Care of the Newborn Preterm Infant Flashcards Preview

Reproductive - Neonatal > Care of the Newborn Preterm Infant > Flashcards

Flashcards in Care of the Newborn Preterm Infant Deck (19):
1

What is meant by 'preterm'?

What are the biggest risk factors for this?

A birth that occurs before 37 weeks completed gestation

Maternal age (> 40 or teenage), smoking and disadvantaged circumstances

2

What is the definition of stillbirth?

A baby born from 24 weeks, dyring before or during birth

3

What is the definition of neonatal death?

A baby born from 24 weeks, dying within the first 4 weeks of life

4

Having had two previous preterm delivery increases a mother's risk of having another one by what?

 

70%

5

What is the biggest difference between term babies and preterm babies in terms of their management?

What is the best way to acheive this?

Preterm babies need more help to stay warm

Placing them immediately (while still wet) in a suitable plastic bag under a radiant heater

6

What problem with regards to thermal regulation is common in preterm infants?

What other problems can this lead to and why?

Which type of acid base balance problem can occur alongside all this?

How is it managed?

Hypothermia

Hypoxia and hypoglycaemia due to increased metaabolism using up stores

Metabolic acidosis

Put the baby in an incubator to keep them warm

7

Early onset neonatal sepsis is acquired when?

Give some examples of bugs which can cause this?

Late onset neonatal sepsis is acquired when?

Give some examples of bugs which can cause this?

Before or during delivery

Group B strep, gram -'s

After delivery

Coagulase negative staph, staph aureus, gram -'s

8

How does late onset neonatal sepsis with coagulase negative staph tend to present?

What can it be associated with?

In babies with neonatal sepsis, you should try hard to stay away from which antibiotics?

Insidious onset

Lines and other foreign objects

Very broad spectrum ones

9

What is the primary pathology behind respiratory distress syndrome?

Structureal immaturity

Surfactant deficiency

10

What are some signs of respiratory distress in a newborn?

Tachypnoea

Grunting

Intercostal recessions

Nasal flaring

Cyanosis

11

Respiratory distress syndrome will worsen over when?

What is the natural history of this condition?

Minutes - hours

Worsens to a peak at 2-4 days and then has a gradual improvement

12

What will be the appearance of this condition on x-ray?

What are some management options for respiratory distress syndrome?

 

Ground glass appearance (can only just make out the heart border, but it is not clear)

Maternal steroids, surfactant, ventilation (ideally non-invasive)

13

Apart from respiratory distress syndrome, what are some other respiratory complications that can be seen in premature babies?

What is the second option and what is its outcome?

Apnoea of prematurity

Bronchopulmonary dysplasia

Chronic lung disease as a result of having premature lung disease, usually go on to be fine

14

Patent ductus arteriosus is a condition which is common in premature babies. What is the function of this structure in the foetus?

When should it normally close?

What are some early signs of this in the first year of life?

What can it lead to if left untreated?

Connects the pulmonary artery to the descending aorta (allows blood from RV to bypass the lungs)

Within a few hours of birth

Increased work of breathing and poor weight gain

Congestive heart failure

15

What is a neurological condition which is common in premature babies and can lead to neurodevelopmental delay or even mortality depending on how severe a case it is?

Intraventricular haemorrhage

16

What is necrotising enterocolitis?

Babies who develop this are almost always what? They have almost always done what?

What can be seen in the bowel on abdominal x-ray?

 

An infection in the gut wall

Premature / tried some milk

Gas (produced by aerobic organisms)

17

When does necrotising enterocolitis tend to present?

What are some symptoms?

What are the outcomes?

The first days-weeks after birth

Tummy tenderness/swelling, blood in the stool, green vomit

Can be fatal, or leave the child with short gut syndrome

18

When does retinopathy of prematurity occur?

Why does this occur?

6-8 weeks after delivery

The retina is not yet vascularised in a preterm baby

19

What are some early metabolic problems that can be seen in preterm babies?

What is a late metabolic problem that can be seen in preterm babies?

Hypoglycaemia, hyponatraemia

Osteopenia