Flashcards in Neonatal Problems Deck (19)
What is necrotising enterocolitis?
Inflammatory bowel necrosis
What are risk factors for necrotising enterocolitis?
Weight < 1500g
what are signs of NEC?
Progress to perforation, peritonitis
What investigations in NEC?
AXR: penumatosis intestinal - gas in gut wall intramural gas
Dilated bowel loops
Bowel wall oedema
Portal venous gas
Pneumoperitoneum if perforated, Riglers's sign
What is management for NEC?
Stop oral feeding except oral probiotics
Antibiotics - cefotaxime + vancomycin
Progressive distension, perforation are indications for laparotomy
What is haemorrhage disease of the newborn?
Newborn babies are vitamin K deficient as they lack enteric bacteria to make it.
This may result in impaired production of clotting factors which can lead to haemorrhage
Baby is usually well apart from bruising/bleeding
Bleeding may range from minor bruise to intracranial haemorrhage
What investigations in HDN?
Prothrombin and partial thromboplastin times raised
What is prevention for HDN?
Newborns in the UK are offered vitamin K IM or oral
Phytomenadione can be given
What are signs of DIC?
What investigations for DIC?
Schistocytes (fragmented RBCs) on film
Mx for DIC?
Trat cause (NEC, sepsis)
Give Vitamin K slow IV + platelet transfusion
What is immune thrombocytopenic purpua?
Immune mediated reduction in platelet count
Typically more acute
May follow infection or vaccination
Usually runs self limiting course
Treat severe thrombocytopenia with compatible platelets or irradiated maternal platelets
What is strawberry naevus?
May not be present at birth
Increase in size over the first few months then fade again
Some may ulcerate or bleed
If large or in critical area consider early propanolol
What are milia?
1-2mm pearly white, cream papules caused by retention of keratin in dermis
What is erythema toxic?
Harmlesss red blotches often with central white pustule which come and go in crops
Described as flea bite appearance
Last around 24h
What is a stork mark?
Areas of capillary dilatation on the eyelids, central forehead and back of the neck where baby is deemed to have been held in the storks beak
When is the neonatal blood spot screening test carried out? What does it test for?
Sickle cell disease
Maple syrup urine disease
What are causes of neonatal hypotonia?