RHCN Flashcards
Causes of neonatal brain injury
Traumatic injury
Hypoglycemia
Hyperbilirubinemia
Infection
What area of the brain is first to be affected by hypoxia?
Basal ganglia and thalsmus
Treatment of neonatal hypoxoa
Brain cooling
When is intraventricular haemorrhage commonly seen?
Before 32 weeks
Where is the haemorrhage in preterm birth?
Subependymal haemorrhage in the Germinal matrix
Treatment of ventricular hemorrhage
Shunt
DRIFT - WASH out ventricles
What is periventricular leucomalacia and what does it result in?
White matter damage in preterm birth
Causes spastic dyplegia
What reduces the risk of periventricular leucomalacia
Prenatal MgSO4
What Igs are in breast milk
IgA+G
How does colostrum aid development
Makes gut less permeable
Downs syndrome + green vomit
Pyloric sphincter atresia
Neonatal encephalopathy
Perinatal asphyxia
Rash from being born
Spares palms and soles
Erythema toxicum
Barlow manouver
Push back to see if the hip clunks out
Ortolani manouver
Rotate out to see if you can feel the hip clunks back in
Cephalohematoma
Subperiosteal hemorrhage
Cephalohematoma
Subperiosteal hemorrhage that does not cross sutures
Kernicterus
Jaundice
Bilirubin crosses BBB and causes cerebral palsy
Baby with white stools and dark urine
Biliary atresia
Treat before 8 weeks
Right shift in Hb dissociation curve
Release
Deoxygenated
Higher 2,3-dpG
HbF
2,3-dpb
Gamma chain has lower affinity for 2,3-dpg
Antimicrobial proteins and peptides in amniotic fluid
FLA2, DEFENSINS, lactoferrin, BPI, histones
Neonatal meningitis
GBS
E.coli
Listeria
Intramural gas
Necrotising enterocolitis
Surfactant production
24 weeks
From canalicular to saccular phase
Prevention of retinopathy of prematurity
Keep sats <95%
CXR - opaque, ground glass appearance
RDS
CXR - coarse streaks and blur along lung fissures
Tachypnea
Paediatric tachypnea
> 60 breaths/ minute
Risk factor for neonatal pneumonia
prolonged rupture of membranes
GBS sepsis
Management of neonates with respiratory problems
stop feeds (puts pressure on lungs)
What does meconium aspiration cause?
mechanical obstruction, chemical pneumonitis, surfactant inactivation
CXR - hyperinflation with coarse streaking and patchy consolidation
meconium aspiration
check for in neonatal meconium aspiration
pneumothorax
typical female pelvis
gynecoid
preferred rotation for foetal head during delivery
occipito-posterior
facing the anus
Sciatic nerve innervation
L4-S3
Peudendal innervation
anterior devision of S2-4
Gravidity
number of times a woman has been pregnant
Parity
number of babies born beyond 24 weeks regardless on life status
Fundal height at 20 weeks
at umbilicus
Latent phase of labour
up to 4cm dilated, irregular tightening, cervix effacement and thinning
First stage of labour
4-10 cm dilated, regular contractions
Active second stage
pushing, baby born
will feel like they need to push
Third stage
delivery of placenta and membranes
Medication in third stage
IM syntocinon
In twins what is shared first?
Food first - placenta
