Neonatology-Prematurity Flashcards
(31 cards)
when is the baby: preterm & extremely preterm
- preterm = < 37 weeks
- extremely preterm = <28 weeks
aetiology of prematurity
- complication to pregnancy - PET, Abruption
- maternal disease- diabetes
- infection
- foetus issues- chromosomal abnormality, twin pregnancy
problems facing premature babies? and some ways to overcome these
- hypoxia
- ventilator support
- hypo/hyperglycaemia
- hypothermia
- due to low brown fat content; incubator controls temp
- anaemia
- bradycardia
- may have to give inotropes in first 72h
- jaundice
complications of prematurity?
- RDS
- Apnoea
- PDA
- Retinopathy of prematurity
- Intraventricular haemorrhage
- Necrotising enterocolitis
- Infection–> Sepsis
- Osteopenia of prematurity
why are premature babies more prone to infection? and what can you do to prevent infection
- because they lack IgG–> more vulnerable
- give prophylactic Penicillin & Gentamicin
long-term consequences of prematurity?
- HT
- IHD
- reduced growth
- obesity
what kind of support will premature babies require?
feeding support- naso/orogastric tube feeds +/- TPN
Mx of anaemia in premature babies?
iron supplements
pathology of RDS
insufficient surfactant secreted; lungs unable to stay expanded
signs /symptoms of RDS
- tachypnoea
- tachycardia
- cyanosis
- hypoxia
- grunting
- nasal flaring
- intercostal recession
what is seen on CXR in RDS?
ground glass appearance of lung fields
prevention of RDS
antenatal steroids
Rx of RDS
- Surfactant
- Respiratory support
- CPAP/ invasive ventilation/ oxygen
pathology of Apnoea?
cessation of breathing up to 20 seconds, due to immaturity of respiratory centres & neurotransmitters
prevention of apnoea?
give steroids antenatally
Rx of apnoea?
- Caffeine < 28 weeks
- CPAP
pathology of Necrotising Enterocolitis
ischaemia & necrosis of bowel mucosa and secondary infection of bowel
presentation of necrotising enterocolitis
- feed intolerance
- distended abdo
- bile stained vomiting
- bloody stool
rapid progression to shock
Risk factor for necrotising enterocolitis
CHD
Ix of Necrotising enterocolitis
XRay- distended loops of bowel
Rx of necrotising enterocolitis
Resus
- NBM
- IV Abx
- Urgent surgical review
what reduced risk of necrotising enterocolitis?
breast milk
pathology of Retinopathy of Prematurity (RoP)
proliferation of blood vessels at junction between vascularised & non-vascularised retina –> may lead to retinal detachment and vision loss
risk factors for RoP
- low birth weight
- prematurity
- excessive oxygen therapy
