Neonatology Flashcards
(22 cards)
Define low birth weight, very low birthweight and extremely low birth weight
LBW <2500g
VLBW <1500g
ELBW <1000g
Define preterm and extremely preterm
Preterm <37 weeks
Extremely preterm <28 weeks
Define the perameters for heart rate and resp rate in neonates
Normal HR: 120 – 160 bpm
Tachycardia >160 bpm
Bradycardia <100 bpm
Normal RR 30-60 /min
Why might a baby be small for dates?
Maternal pre-eclamptic toxaemia Chromosomal syndromes Infection e.g. CMV Placental abruption Twin pregnancy
What short-term problems can arise in small babies?
Perinatal hypoxia Hypoglycaemia Hypothermia Polycythaemia Thrombocytopenia Gastrointestinal problems (feeds, NEC) Respiratory distress syndrome Infection
What long-term problems can arise in small babies?
Hypertension
Reduced growth
Obesity
Ischaemic heart disease
Give two examples of skin marks/rashes which fade in time
Erythema toxicum (maculo-papular rash) Capillary haemangioma (strawberry naevi - cluster of dilated capillaries)
Give two examples of skin marks which are permenant but benign
Mongolian blue spot (accumulation of melanocytes)
Port wine stains (naevus flammus)
What is cephalohaematoma?
Haemorrhage beneath pericranium causing a bulge on the side of the head
Not associated with intracranial haemorrhage Resolves spontaneously in 3 – 4 weeks
What is caput succedaneum?
Head swelling caused by pressure of the presenting part of the scalp against the dilating cervix during delivery Resolves over the first few days
Give three causes of respiratory distress syndrome in term babies
Meconium aspiration
Birth asphyxia
Transient tachypnoea of the new-born
List the acute conditions which require neonatal intensive care (term babies)
RDS Cyanotic heart disease Sepsis Severe jaundice Surgical problems
Describe the approach to a baby with jaundice
Pathological if within first 24 hours
Measure serum bilirubin and conjugated fraction
- worry if conjugated fraction is greater than 20 and 20%
HIDA scan to exclude biliary atresia
Also do FBC, blood film, blood type and Coombs
Describe the management of a baby with jaundice
Treat underlying cause Hydrate Phototherapy Exchange transfusion Immunoglobulin
What is the main complication of severe jaundice?
Kernicterus (bilirubin encephalopathy)
Describe the main components of routine management of the preterm baby
Respiratory function/oxygen sats Fluid balance Thermoregulation (especially hypothermia) Hypoglycaemia Patent ductus arteriosus
What are the potential outcomes of extreme premature birth?
- 1/3 die
- 1/3 have normal life or mild disability
- 1/3 have moderate or severe disability for lifetime
- 1 in 6 is entirely normal at 6 years of age
List the major short-term problems associted with prematurity
Respiratory Distress Syndrome
Ventilation management and complications (e.g. pneumothorax),
Biochemical disorders e.g. acidosis,
Temperature control,
Nutrition and fluid management,
Infection including sepsis and necrotising enteric colitis (NEC),
Brain haemorrhage (Intraventricular Haemorrhage - IVH),
Circulatory issues (e.g. PDA)
Jaundice
List the major long-term problems associated with prematurity
Retinopathy of Prematurity (ROP), Periventricular leukomalacia (PVL), Post haemorrhagic hydrocephalus (PHH), Chronic lung disease/ Broncho Pulmonary Dysplasia (BPD), Developmental delay and cerebral palsy Poor growth.
Give three causes of failure to pass meconium
Hirschsprung’s disease
Cystic fibrosis (meconium ileus)
Bowel/rectal atresia or imperforate anus
Why might there be meconium in the amniotic fluid?
Foetus has passed meconium while still in utero:
- Post-date pregnancy
- Signs of foetal distress
What is the main risk of meconium in the amniotic fluid?
Meconium aspiration syndrome
- baby aspirates meconium which triggers reaction in the lung tissue, causing respiratory distress
