Preterm Infant

Question 1

term is defined as the period between what 2 gestations?

Answer 1

34 and 42 weeks

Question 2

what gestation marks the jump from very preterm to just preterm?

Answer 2

32 weeks

Question 3

why are more babies being born preterm?

Answer 3

inc maternal age
inc rate in pregnancy complications
greater use of infertility treatments
more CS deliveries before term

Question 4

main cause of preterm labour

Answer 4

spontaneous preterm labour

Question 5

what pregnancy complications can induce preterm labour?

Answer 5

preterm rupturing of membranes
PAH
IUGR
antepartum haemorrhage
cervical incompetence
uterine malformation

Question 6

there is a correlation between multiple pregnancy and preterm delivery T or F

Answer 6

T

Question 7

risk factors for preterm birth?

Answer 7

interval <6 months
IVF
substance abuse
poor nutrition
HTN/diabetes in mum
multiple miscarriages/abortions

Question 8

how are sick babies different from sick adults?

Answer 8

get hypothermic easier
lungs are more fragile and ineffective
less reserves

Question 9

what should be done immediately to a preterm baby after birth to keep them warm?

Answer 9

place in a suitable plastic bag and then under a radiant heater later

Question 10

give examples of problems arisen by system immaturity in premature babies?

Answer 10

RDS
patent ductus arteriosus
intraventricular haemorrhage
necrotising enterocolitis

Question 11

causes of sickness in premature babies?

Answer 11

system immaturity
hypothermia
feeding/nutrition
sepsis

Question 12

why do babies have ineffective thermal regulation?

Answer 12

low SC fat
low basal metabolic rate
minimal muscular activity - cant shiver

Question 13

how can you get hypoglycaemic from hypothermia?

Answer 13

uses up your metabolism trying to treat the hypothermia which uses glucose and glycogen stores

Question 14

how can hypoglycaemia cause hypoxia?

Answer 14

decreased surfactant made and pulm vasoconstriction increases work of breathing -> resp distress -> hypoxia

Question 15

how can hypothermia cause hypoxia?

Answer 15

uses up your metabolism which decreases O2 stores -> RR increases but not enough O2 so get anaerobic -> metabolic acidosis

Question 16

methods of keeping baby warm?

Answer 16

wrap or bags
transwarmer mattress
skin to skin
prewarmed incubator

Question 17

why is there an increased risk of nutritional compromise in preterm babies?

Answer 17

limited nutrient reserves
gut immaturity
immature metabolic pathways
increased nutrient demands

Question 18

cause of early onset neonatal sepsis?

Answer 18

bacteria acquired before and during delivery

Question 19

cause of late onset neonatal sepsis?

Answer 19

after delivery

Question 20

what bacteria cause early onset sepsis?

Answer 20

GABHS

gram -ves

Question 21

what bacteria cause late onset sepsis?

Answer 21

staph epi
gram -ves
staph aureus

Question 22

Tx neonatal sepsis?

Answer 22

prevention
handwashing
infection screening
antibiotics
supportive care

Question 23

resp complications of prematurity?

Answer 23

RDS
apnoea of prematurity
bronchopulmonary dysplasia

Question 24

what is the main problem in RDS?

Answer 24

surfactant deficiency due to structural immaturity of the alveoli causing alveolar damage, exudate formation, inflammation

Question 25

presentation of RDS?

Answer 25

tachypnoea
grunting
intercostal recessions
nasal flaring
cyanosis
worses over mins to hrs

Question 26

when does RDS tend to get worse then better?

Answer 26

worsens to nadir at 2-4 days then gradual improvement

Question 27

Tx of RDS?

Answer 27

maternal steroid
surfactant
ventilation

Question 28

main consequences of intraventricular haemorrhage?

Answer 28

neurodevelopmental delay

death

Question 29

when does retinopathy of prematurity tend to occur?

Answer 29

6-8 weeks after delivery

Question 30

main metabolic complications of prematurity?

Answer 30

hypoglycaemia

hyponatraemia