average weight of a neonate?
3.5kg
average head circumference of a neonate?
35cm
average body length of a neonate?
50cm
define low birth weight?
<2.5kg
define very low birth weight?
<1.5kg
Scoring system used right after birth
APGAR
using APGAR at what minutes are checked?
1 , 5 ,10
highest score in APGAR?
10
lowest score in APGAR?
0
what modalities are checked in APGAR?
Pulse Respiratory Effort Colour Muscle tone Reflex Irritability
what is score of 2 in each APGAR modality? (i.e. what is normal)?
Pulse Respiratory Effort Colour Muscle tone Reflex Irritability
Pulse - >100 Respiratory Effort - Strong, crying Colour - Pink Muscle tone - Active Reflex Irritability - cries/sneeze, cough
what is score of 1 in each APGAR modality?
Pulse Respiratory Effort Colour Muscle tone Reflex Irritability
Pulse - <100 Respiratory Effort - Weak, irregular Colour - Body pink, extremities blue Muscle tone - Legs flexed Reflex Irritability - Grimace
what is score of 0 in each APGAR modality?
Pulse Respiratory Effort Colour Muscle tone Reflex Irritability
Pulse - Absent Respiratory Effort - nil Colour - Blue all over Muscle tone - Floppy Reflex Irritability - Nil
normal apgar score?
7-10
moderate Apgar score?
4 - 6
low Apgar score?
0-3
why do babies rarely get 10 on Apgar?
babies still acrocyanotic at 5 minutes
you are doing a head to toe exam on a recently born neonate.
what do you check for at the head?
-2
Subgaleal haematoma
bruises
how will a Subgaleal haematoma look/behave compared to other bruises or swelling?
fluctuating swelling then rapidly expands
you are doing a head to toe exam on a recently born neonate.
what do you check for at the face?
-1
facial nerve palsy
you are doing a head to toe exam on a recently born neonate.
what do you check for in the eyes?
-1
red reflex (cataracts)
you are doing a head to toe exam on a recently born neonate.
what do you check for at the mouth?
-2
cleft lip and palate
Tongue ties
you are doing a head to toe exam on a recently born neonate.
what do you look for at the neck?
-2
torticollis
cystic hygroma
torticollis treatment for neonates?
physiotherapy
what does cystic hygroma look like?
swollen neck
how do you diagnose cystic hygroma?
shine light on swollen neck, goes translucent
how do you treat cystic hygroma?
sclerosing injection
you are doing a head to toe exam on a recently born neonate.
what do you look for at the neck/arm region?
Erb’s palsy
Erb’s palsy is damage to what?
c5 c6 nerves
when did the nerves get damaged in Erb’s palsy?
during birth
sign of Erb’s palsy?
waiter’s tip hand
1st Mx for Erb’s palsy?
wait and watch, resolves on own
how long does it take for Erb’s palsy to resolve on its own?
couple of weeks
2nd line Mx if Erb’s palsy does not resolve on its own?
surgery
you are doing a head to toe exam on a recently born neonate.
what normal sign will you see on skin at the trunk?
-1
Erythema toxicum neonatorum
you are doing a head to toe exam on a recently born neonate.
what do you look for at the abdomen?
-1
gastroschisis
what is gastroschisis?
baby intestines herniates through the umbilicus
you are doing a head to toe exam on a recently born neonate.
what do you look for at the genitalia of males?
-1
Male – testes descended
you are doing a head to toe exam on a recently born neonate.
what do you look for/check for at the pelvic and perineal region?
-2
feel femoral pulses
anal atresia
you are doing a head to toe exam on a recently born neonate.
what MSK conditions do you look for?
-1
hip dysplasia
Ix to confirm neonatal hip dysplasia?
US
1st line Mx for hip dysplasia?
palvik harness
you are doing a head to toe exam on a recently born neonate.
what do you look for at the bottom of the spine?
dimples
you are doing a head to toe exam on a recently born neonate.
what do you look for on the skin of the lower back?
mongolian blue spot
mongolian blue spot aka?
congenital lumbosacral dermal melanocytosis
you are doing a head to toe exam on a recently born neonate.
what do you check for at the hands?
-2
single palmar crease
overriding of fingers
single palmar crease is a sign of what?
downs
overriding of fingers is a sign of what?
Edwards
you are doing a head to toe exam on a recently born neonate.
what do you check for at the feet?
club foot
between day 3 - 10 what screening do you for neonates?
Heel Prick Test
Heel Prick Test aka?
Guthrie test
what conditions do you screen for at the Guthrie test?
-4
and what would be a +ve result for each one?
-3
Phenylketonuria - ↑phenylalanine
congenital hypothyroidism - ↑TSH
cystic fibrosis - ↑immune-reactive trypsin
Sickle cell disease
within 4 weeks what other screening (not a blood test) is done?
hearing test
Causes of low birth weight?
-2
IUGR
TORCH infections
IUGR complications?
-2
easily tire because do not have fat (hypothermia) or glycogen stores (hypoglycaemia)
Cause of high birth weight?
-1
maternal gestational diabetes
explain why maternal gestational diabetes causes a macrocosmic baby?
and what risk is posed to neonates born to mum’s with gestational diabetes?
lots of sugar given to foetus in utero > foetus ↑insulin > once born neonate does not get high glucose nutrition but still has high insulin > RISK = hypoglycaemia
RISK = hypoglycaemia