Flashcards in Fetus and the Newborn Deck (118)
Division of the body from the forehead to the pubis into red and pale halves is known as
harlequin color change
Harmless cyanosis of the hands and feet
Deep, blue masses that, if large, may trap platelets and produce disseminated intravascular coagulation or interfere with local organ function
Slate-blue, well-demarcated areas of pigmentation seen over the buttocks, back, and sometimes other parts of the body
- tend to disappear within the 1st year
Fine, soft, immature hair frequently covers the scalp and brow and may also cover the face of premature infants
- replaced by vellus hair in term infants
Benign rash characterized as small, white papules on an erythematous base which develop 1-3 days after birth
- persists for as long as 1 wk, contains eosinophils, and is usually distributed on the face, trunk, and extremities
A benign lesion seen predominantly in black neonates, contains neutrophils and is present at birth as a vesiculopustular eruption around the chin, neck, back, extremities, and palms or soles; it lasts 2-3 days
Soft areas that are occasionally found in the parietal bones at the vertex near the sagittal suture
- more common in premature infants and in infants who have been exposed to uterine compression
Premature fusion of skull sutures, identified as a hard nonmovable ridge over the suture and an abnormally shaped skull
In the PE of the newborn, take note of symmetric facial palsy, which suggests absence or hypoplasia of the 7th nerve nucleus, otherwise known as
Pupillary reflexes are present from what age of gestation?
28-30 wks AOG
On the hard palate on either side of the raphe, there may be temporary accumulations of epithelial cells called
The newborn's tongue appears relatively large; the frenulum may be short. When is it indicated to repair a tongue-tie (ankyloglossia)?
If there are problems with feedings (breast or bottle) and the frenulum is short, frenulotomy may be indicated
Premature infants may breathe periodically, with complete irregularity, also known as
A solid flank mass, which becomes clinically apparent with hematuria, hypertension, and thrombocytopenia may be caused by
renal vein thrombosis
- Renal vein thrombosis in infants is associated with polycythemia, dehydration, maternal diabetes, asphyxia, sepsis, nephrosis, and hypercoagulable states such as antithrombin III and protein C deficiency
Abdominal wall defect that occurs through the umbilicus
A membrane often covers an omphalocele, and care should be taken to prevent its rupture.
Omphaloceles are associated with other anomalies and syndromes such as Beckwith-Wiedemann, conjoined twins, trisomy 18, meningomyelocele, and imperforate anus
Abdominal wall defect that occurs lateral to the midline
- Gastroschisis is the more common defect and typically the intestines are not covered by a membrane. The exposed intestines should be gently placed in a sterile clear plastic bag after delivery.
The normal umbilical cord contains 2 arteries and 1 vein. What pathology is suggested with a single umbilical artery?
- A single umbilical artery increases the risk for an occult renal anomaly.
Genital defect that usually results in hydrometrocolpos and lower abdominal mass
True or False. The APGAR score is used to predict neurologic outcome.
- the score is normal in most patients in whom cerebral palsy subsequently develops, and the incidence of cerebral palsy is low in infants with Apgar scores of 0-3 at 5 min (but higher than in infants with Apgar scores of 7-10)
Low Apgar scores and umbilical artery blood pH predict neonatal death. Which is a better predictor of neonatal death in both term and preterm infants?
Low Apgar score
- An Apgar score of 0-3 at 5 min is uncommon but is a better predictor of neonatal death (in both term and preterm infants) than an umbilical artery pH ≤ 7.0; the presence of both variables increases the relative risk of neonatal mortality in term and preterm infants
What are the 5 objective signs being evaluate in the Apgar score?
Response to catheter in nostril
Mechanisms of heat loss in newborns (4)
1) convection of heat energy to the cooler surrounding air
2) conduction of heat to the colder materials touching the infant
3) heat radiation from the infant to other nearby cooler objects
4) evaporation from skin and lungs.
What is the most common cause of oligohydramnios?
Rupture of membranes
What is the most serious complication of chronic oligohydramnios?
Ancillary procedure used in the second trimester (15-18 wks) to screen for open neural tube defects, gastroschisis, omphalocele, congenital nephrosis, twins, and other abnormal conditions
maternal serum alpha-fetoprotein (MSAFP)
- Low MSAFP is associated with incorrect gestational age estimates, trisomy 18 or 21, and intrauterine growth restriction
Periodic accelerations or decelerations of the fetal heart rate in response to uterine contractions may be monitored to assess fetal status. Which of the ff conditions reflect early, late, or variable decelerations?
a. associated with cord compression
b. associated with fetal hypoxemia
c. associated with head compression
a. cord compression - variable deceleration
b. fetal hypoxemia - late deceleration
c. head compression - early deceleration
What maternal condition would predispose the fetus to neonatal hypoglycemia, hypocalcemia, respiratory distress syndrome and other respiratory problems, polycythemia, macrosomia, myocardial dysfunction, jaundice, and congenital malformations?
- There is increased risk for incidence of uteroplacental insufficiency, polyhydramnios, and intrauterine death in poorly controlled diabetic mothers.
What maternal conditions would predispose the fetus to IUGR, prematurity, and intrauterine death, all probably caused by diminished uteroplacental perfusion? (3)
1. Eclampsia-preeclampsia of pregnancy
2. chronic hypertension
3. chronic renal disease