Delivery-associated Conditions in the Newborn

Question 1

What causes Subconjunctival Hemorrhages?

Answer 1

Rapid rise in intrathoracic pressure as the chest is compressed while passing through the birth canal

Question 2

How do you treat subconjunctival hemorrhages at birth?

Answer 2

no treatment needed

Question 3

What are the 3 major types of skull fractures in a newborn?

Answer 3

Linear
Depressed
Basilar

Question 4

What is the most common type of Skull fracture in a newborn?

Answer 4

Linear

Question 5

What is the most fatal type of skull fracture in a newborn?

Answer 5

Basilar

Question 6

What can a Depressed skull fracture lead to in a newborn without surgical intervention?

Answer 6

Cortical damage

Question 7

What is Caput Succedaneum?

Answer 7

Swelling of the soft tissues of the scalp that does not cross suture lines

Question 8

What is a Cephalohematoma?

Answer 8

Subperiosteal hemorrhage that does not cross suture lines

Question 9

How do you diagnose Scalp injuries in the newborn?

Answer 9

Clinically

Question 10

How do you treat scalp injuries in the newborn?

Answer 10

Gradually resolve without treatment over a few weeks to months

Question 11

What are Brachial Plexus injuries produced secondary to?

Answer 11

Births with traction in the event of Shoulder Dystocia

Question 12

What condition is brachial plexus injury most common seen with?

Answer 12

Mothers with Diabetes

Question 13

What are the 2 major forms of Brachial Plexus Injury?

Answer 13

Duchenne-Erb Paralysis and Klumpke Paralysis

Question 14

What nerve roots are injured in Duchenne-Erb Paralysis?

Answer 14

C5-C6

Question 15

How does Duchenne-Erb Paralysis present?

Answer 15

“Waiter’s Tip”: infant unable to abduct the shoulder or externally rotate and supinate the forearm

Question 16

How do you diagnose Duchenne-Erb Paralysis?

Answer 16

Clinically

Question 17

What is the best treatment for Duchenne-Erb Paralysis?

Answer 17

Physical Therapy with Immobilization

Question 18

What nerve roots are injured in Klumpke Paralysis?

Answer 18

C7-C8 +/- T1

Question 19

How does Klumpke Paralysis present?

Answer 19

“Claw hand”: lack of grasp reflex

Paralyzed hand with Horner syndrome

Question 20

What are the components of Horner Syndrome?

Answer 20

Ptosis, Miosis, Anhidrosis

Question 21

How is Klumpke Paralysis diagnosed?

Answer 21

Clinically

Question 22

What is the best treatment for Klumpke Paralysis?

Answer 22

Immobilization

Question 23

What is the most common newborn fracture as a result of shoulder dystocia?

Answer 23

Clavicular Fracture

Question 24

What is the best diagnostic test for a Clavicular fracture?

Answer 24

X-Ray

Question 25

What is the treatment for a shoulder fracture?

Answer 25

Immobilization, Splinting and Physical Therapy

Question 26

What is Facial Nerve Palsy?

Answer 26

Paralysis of the structures innervated by the facial nerve

Question 27

What is a common cause of facial nerve palsy in a newborn?

Answer 27

Trauma secondary to forceps use during delivery

Question 28

How does facial nerve palsy present in a newborn?

Answer 28

During crying the mouth is drawn to the unaffected side

Question 29

How do you diagnose facial nerve palsy in a newborn?

Answer 29

Clinically

Question 30

How do you treat Facial Nerve Palsy in a newborn?

Answer 30

resolves gradually over a few weeks to months: if it doesn't resolve surgical nerve repair is needed

Question 31

What is the composition of Amniotic fluid?

Answer 31

80% filtrate of the mother's plasma 20% produced by the baby: swallowing, absorbing, filtering and urinating

Question 32

What is Polyhydramnios?

Answer 32

Too much amniotic fluid secondary to fetus not swallowing

Question 33

What are the 2 major etiologies of Polyhydramnios?

Answer 33

Neurological: Werdnig-Hoffman: infant unable to swallow GI: Intestinal Atresias

Question 34

What is Oligohydramnios?

Answer 34

Too little amniotic fluid because the fetus cannot urinate

Question 35

What are the 2 major causes of Oligohydramnios?

Answer 35

Prune Belly Renal agenesis

Question 36

What is Prune Belly?

Answer 36

Lack of abdominal muscles: so fetus is unable to bear down and urinate

Question 37

How is Prune belly treated?

Answer 37

Serial placement of foley catheter: associated with high-risk of UTI

Question 38

What is Renal Agenesis?

Answer 38

Incompatible with life, associated with potter syndrome

Question 39

What is potter syndrome associated with?

Answer 39

Flat facies: high atmospheric pressure causes compression of the fetus that is normally buffered by amniotic fluid