Neonatology Flashcards
(26 cards)
Extremely preterm
<28w
Very preterm
28-32w
Moderate preterm
32-42
Late preterm
34-36w
Post term
> 42 w
Low birthweight
<2.5kg
Very low birthweight
<1.5kg
Extremely low <1kg
Neonatal death
Liveborn infant after 20 weeks gestation who died before 28 days after birth
Neonatal Mortality Rate (NMR)
Deaths in first 4 weeks of life per 1000 live births
Extended Perinatal Death
any stillbirth or neonatal death
Perinatal Mortality Rate (PMR)
Stillbirths plus early neonatal deaths per 1000 births
Post-neonatal mortality rate
Deaths from 28 days to 1 year per 1000 live births
Infant mortality rate
Deaths in first year of life per 1000 live births
APGAR
Scoring system
Measured at 1 and 5 minutes of
life
• Do NOT use to determine need
for resuscitation
• If <7 or infant requires
resuscitation, continue every 5 min until 20 min of life
APGAR for 0 points, 1 and 2 points for each
Low APGAR <3 beyond 10 minutes of age = high risk of neurological damage leading to cerebral palsy
Can be used in preterm infants as well
Neonatal resuscitation
Principles: optimise airway, breathing
and circulation whilst keeping infant
warm
• Most infants respond to lung inflation
• Very few require chest compressions
(1-3 per 1000) or medication
What is a chignon
Edema bruising and sometimes skin damage by vacuum assisted birth , resolves over few days
What is a cephalhaematoma
Relatively common , subperiosteal bleeding usually parietal or occipital by be bilateral from long labor and instrumental delivery xax on day 2 of life , may calcify and take weeks to resolve
Subgaleal haemorrhage
Rare but serious boggy mobile swelling at back of scalp which may displace ears anteriorly,
risk factors, prematurity, vacuum del, can lead to massive blood loss and shock requiring transfusion
Facial palsy
Usually unilateral due to forceps or pressure from pelvis
If bilateral suspect congenital cause
If eye open may need methylcellulose eye drops
Palsy usually resolved 2-3 weeks but if present at 4-6 weeks refer for nerve repair
Asymmetric crying fancies
Unilateral congenital absence of the orbicularis orbis muscle , more common than facial palsy - can eye close , weakness is permanent
Treatment is cosmetic and Botox
Era Palsy
C5-C6 avulsion
Reduced shoulder abduction and external rotation of formal with supination of wrist waiters too
Usually resolve by 4 months
Klumpke palsy
C8-t1 nerve root damage
Dorsiflextion of wrist and flexion of fingers
New born blood spot test
Done on day 5 of life
Screens for
sickle cell disease
CF
Cong hypothyroidism
Inherited metabolic diseases - OKY, MCAAD, maple syrup disease, isovaleric acidaemia, glutamic acid urea type 1 , homocystinuria
Severe combined immunodeficiency - only in some areas in UK
