A

necrotizing enterocolitis

33
Q

What is the clinical features of NEC

A

Usually after RDS
Lethargy, gastric residuals
Bloody stool , temp instability, apnoea, bradycardia

Reproduction (52 decks)

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