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Flashcards in Preterm infant Deck (33)
1

when a baby pre term

before 37 weeks

2

Extremely preterm

before 27weeks

3

very preterm

before 31 weeks

4

What are the risks and factors which contribute to neonatal death

smoking
maternal age
being born before 32 weeks
twins
poor social circumstances

5

how many deaths occur among babies born at term

1 in 3

6

What are the most common causes for preterm birth

Spontaneous
Multiple pregnancy
Preterm rupture of membrane

7

Name other risk factors for preterm birth

more than 2 preterms before increases the risk of another premature baby by 70 percent
abnormally shaped uterus
multiple pregnancies
short interval between pregnancies (less than 6 months)
IVF
Smoking alcohol and drugs
Nutrition poor
Diabetes and high BP
Multiple miscarriages or abortions

8

What is the difference between a term and preterm baby

Preterms get cold faster
Most fragile lungs
Don't breathe well
Fewer reserves
Pulse oximetry often indicated

9

Why are preterm babies not often resuscitated?

The need help to transition to air breathing rather than because they are asphyxiated like a term baby might be

10

Why is cord clamping 'paused' in preterms

If the baby can be kept warm then pause for a minute to allow placental transfusion and assess baby.

11

How are preterm babies kept warm

A plastic bag under a radiant heater
Immediately

12

Name problems that can occur in preterms due to system immaturity

Resp distress syndrome
Patent ductus arteriosis
Intraventricular haemorrhage
Nectrotising enterocolitis
Retinopathy of prematurity

13

Why are preterms not able to thermoregulate effectively

Low BMR
Minimal muscular activity
Subcutaneous fat insulation is negligible
High ratio of surface area to body mass

14

Why might preterms run into problems with growth and nutrition

Increased risk of potential nutritional compromise
Limited nutrient reserves
Immature metabolic pathways
Increased nutrient demands

15

What is gestational correction

Adjustemtn of the plot of measurement of growth charts to account for the number of week a baby was born early

16

When should gestational correction be used until

1 year for prems born 32-36 weeks
2 years for prems born before 32 weeks

17

What is early onset neonatal sepsis usually caused by

Mainy due to bacteria acquire before or during delivery

18

What is the most common cause of neonatal sepsis

Group B strep

19

What is an important risk factor for neonatal sepsis

Incubation

Incubators increase infection

20

What causes respiratory distress syndrome

Surfactant deficiency or structural immaturity (Primary)

Secondary pathology - alveolar damage, build up of exudate, inflammation, repair

21

How common is RDS

75 percent of babies born before 29 weeks

22

what are the clinical features of RDS

Tachypnoea
Grunting
Intercostal recessions
nasal flaring
cyanosis

Worsen over minutes to hours

23

How is RDS managed

Maternal steroid before delivery
Surfactant
Ventilation

24

What is a complication of RDS

Bronchopulmonary dysplasia (BPD) is a long-term lung condition that can affect some children with NRDS. It develops when the ventilator used to treat NRDS causes scarring to the lungs

25

what are the symptoms of patent ductus arteriosis

heart failure - congestive
poor weight gain
exacerbated RDS

26

Where does intraventricular haemorrhage in infants begin

germinal matrix

27

what are the two major rsik factors for IVH

prematurity
respiratory distress syndrome

28

When do most IVH occur

first day of life

29

How can IVH be prevented

antenatal steroids

30

What percentage of grade 1-2 IVH will have neurodevelopmental delay or die

NDD- up to 20 percent
death- 10 percetn

31

What percentage of grade 3-4 IVH will have neurodevelopmental delay or die

NDD- up to 80 percent
mortality- 50 percent

32

What is the most common neonatal surgical emergency

necrotizing enterocolitis

33

What is the clinical features of NEC

Usually after RDS
Lethargy, gastric residuals
Bloody stool , temp instability, apnoea, bradycardia