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Flashcards in Preterm infant Deck (43):
1

preterm defiintion

<37 weeks

2

term birth definition

between 27-42 weeks

3

post term definition

>42 weeks

4

below 31 weeks is what

very preterm

5

below 27 weeks is what

extremely preterm

6

why do half of deaths in childhood occur during the first year of a child's life

strongly influenced by prefer delivery and low brith weight

7

causes of preterm birth

cervical incompetence/uterine malformation
antepartum haemorrhage
IUGR
preg assoc htn
premature pre labour rupture of membranes
multiple pregnancy
spontaneous preterm labour

8

what does >2 preterm deliveries increase the risk of

another preterm baby by 70%

9

how much does an abnormally shaped uterus increase the risk of giving birth early by

19%

10

how many more times likely are women to give birth early if they have multiple pregnancy

9x more likely

11

risk factors of preterm birth

interval of <6 months between pregnancies
conceiving through in vitro fertilisation
smoking, alcohol, drugs
poor nutrition, chronic conditions (BP, DM), multiple miscarriages or abortions

12

different between a term baby and a preterm baby when they are first born

get cold faster - smaller
have more fragile lungs so don't breathe effectively
have fewer reserves
pulse oximetry often indicated

13

do preterm babies need assistance or resuscitations

most very preterm babies need help with transition to air breathing - assistance

14

when should cord clamping be done in preterm babies

if the baby is okay and can be kept warm pause for at least a minute to allow placental transfusion

15

how are preterm babies kept warm

using a plastic bag or a heater
prewarm incubators
skin to skin
trans warmer mattress

16

risks of lung inflation

lungs are fragile so over inflation can cause damage leading to inflammation and long term morbidity - can lead to bronchopulmonary dysplasia

17

concerns in a preterm baby

temp control
feeding/nutrition
sepsis
systemic immaturity - RDS, PDA, ibraventricular haemorrhage, necrotising enterocolitis

18

hypothermia is a risk factor for what
what does it increase

neonatal death
increases severity of all preterm morbidities

19

why is thermal regulation ineffective in a preterm baby

low BMR
minimal muscle activity
subcut fat insulation is negligible
high ratio of surface area to body mass

20

why is there an increased risk of potential nutritional compromise

limited nutritional reserves
immature metabolic pathways
increased nutritional demands

21

what is gestational correction

adjusts the plot of measurement on the graph to account for the number of weeks a baby was born early

22

when should gestational correction not be used for under 40 weeks baby

for 37+ weeks

23

when should gestational correction be used till

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

24

what are the two types of neonatal sepsis

early onset mainly due to bacteria acquired before and after delivery

late onset acquired after delivery

25

which organisms cause neonatal sepsis

group b strep
gram neg - klebsiella, EColi, pseudomonas, salmonella
gram pos - SA, coag neg staph, strep pneumonia, strep pyogenes

26

management of neonatal sepsis

prevention
hand washing
super vigilant and infection screening
judicial use of antibiotics
optimum supportive measures

27

what increases infection

incubators

28

what are some of the respiratory complications of prematurity

RDS
apnoea of prematurity
bronchopulmonary dysplasia

29

NRDS pathology

primary - surfactant deficiency, structural immaturity
secondary - alveolar damage, formation of exudate from leaky capillaries, inflammation, repair

30

when is RDS common

75% in <29 weeks born
10% in >32 weeks gestation

31

clinical features of RDS

resp distress - tachypnoea, grunting, intercostal recession, nasal flaring, cyanosis
worsening over minutes to hours
usually improves over 2-4 days with active treatment

32

management of RDS

maternal steroids
surfactant
ventilation - invasive or non invasice

33

CVS complications in preterm

PDA
systemic hypotension

34

PDA is what
who is at risk
what does it lead to
oxygen requirements
exacerbates what

when DA doesn't close
premature infants
symptoms of congestive HF
are high
RDS

35

intraventricular haemorrhage is what

form of intracranial haemorhhage which begins with bleeding in the germinal matrix and 80% of the cases leads to bleeding intraventricular

36

clinical presentation of a intraventricular haemorrhage

clinically silent 25-50%
intermittent deterioration
catastrophic deterioration

most occur in first day of life - up to 90% of GMH-IVH insult is present by 72 hours

37

risk factors for IVH

prematurity
RDS

38

IVH preventive measures

antenatal steroids
prompt and appropriate resuscitation
avoid haemodynamic instability
avoid hypoxia, hypercarbia, hyperopia and hypocardia

39

IVH grade 1 and 2

neurodevelopment delay up too 20% and mortality is 10%

40

IVH grade 3 and 4

neurodevelopment delay up to 80% and mortality is 50%

41

NEC is the most common what
what is it
high incidence in who

neonatal surgical emergency
widespread necrosis in the small and large intestine
in premature infants

42

clinical picture of NEC

usually after recovering form RDS
early signs: lethargy and gastric residuals
bloody stool, temp instability, apnoea and bradycardia

43

other complications of prematurity

retinopathy - usually 6-8 weeks after delivery
hypoglycaemia and hyponatraemia early cx
osteopenia of prematurity later cx