SEMIS - OLEDAN Flashcards
is a term for the broad
category of neonates born at less
than 37 weeks & 39 weeks gestation
Prematurity
is the leading neonatal
mortality and the most common
reason for antenatal hospital.
Preterm birth
born between 34 and
36 completed weeks of pregnancy.
late preterm
born between
32 weeks and 34 weeks of
pregnancy.
moderately preterm
born at less than 32
weeks of pregnancy
very preterm
born on before
25weeks of Pregnancy.
extremely preterm
Initial Management begins
_____
if there is a threat of preterm delivery
identified.
antenatal
The delivery of an extremely preterm
infant should be planned for a
hospital with a ______
tertiary level neonatal
unit.
- translucent, smooth, shiny
(edematous). visible blood vessels
skin
” relaxed attitude”, limbs
more extended, the body size is
small, the head is somewhat larger in
proportion) on to the body size.
posture
cartilages are poorly developed,
and may fold easly
ear
appears turgid, less creases.
sole
clitoris is prominent, labia
majora are poorly develop and
gaping.
female genital
- scrotum is undeveloped and
not pendulous. Minimal rugae, testes
may be in the inguinal canals or in
abdominal cavity-
male genital
abundant over the body,
but sparse, fine, and fuzzy on the
head
lanugo
abundant over the
body
vernix caseosa
are unable to maintain
body temperature, have limited ability to
excrete solutes in the urine and have an
increased susceptibility to infection.
premature infants
periodic breathers, period of rapid
respirations, separated by periods of
slow breathing.
Apnea of Prematurity
condition of the surfactant deficiency
and physiologic immaturity of the
thorax
respiratory distress syndrome
occurs when a fetus passes out
meconium while in the utero due to
intrauterine stress.
Meconium Aspiration Syndrome
or septicemia, refers to a generalized
bacterial infection in the
bloodstream.
Sepsis
other name of Sepsis
septicemia
Neonates are highly
susceptible to infection because of
diminished nonspecific
(inflammation) and specific
(humoral) immunity
diminished nonspecific
(inflammation) and specific
(humoral) immunity examples
impaired phagocytosis, delayed &
absence of immunoglobulin.
refers to an excessive level of
accumulated bilirubin in the blood
and is characterized by jaundice or
icterus
Hyperbilirubinemia
sudden death of infant under 1 year
of age. Time of death is during sleep.
It is common in premature infant
especially low birth weight, neonates
with low APGAR score and infant
with CNS disturbance and
respiratory disorders. Feeding habits
is also one of cause of SIDS.
Sudden Death Syndrome
Their little bodies still have areas
that need to mature and fully
develop. Some of these areas include
the
Lungs
Digestive system
Immune system
skin
This is
commonly used to help
assess the respiratory and
metabolic state of the Infant.
blood gas
Imaging or Invasive tests
Chest x-ray
Abdominal x-ray
Your
baby will probably stay in an
enclosed plastic bassinet
(incubator)that keep warm to help
your baby maintain normal body
temperature.
placed in incubator
At first your
baby may receive fluid and nutrients
through an intravenous (IV) tube.
feeding tbue
with direct skin to-Skin contact
kangaroo care
Refers to any baby born after 42
weeks gestation past the first day of
the mother’s last menstrual period.
POST MATURITY?
Risks can increase during labor and
birth fetus with
poor with oxygen
supply
Problems may occur during birth if
the baby is
large
Post premature babies may be at risk
for ______ when a
baby breathes in fluld containing the
first stool
meconium aspiration
SIGNS OF POST MATURITY?
Before deliver there may be reduced
fetal movement.
A reduced volume of amniotic gluid
may cause reduction in the size of
the uterus.
Meconium-stained amniotic fluid
may be seen when the membranes
have rupture.
is done by monitoring the baby’s
heart rate in a small device that is
placed on the mothers a abdomin.
non stress test
These tests give information about
the health of the fetus and about the
risks of allowing the pregnant to
continue.
Antenatal fetal monitoring
assessment of amniotic fluid volume
and fetal movement, tone, breathing,
and heart rate
Biophysical profile
is recommended over expectant
management in a woman post-term
pregnancy to reduce rate of cesarean
delivery.
induction of labor
(or “stripping)
may be used to prevent post-term
pregnancy.
Reduces the percentage of patients
going post-term from 41% to 23%.
membrane sweeping
Reserved for women decline
induction or labor have a
contraindication.
conservative management
an
infant whose rate of intrauterine growth was
slowed and whose birth weight falls below
the percentile on intrauterine growth curves.
less than 2500 grams or 5 lbs. 8 oz.
small for gestation age
SGA
– 2.5kg
Preterm babies
Small for age Babies
LOW BIRTH WEIGHT
TYPE OF SGA:
- Malnourished SGA
- Hypoplastic SGA
- Mixed SGA
Most Common type of SGA
Asymmetric IUGR
2/3 rd of IUGR
Malnourishment during latter part of
gestation - placental dysfunction
(uteroplacental insufficiency)
- Malnourished SGA
Symmetric lUGR
1/3 rd of lUGR
Growth retardation in early
pregnancy
intrauterine infection, genetic
defects, chromosomal aberrations
Incidence of anomalies 10 - 20 times
higher
2.Hypoplastic SGA
Adverse factors during both early &
mid pregnant
Neither obvious malnourished, nor
grossly hypoplastic
Decrease in both cell size and count.
MIXED SGA
Causes of SGA
- Maternal
- Fetal
- Placental
- Environmental
MATERNAL FACTORS SGA
- Maternal Nutrition
- Previous History
- Grandmultipara
- Maternal disease
- Smoking tobacco, Alcohol
- Poor weight gain
FETAL FACTORS SGA
- First born.
- Genetic defects
- Multiple gestation
- IU Infection
PLACENTA FACTORS SGA
- Abruption
- Placenta infarct
- Structural abnormality
- Vascular thrombosis
ENVIRONMENTAL FACTORS SGA
- Ethnic/racial/geographic
- Socio-economic status
- Nutritional
MANAGEMENT OF SGA
Emergency CS - fetal distress
Screening for congenital
malformations
Early and adequate breast feeding
(NGT/IVF)
Correct hypoglycemia,
hypocalcemia, polycythen
Control infections, temperature
regulation
an infant whose birth weight falls
above the 90th percentil on
intrauterine growth chart
birth weight of more than 4000
grams or 8lbs. and 13oz
Large Gestational Age (LGA)
Most Common cause for LGA fetus
MATERNAL DIABETES
Increased Adiposity
Increased Skin fold thickness
Visceromegaly (liver)
MACROSOMIA
Mean birth wt is higher in babies
with Congenital hypothyroidism.
CRETINISM
large size due to generalised ansarca
rather than due to stomatic growth
Birth weight may also be related to
the amount of weight a mother gain
during pregnancy.
Excessive weight gain — increased
fetal weight
HYDROPS FETALIS
How is LGA diagnosed
.
Ultrasound
A mother’s weight gain
Prevention of LGA
Prenatal care.
Careful management of diabetes
Proper weight gain
) describes a fetus or newborn
infant whose size is within the
normal range for his or her
gestational age
Appropriate for gestational age
(AGA
Appropriate for Gestational Age:
birthweight b/w
10th & 90th
percentile
An appropriate for gestational age
full term infant is heavier than
2500
grams and lighter than about 4000
grams
SGA weight
less 10th percentile.
an intestinal obstruction in children
between the ages of 3 months and 3
years old.
The peak occurrence is between the
ages of 5 to 9 months old
Intussusception
This is the sign of inadequate growth
resulting of inability to obtain or use
the calories required for growth.
Congenital Problem: Failure to Thrive
Categories of Failure to Thrive
- Organic failure to thrive (OFTT)
- Nonorganic failure to thrive (NFTT)
Idiopathic failure to thrive
result of a physical cause such as
Congenital heart defects
Neurologic lesions
Cerebral palsy
Microcephaly,
Chronic renal failure
Gastroesophageal reflux
Malabsorption syndrome
Endocrine dysfunction,
AIDS
- Organic failure to thrive (OFTT)
Unrelated to diseases most often
psychosocial factors such as:
Parental knowledge of nutrition
Deficiency in maternal care
Disturbance in maternal-child
attachment
Disturbance in the child’s ability to
separate from parent, leading to food
refusal to maintain attention.
- Nonorganic failure to thrive (NFTT)
unexplained by the usual organic and
environmental causes but may also
be classified as NFTT.
Idiopathic failure to thrive
(cerebral gigantism)
large baby
macrognathia
large hands & feet
mentally subnormal
lag in maturation of carpal bones
Sotos syndrome
The condition is generally described
as cramping that is manifested by
loud crying and drawing the legs up
to the abdomen.
Duration of cry greater than 3 hours
a day occurring more than 3 days per
week
Congenital Problem: Paroxysmal
Abdominal Pain (Colic)
____ is more common in infants
under the age off 3 months old
Colic
Infants with “difficult” temperaments
are more likely to be _____
colicky.
Colic is ______ and, in most
cases, resolves as the infant matures
self-limiting
(Down Syndrome)
Trisomy 21
Cause is not known.
Genetic predisposition
Exposure to radiation before
conception
Immunologic problems and infection
Greater risk for older women (over
the age of 35)
Translocation of chromosome 21
(this type is advanced parental age)
Usually hereditary and is not
associated with advance parental age
Trisomy 21
Development may be _____
beyond the mental age, especially
during the early childhood.
2-3 years
_______have congenital heart
disease, renal agenesis, duodenal
atresia, Hirschsprung disease and
tracheoesophageal fistula
40% to 45%
down syndrome Skeletal defects include ______
patella
dislocation instability of the
vertebrae
it is the most common craniofacial
malfvenation and occurs with a
frequency of 1 in 700 live births.
Cleft Lip and Palate
The cleft may
be __________ and is often
associated with abnormal
development of the external nose,
nasal cartilages, nasal septum, and
maxillary alveola ridge.
unilateral or bilateral
occurs when the primary and
secondary palatine plates fail to fuse
during embryonic development.
Cleft Palate
- it may involve only the soft palate or
may extend into the hard palate
Cleft Palate
- it may occur only in the midline of
the posterior palate or may extend to
the nostril on one or both side.
Cleft Palate
Feed infant in an __________ to decrease possibility of
fluid being aspirated or returned
through the nose or back to the
auditory canal.
upright, sitting
position
The cleft lip is generally repaired before
the palate defect.
- Immediate repair= ??
several hours to
several weeks after birth.
cleft palate Later repair when infant is
6 to 12
- Weeks old
Cleft palate repair may be done any
time between ages _________
6 months and 5
years.
- because speech patterns have not
been set, yet growth of involved
structures allows for improved
surgical repair.
Repair at age 9 to 18 months may be
preferred
- a special denture palate is used to
help occlude the cleft and aid in
establishing speech patterns
If repair is delayed to age 4 or 5,
Use ___________ and insert from the _____ to avoid
suture line or to avoid stimulating
sucking.
dropper or syringe with a rubber
tip.
side
