Neonatal history - NNU teaching Flashcards
(21 cards)
Fetal complcations of pre-eclampsia
- Foetal hypoxia
- Fetal growth restriction
- Low platelet counts
Fetal complications of gestational diabetes
- Macrosomia
- Fetal growth restriction
- Neonatal hypoglycaemia
Foetal complications of premature rupture of membranes
- Neonatal sepsis
- Pulmonary hypoplasia –> respiratory distress syndrome - lack of liqour (if very prolonged)
Bloods done antenatally
- Sickle cell
- ABO group and Rh status
- Hep B
- HIV
- Syphillus
Testing for chromosomal anomalies
- NIPT - check for fetal cells from mums blood, check for trisomy 21, 13 - privately
- Quad test - check for hormone levels in the blood - NHS
- Quad test combined with nuchal translucency test - gives you a risk - NHS
Quad test + nuchal translucency risk
- Gives risk - either high or low
- Threshold is 1 in 150 - if this or higher risk, offered amniocentesis or chorionic villus sampling
If previous GBS, what is management?
- Intrapartum abx - IV benzylpenicillin
- Baby gets abx and frequent testing
Risk of alcohol during pregnancy
- Fetal alcohol syndrome - facial abnormalities, intellectual disability
Risks of smoking during pregnancy
- IUGR
- Sudden infant death syndrome
- Stillbirth
What causes Epsteins anomaly?
Lithium
What can cause dental anomalies in babies?
Tetracyclines
Medications which you absolutely should not breastfeed with
- Cytotoxic drugs eg chemotherapy
- Antiretroviral for HIV - if low viral load it can be ok though, medication is ok
What is Reyes syndrome?
What key conditions are important to screen for in mums PMH?
- Cardiac conditions in first degree relatives only
- GBS positive
- SLE
What is the importance of SLE in the mother?
- Neonatal lupus - anti Ro and La can cross placenta and can cause this
- Congenital heart block can present - bradycardia, needs pacing externally then internally when large enough
- Can be liver impairment or rash too
Reasons for premature labour
- Maternal infection –> premature rupture of membranes
- Cervical incompetence - previous cervical surgery, lower segment C sections in second stage labour (fully dilated)
- Babys not made quite right - body assesses whether abnormal/normal, if congenital anomaly, body induces labour or become distressed
Why neonatologist concerned about mode of delivery?
- Emergencies - higher risk
- C section - breathing affected, may need resp support, fluid in lungs as not squeezed out through birth canal
- Shoulder dystocia - traction injury eg Erbs palsy
- Forceps delivery - caput haematoma, facial nerve palsy
- Ventouse - cephalohaematoma, subgalial haemorrhage
When is IV magnesium and steroids given for premature babies?
- 34 weeks or before - steroids
- 32 weeks or before - IV Magnesium
Subgalial haemorrhage
- Shearing injury under skull, fetal blood vessels rupture
- Can take entire circulating volume
- Moves across suture lines
- Linked to ventouse delivery
- Neonatal emergency
APGAR score
- Appearance
- Pulse
- Grimace
- Activity
- Respiration
1, 5 and 10 minutes
What to ask re admission to neonatal unit?
- Temperature on admission - if cold, increases mortality
- Passed meconium
