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Repro > Preterm infant > Flashcards

Preterm infant Flashcards

1
Q

preterm defiintion

A

<37 weeks

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2
Q

term birth definition

A

between 27-42 weeks

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3
Q

post term definition

A

> 42 weeks

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4
Q

below 31 weeks is what

A

very preterm

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5
Q

below 27 weeks is what

A

extremely preterm

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6
Q

why do half of deaths in childhood occur during the first year of a child’s life

A

strongly influenced by prefer delivery and low brith weight

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7
Q

causes of preterm birth

A

cervical incompetence/uterine malformation
antepartum haemorrhage
IUGR
preg assoc htn
premature pre labour rupture of membranes
multiple pregnancy
spontaneous preterm labour

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8
Q

what does >2 preterm deliveries increase the risk of

A

another preterm baby by 70%

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9
Q

how much does an abnormally shaped uterus increase the risk of giving birth early by

A

19%

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10
Q

how many more times likely are women to give birth early if they have multiple pregnancy

A

9x more likely

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11
Q

risk factors of preterm birth

A

interval of <6 months between pregnancies
conceiving through in vitro fertilisation
smoking, alcohol, drugs
poor nutrition, chronic conditions (BP, DM), multiple miscarriages or abortions

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12
Q

different between a term baby and a preterm baby when they are first born

A

get cold faster - smaller
have more fragile lungs so don’t breathe effectively
have fewer reserves
pulse oximetry often indicated

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13
Q

do preterm babies need assistance or resuscitations

A

most very preterm babies need help with transition to air breathing - assistance

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14
Q

when should cord clamping be done in preterm babies

A

if the baby is okay and can be kept warm pause for at least a minute to allow placental transfusion

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15
Q

how are preterm babies kept warm

A

using a plastic bag or a heater
prewarm incubators
skin to skin
trans warmer mattress

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16
Q

risks of lung inflation

A

lungs are fragile so over inflation can cause damage leading to inflammation and long term morbidity - can lead to bronchopulmonary dysplasia

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17
Q

concerns in a preterm baby

A

temp control
feeding/nutrition
sepsis
systemic immaturity - RDS, PDA, ibraventricular haemorrhage, necrotising enterocolitis

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18
Q

hypothermia is a risk factor for what

what does it increase

A

neonatal death

increases severity of all preterm morbidities

19
Q

why is thermal regulation ineffective in a preterm baby

A

low BMR
minimal muscle activity
subcut fat insulation is negligible
high ratio of surface area to body mass

20
Q

why is there an increased risk of potential nutritional compromise

A

limited nutritional reserves
immature metabolic pathways
increased nutritional demands

21
Q

what is gestational correction

A

adjusts the plot of measurement on the graph to account for the number of weeks a baby was born early

22
Q

when should gestational correction not be used for under 40 weeks baby

A

for 37+ weeks

23
Q

when should gestational correction be used till

A

1 year for infants born 32-36 weeks

2 years for infants born before 32 weeks

24
Q

what are the two types of neonatal sepsis

A

early onset mainly due to bacteria acquired before and after delivery

late onset acquired after delivery

25
Q

which organisms cause neonatal sepsis

A

group b strep
gram neg - klebsiella, EColi, pseudomonas, salmonella
gram pos - SA, coag neg staph, strep pneumonia, strep pyogenes

26
Q

management of neonatal sepsis

A 
prevention 
hand washing 
super vigilant and infection screening 
judicial use of antibiotics
optimum supportive measures
27
Q

what increases infection

A

incubators

28
Q

what are some of the respiratory complications of prematurity

A

RDS
apnoea of prematurity
bronchopulmonary dysplasia

29
Q

NRDS pathology

A

primary - surfactant deficiency, structural immaturity

secondary - alveolar damage, formation of exudate from leaky capillaries, inflammation, repair

30
Q

when is RDS common

A

75% in <29 weeks born

10% in >32 weeks gestation

31
Q

clinical features of RDS

A

resp distress - tachypnoea, grunting, intercostal recession, nasal flaring, cyanosis
worsening over minutes to hours
usually improves over 2-4 days with active treatment

32
Q

management of RDS

A

maternal steroids
surfactant
ventilation - invasive or non invasice

33
Q

CVS complications in preterm

A

PDA

systemic hypotension

34
Q 
PDA is what 
who is at risk 
what does it lead to 
oxygen requirements
exacerbates what
A 
when DA doesn't close
premature infants 
symptoms of congestive HF
are high 
RDS
35
Q

intraventricular haemorrhage is what

A

form of intracranial haemorhhage which begins with bleeding in the germinal matrix and 80% of the cases leads to bleeding intraventricular

36
Q

clinical presentation of a intraventricular haemorrhage

A

clinically silent 25-50%
intermittent deterioration
catastrophic deterioration

most occur in first day of life - up to 90% of GMH-IVH insult is present by 72 hours

37
Q

risk factors for IVH

A

prematurity

RDS

38
Q

IVH preventive measures

A

antenatal steroids
prompt and appropriate resuscitation
avoid haemodynamic instability
avoid hypoxia, hypercarbia, hyperopia and hypocardia

39
Q

IVH grade 1 and 2

A

neurodevelopment delay up too 20% and mortality is 10%

40
Q

IVH grade 3 and 4

A

neurodevelopment delay up to 80% and mortality is 50%

41
Q

NEC is the most common what
what is it
high incidence in who

A

neonatal surgical emergency
widespread necrosis in the small and large intestine
in premature infants

42
Q

clinical picture of NEC

A

usually after recovering form RDS
early signs: lethargy and gastric residuals
bloody stool, temp instability, apnoea and bradycardia

43
Q

other complications of prematurity

A

retinopathy - usually 6-8 weeks after delivery
hypoglycaemia and hyponatraemia early cx
osteopenia of prematurity later cx

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