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Sick Preterm Baby Flashcards

1
Q

What is very preterm defined as?

A

<32 weeks

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2
Q

How were premature births affected by the smoking ban?

A

fell 10%

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3
Q

What is the risk of preterm birth with mulitple pregnnacy?

A

x9 risk

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4
Q

What is the average gestation at birth for twins?

A

37 weeks

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5
Q

What is the average gestation at birth for triplets?

A

34 weeks

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6
Q

What can hypothermia result in?

A

increased oxygen and energy consumption–hypoxia; metabolic acidosis and hypoglycaemia; apnea; noenatal cold injury; reduced blood coagulability; failure to gain weight; increased mortality

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7
Q

What is neonatal cold injury?

A

redness of the skin from dissociation of haemoglobin

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8
Q

Why are newborn babies liable to hypothermia?

A

large SA realtive to mass; skin is thin; little subcut fat; limitied capacity to generate heat; unable to curl up to reduce skin exposure

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9
Q

How are babies under 28 weeks kept warm?

A

placed in a plastic bag immediately whilst still wet under a radiant heater

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10
Q

What happens if you over-inflate a preterm babies lungs?

A

causes damage leading to inflammation and long-term morbidity; predisposes to bronchopulmonary dysplasia

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11
Q

What are the options for keeping a baby warm?

A

wrap or bags; skin-skin care; transwarmer mattressl prewarmed incubator

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12
Q

Why are extremely preterm infants unable to breastfeed immediately?

A

unable to suck and swallow until 34-35 weeks; initially unable to tolerate milk in enough quantity

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13
Q

Why are preterm babies are risk of nutritional compromise?

A

limited nutrient reserves; immature metabolic pathways; increased nutrient demands

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14
Q

What effect does oxygen have on pulmonary vasculature?

A

potent vasodilator

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15
Q

What is gestational corrrection?

A

adjusts the plot of a measurement to accoutn for the number of weeks a baby was born early

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16
Q

How long should gestational correction be continued for infants born between 32 and 36 weeks?

A

1 year

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17
Q

How long should gestational correction be continued for infants born before 32 weeks?

A

2 years

18
Q

What is the cause of early onset noenatal sepsis?

A

due to bacteria acquired before and during delivery

19
Q

What is the cause of late onset neonatal sepsis?

A

acquired after delivery

20
Q

What is the primary problem in respiratory distress syndrome?

A

surfactant deficiency and structural immaturity

21
Q

What causes the secondary pathology in respiratory distress sundrome?

A

from treating- ventilation

22
Q

How many calories per kg does a preemie need?

A

> 100kcal/kg

23
Q

What are the secondary problems in respiratory distress syndrome?

A

alveolar damage and formation of exudate from leaky capillaires due to damaged fragile lungs

24
Q

How common is RDS in babies born before 29 weeks?

A

75%

25
Q

What is the natural history of RDS?

A

worsens over minutes to hours; nadir at 2-4 days then gradual improvement

26
Q

What is the management for RDS?

A

maternal steroids; surfactant; ventilation

27
Q

What are the CVS concerns in preterm infants?

A

PDA; systemic hypotension

28
Q

What does PDA lead to?

A

symptoms of congestive heart failure; babies need lots of oxygen and will exacerbate RDS

29
Q

What is an intraventricular haemorrhage?

A

form of intracranial haemorrhage that begins with bleeding into the germinal matrix

30
Q

What are the 2 major risk factors for IVH?

A

prematurity and respiratory distress syndrome

31
Q

When does IVH usually occur?

A

first day of life

32
Q

Why is prematurity a RF for IVH?

A

germinal matrix is present but cerebral autoregulation is immature

33
Q

Why does RDS inrease risk of IVH?

A

hypoxia; acidosis and hypotension make the cerebral circulation more unstable

34
Q

What is the most common neonatal surgical emergency?

A

necrotizing enterocolitis

35
Q

What happens in NEC?

A

widespread necrosis in the small and large intestine

36
Q

What is the clinical picture of NEC?

A

usually after recovering from RDS; lethargy and gastric residuals; bloody stool; temperature instability; apnoea and bradycardia

37
Q

What are the early metabolic comlplications in preterm babies?

A

hypoglycaemia and hyponatraemia

38
Q

When does retinopathy of prematurity tend to develop?

A

6-8 weeks after delivery

39
Q

What is a late metabolic complication of prematurity?

A

osteopenia of prematurity

40
Q

Why do preemies get retinopathy?

A

the retina isnt well developed or vascularised- get a diabetic retinopathy type picture

41
Q

What effects does being premature have on their adult health?

A

insulin resistance; hypertension and vascular changes; decreased reproduction- and F more likely to have preemie

42
Q

How common is prematurity?

A

around 6 %

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