Before which point in gestation is a birth pre-term?
Birth before ___ weeks is incompatible with life.
Fatal birth before 22 weeks is also known as what?
At which point in gestation is a birth at term?
38 - 42 weeks
Pre-term babies are more likely to have a (high / low) birth weight.
low birth weight
Which lifestyle choice has an effect on the rates of pre-term delivery?
Smoking ban saw a 10% decrease in pre-term births
What is a neonatal death?
Death within the first four weeks of life
Which type of pregnancy is associated with pre-term birth?
Ferguson reflex - increased distension of uterine walls
The majority of pre-term births are ___ in origin.
nobody knows why
Having more than one baby in the womb is a common cause of ___ delivery.
A history of ___ delivery increases a woman's risk of pre-term delivery.
Pre-term babies are more vulnerable to ___ stress, have less developed ___ and are more likely to be (hyper/hypo)glycaemic.
vulnerable to cold stress - less brown fat
less developed lung - less surfactant
hypoglycaemic - less glycogen reserves
What is the purpose of delayed cord clamping?
Allows maximum volume of blood to transfer from mother to baby
--> reduce chances of anaemia, hypovolaemia
What does cold stress lead to in premature babies?
How does hypothermia cause hypoglycaemia in babies?
Increased non-shivering thermogenesis
Which uses glycogen stores
When glycogen is depleted, free circulating glucose is used up
How does hypothermia cause hypoxia in premature babies?
Increased oxygen demand due to increased thermogenesis
> Hypoxia and metabolic acidosis (anaerobic respiration)
How are pre-term babies initially fed?
What is the risk of parenteral feeding in pre-term babies?
As it involves IV access
Which disease, involving widespread ischaemia of the bowel, can be treated using parenteral nutrition?
Necrotising enterocolitis (NEC)
What is the ideal form of feeding for babies?
If a mother can't breastfeed, what forms of nutrition can be offered to pre-term babies?
What can untreated infection cause in neonates?
What are the two forms of neonatal sepsis seen in babies?
Early onset - probably acquired during pregnancy / birth
Late onset - acquired post-birth
What are the most common bacteria causing
b) late-onset neonatal sepsis?
a) Group B Strep, Coliforms
b) Coagulase negative Staph i.e Staph epidermidis
What causes respiratory distress in pre-mature babies?
Lack of pulmonary surfactant
Which abnormal breathing patterns can pre-mature babies present with?
How does a baby with respiratory distress present?
How is a baby with respiratory distress managed?
What appearance do the lungs have on CXR in a baby with respiratory distress?
Ground glass appearance
None of the blood in the foetal circulation has a large oxygen concentration.
What helps a baby to get around this?