reducing risk of premature delivery

Question 1

what 10 perinatal intervention can reduce brain injury and neonatal mortality across the south west of england

Answer 1

place of birth
antenatal steriods - less than 34 weeks
antenatal mgso4 - less than 30 weeks - reduce degree of cerebral palsy
deferred cord clamping - at or after 1 minute if 34 weeks gestation
norothermia - measured within 1 hour of birth
early maternal breast milk - within 6 hours
caffiene - babies started on in frist 6 hours
probiotics - if less than 32 weeks and under 1500g
volume guarantee or voluem target ventilation
prophyalcitc hydrocortisone - under 28 weeks from first day of life

Question 2

lung immaturity what and when is the canalicular stage

Answer 2

17-26weeks

Question 3

accular termnial stage

Answer 3

24-36 weeks

Question 4

aleveolar stage

Answer 4

36weeks to 36months post-term

Question 5

surfactant deficiency is due to type 2 alveolar cells
surfactant phospholipoprotein necessary to prevent alveolar collapse

Question 5

surfactant deficiency is due to type 2 alveolar cells
surfactant phospholipoprotein necessary to prevent alveolar collapse
what resp support do we give

Answer 5

ambient o2 conc measured
surfactant
CPAP
ventilation high frequency oscillation

Question 6

what medications close the patent ductus arteriosus

Answer 6

ibruprofen and paracetamol

Question 7

gastro interventions

Answer 7

tube feed with EBM
feeding fills stomach and splitn diaphragm , aspiration more liekly too

Question 8

NEC is hypoxic ischaemia to gut and ifnection causing systmeic illness and abdo distention what else is seen

Answer 8

blood stools and bile stained gastric aspirates

mother has really large abdo that is shiny and XR bubbles

Question 9

need to monitor babies eyes routinely when

Answer 9

under 32 weeks and or 1500g

too much oxygen can blind

Question 10

neuro problems

Answer 10

hypoxia
intra ventricualr haemorrhage
kernicterus

Question 11

cerebral palsy features - single infarct to brain in preg

Answer 11

hypotonia, spasticity, ataxia, or involuntary posture either singly or in combination

spastic cp - extreme prematurity - diplegia , paraplegia , hemiplegia

grades 3 - walks with equipmetn
4 - powered mobility
5 - cannot control head and neck

Question 12

most common cause of febrile conuvlsion sin uk

Answer 12

roseola infantartum

Question 13

duodenal atresia - billairy vomit from brith
GORD

Answer 13

newborns and nto stianed by anthing

Question 14

blue nodule visible between 7-12 year old and small amount of pain

Answer 14

torsion of the ependymal appendage