Preterm Baby

Question 1

Extremely preterm

Answer 1

<28 weeks

Question 2

Very preterm

Answer 2

8-32 weeks

Question 3

Moderate to late preterm

Answer 3

32-37 weeks

Question 4

What are the risks factor for premature birth?

Answer 4

uterine abnormalities. fibrosis. hx of preterm births, family hx of preterm births
multiple pregnancy
maternal lifestyle: smoking, drug and/or alcohol abuse
maternal weight: low or high BMI
maternal age: <17, >35
race
maternal conditions: diabetes, preeclampsia
low socioeconomic status
limited pregnancy care
stress
vaginal bleeding during pregnancy

Question 5

What are the prevention of preterm labour?

Answer 5

1. Primary prevention
2. Secondary prevention

Question 6

What is primary prevention?

Answer 6

Smoking cessation
public education
nutritional counseling (underweight/obesity)reduction of workload and stress at workplace

Question 7

What is secondary prevention?

Answer 7

cervical cerclage
progesterone supplementation
measurement of vaginal pH
cervial length measurement by trans vaginal ultrasonography

Question 8

What are common complications of preterm birth for newborn?

Answer 8

respiratory problems
metabolic problems
sepsis
seizures
structural organic problems
cerebral palsy
infections
feeding difficulties
hypoxic ischaemic encephalopathy
visual and hearing problems

Question 9

What are the characteristics of the preterm neonate?

Answer 9

large head an small face
soft skull bones and large fontanelles
skin is red and thin
subcutaneous fat it almost absent and surface veins are prominent
small narrow chest
large abdomen and low-set umbilicus
thin limbs and soft nails
small genitalia
muscle tone poor
normal reflexes may be absent

Question 10

What type of care is needed?

Answer 10

tertiary - intensive newborn care
secondary - special newborn care
primary - essential newborn care

Question 11

What innovations are required for the care of preterm babies?

Answer 11

thermal care
kangaroo mother care
CPAP
phototherapy lamps and eye shields

Question 12

What is the role of the midwife in preterm labour intrapartum care?

Answer 12

1. awareness of the relevant medical history
2. preparation of the equipment for resuscitation of the preterm infant
3. resuscitation

Question 13

What is the role of the midwife in preterm newborn on postnatal ward?

Answer 13

maintenance of temperature
establishment of feeding
hiperbilirubinemia management
skin care
vital signs monitoring
blood glucose establishment
apnea
discharge home education

Question 14

What is SGA?

Answer 14

Small for gestational age
weight below the 10th percentile for gestational age as per the population growth charts

Question 15

What is moderate SGA?

Answer 15

birth weight from third to tenth percentile

Question 16

What is severe SGA?

Answer 16

birth weight less than the third percentile

Question 17

What is FGR?

Answer 17

Fetal Growth Restriction
e fetuses with an estimated fetal weight (EFW) <10th centile

Question 18

What is IUGR?

Answer 18

Intrauterine growth restriction
pathologically small fetus (ie EFW<10th centile, oligohydramnios, abnormal umbilical artery (UA) Doppler and/or poor interval growth velocity and/ or EFW <3rd centile)

Question 19

What are the clinical features of infants at birth that have IUGR?

Answer 19

large head
long finger nails
loose,dry and easy peel able skin
small/scaphoid abdomen
poor skeletal muscle mass
loose fold of skin in nape of neck
large an thin hands an legs
thin umbilical cord
poor breast bud formation
absence of buccal fat

Question 20

What are the immediate neonatal complications seen in intrauterine growth restricted neonates?

Answer 20

birth/perinatal asphyxia
retinopathy of prematurity
hypothermia
hypoglycamia/hyperglycemia
polycythaemia/hyperviscosity
intrauterine fetal death
low serun ferritin
pulmonary haemorrhage
immunodeficiency
renal dysfunction
NEC
MAS
PPHN