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REPRODUCTION & GYNAECOLOGY > The Healthy Term Infant > Flashcards

The Healthy Term Infant Flashcards

1
Q

When is a baby considered to be Term and when are they considered Post Term?

A

Term after 37 weeks

Post term after 41 weeks

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2
Q

What is the normal weight of a Term baby?

A

“Normal” weight 2.5 kg – 4.0 kg
>4.0 Kg, large for gestational age (LGA)
<2.5 kg, small for gestational age (SGA)

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3
Q

Describe the difference in weight of a baby between 28 weeks and term

A

Average male at 28 weeks = 1150g, 3.5% fat
Average male at term = 3550g, 15% fat
=> Daily weight gain = 24 g

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4
Q

A post-term delivery increases the risk of a baby with cerebral palsy. TRUE/FALSE?

A

TRUE

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5
Q

Why does the placenta aim to deliver a foetus enough iron to last throughout their first year of life?

A

Not enough iron produced in breast feeding

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6
Q

How does the appearance of a term baby differ to that of a preterm baby?

A

Term:

  • No bony bits poking out
  • Good layer of s/c fat
  • wrinkled hands/feet
  • Flexed position

Pre-term:

  • lying flat (not flexed)
  • Bony bits prominent
  • Fat yet to develop
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7
Q

Why may labour cause problems for a previously healthy baby?

A
  • Hypoxic environment during contractions

- Prolonged labour reduces fetal reserves

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8
Q

HOw is perinatal adaptation assessed?

A

Apgar Score /10
- HR, RR, Responsiveness, Tone, Colour

Normal Score = 8 or above

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9
Q

What 2 things are most important after the baby is born?

A
  • Keeping baby warm + skin-to-skin contact

- Establishing feeds - usually high calorific intake in first 24hrs

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10
Q

What is haemorrhagic disease of the newborn and how is this prevented?

A
  • Coagulopathy => ability to clot is impaired
    => excessive bleeding at many sites in body
  • Given VItamin K to help with clotting (IM depot or drops)
  • If formula fed then infant may get VItamin K from formula milks
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11
Q

What infections must you check if the baby is at risk?

A
  • Hepatitis B - if yes => Immediate vaccine/immunoglobullin
  • Hepatitis C
  • HIV - transmission low if undetectable viral load
  • Syphilis
  • TB - BCG vaccine offered if family at high risk
  • Group B Strep.
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12
Q

What is provided to Mums and Dads to help them understand what is required in the postnatal care of their baby?

A

Newborn Snuggle Bundle

- e.g. recommends keeping baby warm with hat, blankets etc. Tells them correct temperature of baby.

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13
Q

What vaccines is the mother given to help prevent infection in the baby?

A

Pertussis (whooping cough) and Influenza

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14
Q

What does the Newborn Blood Spot Screening look for?

A
  • Cystic fibrosis (indirect test for immuno-reactive trypsin => if abnormal, babies will be offered genetic testing)
  • Thyroid Function tests
  • Haemoglobinopathies
  • Metabolic disease (e.g. phenylketonuria (PKU))
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15
Q

What other screening tests are carried out in newborns and don’t require bloods to be taken?

A
  • Universal hearing screening

- Hip screening (for DDH) - clinical diagnosis

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16
Q

When is a top-toe examination of the newborn usually carried out, and who completes this?

A
  • Generally carried out at around 24 hours of age

- Usually by a midwife or member of neonatal team

17
Q

What abnormal swellings can occur in a newborn and present in the examination at 24hours?

A

Caput Succedaneum

  • swelling in outer layer of skin
  • dramatic soft tissue swelling
  • Usually reduces by 12 hours, but may not completely disappear until later

Cephalhaematoma

  • bruising/bleeding between periosteum and epicranial aponeurosis
  • often parietal
  • doesnt cross suture line

Subgleal Haematoma

  • RARE
  • blood can extend from orbits to back of skull
18
Q

What signs in the eyes are being looked for on neonatal examination?

A
  • Size
  • Red reflex
  • Conjunctival haemorrhage (due to increased pressure in labour)
  • Squints (frequent)
  • Iris abnormality (e.g. Coloboma = keyhole shape)
19
Q

What features of the ears must be assessed on neonatal examination?

A
  • Position (this may be wrong if increased moulding at birth - they will move back very quickly)
  • External auditory canal
  • Tags/pits
  • Folding
  • Family history of hearing loss?
20
Q

What parts of a babys mouth must be assessed on neonatal examination?

A
  • Shape
  • Philtrum
  • Tongue tie (frenulum may need cut for breastfeeding)
  • Palate
  • Neonatal teeth
  • Ebsteins pearls (white lesions along midline of palate)
  • Sucking/rooting reflex
21
Q

Cleft lip and palate surgery now has a very good outcome. TRUE/FALSE?

A

TRUE

22
Q

What facial abnormalities may be picked up on an examination of the newborn?

A
  • Facial palsy (often side of face without a Nasiolabial fold present)
  • Dysmorphism (e.g. foetal alcohol syndrome [although this is usually picked up later])
23
Q

How should you assess the respiratory system of the newborn in an examination?

A
  • Chest shape - pectus excavatum?
  • Nasal flaring
  • Grunting/Breath sounds
  • Tachypnoea
  • Check for diaphragmatic hernia (loops on bowel in lung on CXR)
24
Q

HOw do we carry out a cardiovascular examination of the neonate?

A
  • Colour/Saturation (SaO2)
  • Pulses: femoral
  • Apex
  • Thrills/heaves
  • Heart sounds
25
Q

A physiological murmur may be present during the neonatal examination. TRUE/FALSE?

A

TRUE

murmur from patent foramen ovale may be present whilst it is still closing after birth

26
Q

What congenital heart disease needs to be screened for during a neonatal examination?

A

Tetralogy of Fallot

  • VSD
  • Overriding Aorta
  • Pulmonary Stenosis
  • RV Hypertrophy
27
Q

What should be assessed on abdominal examination of the newborn?

A
  • Distension?
  • Umbilical Hernia (regresses by 1 year)
  • Unguinal hernia (more common in boys)
  • Umbilicus for signs of erosion/infection (may lead to SEPSIS)
  • Bile stained vomiting
  • Passage of meconium
  • Anus
28
Q

What should you assess in a newborn examination of the genitourinary tract?

A
  • Normal passage of urine
  • Normal genitalia
  • Undescended testes
  • Hypospadius
29
Q

What parts of the MSK system are assessed in a neonatal examination?

A
  • Movement/ posture
  • Limbs and digits
  • Spine (e.g. spina bifida lesions)
  • Hip examination (if DDH - corrected with brace of Pavlik harness)
30
Q

What is gastrochisis?

A
  • Bowel comes out of abdominal cavity, twists and goes back in again
  • good surgical outcome if noticed in utero
31
Q

What neurological symptoms should be assessed in a neonatal examination?

A
  • Alert, responsive
  • Cry
  • Tone
  • Posture
  • Movement
  • Primitive reflexes
32
Q

What primitive reflexes are tested in a neonatal neurological examination?

A
  • Sucking and Rooting
  • Moro
  • Asymmetric Tonic Neck Reflex
  • Stepping
  • Grasp
33
Q

Why are babies left to sleep on their back?

A

To prevent Sudden Infant Death Syndrome

REPRODUCTION & GYNAECOLOGY (58 decks)

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