prematurity and respiratory distress

Question 1

25 y.o. mother 31 weeks into her 2nd pregnancy arrives in A+E after her waters broke. you suscpect she will be going into premature labour.

(a) you are asked to speak to the mother regarding delivery.

list 3 complications of prematurity that would be relevant to a child of this age that you would discuss with her.

Answer 1

1. respiratory distress: may need support with CPAP or oxygen therapy
2. sepsis: premature babies are more prone to infection
3. GI: baby will not be able to suck and will require NG feeds
4. more likely to get jaundiced and need phototherapy
5. bleeding: increased risk of intraventricular haemorrhage
6. PDA: increased risk

Question 2

(b) at 4 hours of age, the baby continues to have signs of respiratory distress. list 4 signs that you would look for in a child with resp distress.

Answer 2

• increased RR
• nasal flaring
• accessory muscle use
• intercostal indrawing
• grunting
• tracheal tug
• sunken fontanelle
• head bobbing
• cyanosis
• stridor
• stertor
• inability to lie down or cry
• apnea
• agitation

Question 3

(c) list 4 ix you would consider relevant to your mx of this child

Answer 3

1. pulse oximetry
2. FBC
3. CXR
4. blood cultures
5. blood gases

Question 4

(d) list 4 rx you think would be considering in this case

Answer 4

Call senior!

1. oxygen therapy
2. CPAP
3. intubation
4. abx to cover for sepsis