Preterm Infant Flashcards
term is defined as the period between what 2 gestations?
34 and 42 weeks
what gestation marks the jump from very preterm to just preterm?
32 weeks
why are more babies being born preterm?
inc maternal age
inc rate in pregnancy complications
greater use of infertility treatments
more CS deliveries before term
main cause of preterm labour
spontaneous preterm labour
what pregnancy complications can induce preterm labour?
preterm rupturing of membranes PAH IUGR antepartum haemorrhage cervical incompetence uterine malformation
there is a correlation between multiple pregnancy and preterm delivery T or F
T
risk factors for preterm birth?
interval <6 months IVF substance abuse poor nutrition HTN/diabetes in mum multiple miscarriages/abortions
how are sick babies different from sick adults?
get hypothermic easier
lungs are more fragile and ineffective
less reserves
what should be done immediately to a preterm baby after birth to keep them warm?
place in a suitable plastic bag and then under a radiant heater later
give examples of problems arisen by system immaturity in premature babies?
RDS
patent ductus arteriosus
intraventricular haemorrhage
necrotising enterocolitis
causes of sickness in premature babies?
system immaturity
hypothermia
feeding/nutrition
sepsis
why do babies have ineffective thermal regulation?
low SC fat
low basal metabolic rate
minimal muscular activity - cant shiver
how can you get hypoglycaemic from hypothermia?
uses up your metabolism trying to treat the hypothermia which uses glucose and glycogen stores
how can hypoglycaemia cause hypoxia?
decreased surfactant made and pulm vasoconstriction increases work of breathing -> resp distress -> hypoxia
how can hypothermia cause hypoxia?
uses up your metabolism which decreases O2 stores -> RR increases but not enough O2 so get anaerobic -> metabolic acidosis
methods of keeping baby warm?
wrap or bags
transwarmer mattress
skin to skin
prewarmed incubator
why is there an increased risk of nutritional compromise in preterm babies?
limited nutrient reserves
gut immaturity
immature metabolic pathways
increased nutrient demands
cause of early onset neonatal sepsis?
bacteria acquired before and during delivery
cause of late onset neonatal sepsis?
after delivery
what bacteria cause early onset sepsis?
GABHS
gram -ves
what bacteria cause late onset sepsis?
staph epi
gram -ves
staph aureus
Tx neonatal sepsis?
prevention handwashing infection screening antibiotics supportive care
resp complications of prematurity?
RDS
apnoea of prematurity
bronchopulmonary dysplasia
what is the main problem in RDS?
surfactant deficiency due to structural immaturity of the alveoli causing alveolar damage, exudate formation, inflammation
presentation of RDS?
tachypnoea grunting intercostal recessions nasal flaring cyanosis worses over mins to hrs
when does RDS tend to get worse then better?
worsens to nadir at 2-4 days then gradual improvement
Tx of RDS?
maternal steroid
surfactant
ventilation
main consequences of intraventricular haemorrhage?
neurodevelopmental delay
death
when does retinopathy of prematurity tend to occur?
6-8 weeks after delivery
main metabolic complications of prematurity?
hypoglycaemia
hyponatraemia