Normal Term and Preterm Infant Flashcards by S B

what is the definition of extremely preterm

23 weeks to 27 weeks

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what is the definition of very preterm

28 weeks to 31 weeks

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what is the definition of preterm

32 weeks to 36 weeks

i.e. anything before 37 weeks gestation

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what is the definition of term

37 weeks to 42 weeks

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what is the definition of post term

anything after 42 weesk

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what is important about the 3rd trimester for the baby

daily weigh again of about 7g of fat per day

about 24g by end of the semester

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what is transferred via the placenta in the 3rd trimester

iron, vitamins, calcium, phosphate & antibodies

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what is the normal weigh range for a baby

2.5kg - 4kg

> 4kg is large for gestational age
< 2.5kg is small for gestational age

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what type of environment is the baby faced with during contractions and how does it try deal with this

hypoxic environment

- fetal Hb helps release O2

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what happens in the first few minutes after a baby is born

first breath/cry

alveolar expansions

decreased pulmonary arterial pressure

change from fetal to newborn circulation

increased PaO2

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what is a normal APGAR score

8/10 or greater

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what are the 5 categories of the APGAR score

HR
Resp
Responsiveness
Tone 
Colour

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what is Haemolytic Disease Newborn

alloimmune condition

the IgG antibodies passed from mother to foetus attack the red blood cells causing haemolysis
range of severity
can cause anaemia and a reticulocytosis

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what vaccinations do infants get

Hepatitis B at birth
BCG first month
Routine vaccinations 8 weeks

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what is caput succedaneum

oedema, of a newborn’s scalp soon after delivery
appears as a lump or a bump
should disappear after a few days

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what is moulding

the shape of the infant head to the shape of the mothers birth canal

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what are Ebsteins pearls

small white or yellow cystic vesicles often seen in the median palate

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what are the characteristics of fetal alcohol syndrome

epicanthal folds 
small eye openings
flat mid face 
upturned nose
smooth philtrum
thin upper lip

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what are the hip examinations preformed on a new born baby

barlow manoeuvre

screens for DDH,
dislocates the hip

ortolani
- relocated the hip

what puts a baby at high risk of being born premature

maternal smoking/alcohol/drug use
abnormally shaped uterus
multiple pregnancy
interval of < 6 months between pregnancies
conceiving through in vitro fertilisation
maternal poor nutrition

what are causes of preterm birth

spontaneous preterm
multiple pregnancy 
preterm prelabour rupture of membrane
pregnancy associated HTN
IUGR
antepartum haemorrhage
cervical incompetence

what is the difference between a preterm infant and a term infant

Get cold even faster
Have more fragile lungs
Don’t breathe effectively
Have fewer reserves

what are examples of conditions caused by system immaturity

respiratory distress syndrome
patent ductus arteriosus
intraventricular haemorrhage
nectrotising enterocolitis

neonatal sepsis can be split into two types

early onset (EOS)
- mainly due to bacteria acquired before and during delivery

late onset (LOS)
- acquired after delivery

what organisms commonly cause neonatal sepsis

Group B streptococcus (GBS) Gram negative organisms: Klebsiella, Escherichia coli, Pseudomonas, and Salmonella Gram positive organisms: Staphylococcus aureus, Coagulase negative staphylococci (CONS), Streptococcus pneumoniae, Streptococcus pyogenes

what is important to remember when using incubators

incubators increase infection

what are resp complications of prematurity

RDS Apnoea of prematurity Bronchopulmonary dysplasia

several pathologies can cause RDS - what are the primary pathology

Surfactant deficiency | Structural immaturity

several pathologies can cause RDS - what are the secondary pathology

Alveolar damage Formation of exudate from leaky capillaries Inflammation

what are features of RDS

Tachypnoea Grunting, Nasal flaring Intercostal recessions Cyanosis

Mx of RDS

maternal steroid surfactant ventilation [invasive/non-invasive]

what are the cardiovascular concerns in the preterm infant

PDA | Systemic hypotension

what happens in PDA

Duct does not respond to “close” signals Leads to symptoms of congestive heart failure Oxygen requirements are high Exacerbates RDS

what type of murmur is heard in PDA

machine like murmur

what is an Intraventricular Haemorrhage

a form of intracranial haemorrhage that occurs in preterm infants, which begins with bleeding into the germinal matrix.

Risk factors for IVH

prematurity | RDS

when does IVH commonly present

most occur within first day of life or within 72 hours

how does IVH present

``` Diminished/absent Moro reflex. Poor muscle tone. Sleepiness. Lethargy. Apnoea. ```

Mx of IVH

preventive measures | - antenatal steroids

what is NEC

widespread necrosis in the small and large intestine | usually after recovering from RDS

Sx of NEC

``` lethargy bloody stool temperature instability aponea bradycardia abdominal extension ```

what are long term potential complications of prematurity

cerebral palsy

what is the HR range expected in a newborn

120-140/min

what is the RR range expected in a newborn

40-60/min

what type of infections do new borns get

Septicaemia CNS - meningitis Respiratory - pneumonia GU – UTI

what is the most common bacterial cause of septicaemia

group B strep

what is transient tachypnoea of the newborn (TTN)

presents in the neonate as tachypnoea for the first few hours of life, lasting up to one day. The tachypnoea resolves by two days.