Flashcards in Neonates Deck (36)
What is the compression to ventilation ratio for newborn resuscitation?
How long should cord clamping be delayed for following complete delivery?
Cord clamping should be delayed for at least 1 minute
Should you attempt to aspirate meconium from the nose and mouth of an unborn infant while the head is still on the perineum?
What are the 3 fetal ducts which should close/ constrict in the perinatal period?
What happens to circulating prostaglandin levels after birth?
Circulating prostaglandins drop
What does the ductus arteriosus become?
The ligamentum arteriosus
What does the ductus venosus become?
The ligamentum teres
Why does persistent pulmonary hypertension of the newborn occur?
The ductus arteriosus remains open, causing shunting of blood from the RV to the descending aorta, causing hypertension
What are the management options for persistent pulmonary hypertension?
Ventilation and oxygen
What factors make newborns susceptible to heat loss and hypothermia in the first few hours of life?
Wet when born
Large surface area
Main source of heat production is the breakdown of brown fat (this is not efficient in the first 12 hours of life)
Why are small for dates/ preterm babies most susceptible to hypothermia?
They have lower stores of brown fat, little subcutaneous fat and a large surface area
Describe the changes in glucose homeostasis in newborns
Drop in insulin, increase in glycogen
Mobilisation of hepatic glycogen stores for gluconeogenesis
Ability to use ketones as brain fuel
Why does physiological anaemia occur in newborns?
Adult Hb is synthesised more slowly than fatal Hb is broken down
Why does physiological jaundice occur?
Liver enzyme pathways are present but immature
Breakdown of fetal Hb causes a rise in unconjugated bilirubin
What is considered a normal weight for a neonate?
2.5kg to 4kg
Large for gestational age >4kg
Small for gestational age <2.5kg
When is considered term?
37- 41 weeks
What is the apgar score used for?
The apgar score is a measure of perinatal adpation scored out of 10
Normal is >8
What does APGAR stand for?
Alertness, pulse, grimace (reflexes), activity (muscle tone), respiration
What respiratory bacterial infection are neonates at risk of?
Group B streptococcus infection
What is hydrops fetalis?
What is potter's syndrome?
Kidney failure causes oligohydramnios (lack of amniotic fluid) which causes abnormal features in the newborn
How does respiratory distress syndrome present?
What is the underlying pathology behind RDS?
Surfactant deficiency and structural abnormalities
When does retinopathy usually present in newborns?
6-8 weeks following delivery
When does necrotising enterocolitis present?
After the baby has had its first milk as there is then substrate in the bowel - this will be within the first couple of weeks of life
How does necrotising enterocolitis present?
Causes an infection in the bowel wall which can involve necrosis and abscess formation
Feeding intolerance, abdominal distension, blood stools
May be fatal or result in small gut syndrome
What is meconium ileus?
Blockage to the passage of meconium through the bowel due to poor quality of the meconium
When and how does meconium ileus present?
Presents in the first 24-48 hours
Abdominal distension and vomiting
What would be the x-ray appearance in a newborn with meconium ileus?
Colon appears narrow and thin - meconium has not been passed and therefore the bowel has never been used before