neonates Flashcards
what does delayed cord clamping do
improved haemoglobin, iron stores and blood pressure
reduction in intraventricular haemorrhage and NEC
may increase neonatal jaundice
immediate care of the baby after birth
skin to skin
clamp the cord
dry the baby and keep warm
vit K injection
label the baby
and weigh and measure
when is the blood spot screening test done
day 5
what does the blood spot screen for
sickle cell
cystic fibrosis
congenital hypothyroidism
phenylketonuria
medium chain acyl-coA dehydrogenase deficiency
maple syrup urine disease
isovaleric acidaemia
glutaric aciduria type 1
homocystin
what is caput succedaneum
fluid collecting on the scalp, outside the periosteum
caused by pressure to specific area during traumatic, prolonged or instrumental delivery
does not require treatment
what is a cephalohaematoma
swelling on newborns head
develops several hours after delivery
due to bleeding between periosteum and skull
most common site affected is parietal region
takes months to resolve
erbs palsy
result of injury to C5/C6 nerves in brachial plexus during birth
presents with weakness of should abduction, external rotation, arm flexion and finger extension
function normally returns spontaneously
how to categorise neonatal sepsis
EOS: within 72 hours
LOS: between 7-28 days
most common causes of neonatal sepsis
GBS (75% of EOS)
e.coli
LOS: staph epidermidis, pseudomonas, klebsiella and enterobacter
risk factors for neonatal sepsis
mother with previous baby with GBS, currently has GBS, current bacteruria, intrapartum temp > 38, membrane rupture > 18 hours, current infection
premature
low birth weight
evidence of maternal chorioamnionitis
presentation of neonatal sepsis
respiratory distress: grunting, nasal flaring, use of resp muscles
tachycardia
apnoea
lethargy
jaundice
seizure: sepsis is meningitis
poor/reduced feeding
abdominal distention
vomiting
temp- not reliable
investigations for neonatal sepsis
blood culture
full blood examination
ABG: metabolic acidosis- BAD
urine microscopy, culture (more useful in LOS)
lumbar puncture
management of neonatal sepsis
IV benzylpenicillin with gent
- abx can stop at 48 hours if CRP < 10 and negative culture
maintain oxygen
maintain fluid and electrolyte status
definition of prematurity
born before 37 weeks
under 28 weeks: extreme prematurity
management if women shows cervical shortening before 24 weeks gestation
prophylactic vaginal progesterone
prophylactic cervical cerclage
management of preterm labour
tocolysis with nifedipine
maternal corticosteroids
IV Mg sulphate
delayed cord clamping
issues related to prematurity in early life
respiratory distress syndrome
hypothermia
hypoglycaemia
poor feeding
apnoea and bradycardia
neonatal jaundice
intraventricular haemorrhage
retinopathy of prematurity
NEC
what babies get screening for retinopathy
before 32 weeks or under 1.5kg
treatment of premature retinopathy
transpupillary laser photocoagulation (to halt and reverse neovascularisation)
cryotherapy and intravitreal VEGF inhibitor injections
chest x-ray shows ground glass appearance
respiratory distress syndrome
pathophysiology of respiratory distress syndrome
not enough surfactant leads to high surface tension with alveoli
causing atelectasis
management of respiratory distress syndrome
antenatal steroids (dexamethasone)- to the mum
for the baby:
- intubation and ventilation
- endotracheal surfactant
- CPAP
- supplementary oxygen
complications of respiratory distress syndrome
short term:
- pneumothorax
- infection
- apnoea
- intraventricular haemorrhage
- pulmonary haemorrhage
- NEC
long term:
- chronic lung disease
- retinopathy
- neurological
risk factors for developing NEC
very low birth weight or prematurity
formula feeds
respiratory distress and assisted ventilation
sepsis
patient ductus arteriosus
