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Preterm Infant Flashcards

1
Q

what is defined as a preterm infant?

A

a birth that occurs before 37 completed weeks of gestation

  • term = 37-42
  • post term = >42
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2
Q

what is defined as a preterm infant?

A

a birth that occurs before 37 completed weeks of gestation

  • term = 37-42
  • post term = >42
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3
Q

premature births fell 10% after which ban?

A

the smoking ban

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4
Q

over a quarter of deaths in childhood occur during first year of childs life and are strongly influenced by pre-term delivery and low birth weight - true or false?

A

false - over a half

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5
Q

which babies are more at risk of stillbirths and neonatal deaths?

A

black or asian families
teenage mothers and mothers >40
mothers in poverty (highest risk)

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6
Q

what is thought to be the reason behind the rise in number of preterm babies?

A

increased maternal age
increasing rate in pregnancy related complications
greater use of infertility treatments
more caesarean deliveries before term

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7
Q

what are some of the many causes of preterm birth?

A 
spontaneous preterm labour 
multiple pregnancy 
preterm prelabour rupture of membranes 
pregnancy associated hypertension
IUGR
antepartum haemorrhage 
cervical incompetence / uterine malformation
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8
Q

what are the risk factors for a preterm birth?

A

interval of <6 months between pregnancies
conceiving through IVF
smoking, drinking alcohol and using ilicit drugs
poor nutrition
some chronic conditions (high BP, diabetes)
multiple miscarriages or abortions

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9
Q

what is the difference between managing a preterm infant and one born at term?

A 
need more help to stay warm
have more fragile lungs
don't breathe effectively 
have fewer reserves 
delay cord clamping if possible
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10
Q

how is a preterm baby kept warm?

A

using a plastic bag under a radiant heater

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11
Q

what are the common problems as a result of prematurity?

A 
temperature control 
feeding / nutrition 
sepsis 
system immaturity / dysfunction 
other - metabolic, ROP
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12
Q

what conditions are often caused by system immaturity / dysfunction?

A

respiratory distress syndrome
patent ductus arteriosus
intraventricular haemorrhage
necrotising enterocolitis

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13
Q

why is thermal regulation ineffective in premature babies?

A

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

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14
Q

why is there an increased risk of nutritional compromise in premature babies?

A

limited nutrient reserves
gut immaturity
immature metabolic pathways
increased nutrient demands

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15
Q

what is the difference between early onset (EOS) and late onset sepsis (LOS)?

A

early = mainly due to bacteria acquired before and during delivery

late = acquired after delivery (nosocomial or community sources)

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16
Q

what organisms cause early onset neonatal sepsis?

A

gp B streptococcus

gram negatives

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17
Q

what organisms cause late onset neonatal sepsis?

A

coagulase negative staph
gram negatives
staph aureus

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18
Q

how is neonatal sepsis managed?

A 
prevention 
hand washing 
super vigilant and infection screening 
judicious use of antibiotics 
supportive measures
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19
Q

what are the respiratory complications of prematurity?

A

RDS
apnoea of prematurity
bronchopulmonary dysplasia

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20
Q

what is respiratory distress syndrome in newborn commonly known as?

A

hyaline membrane disease

21
Q

what causes RDS in newborn?

A

primary pathology - surfactant deficiency, structural immaturity

secondary pathology

alveolar damage - formation of exudate from leaky capillaries, inflammation

22
Q

how common is RDS in newborn?

A

75% of infants born before 29 weeks

10% in infants born after 32 weeks

23
Q

what is the clinical features of RDS in newborn?

A

respiratory distress

tachypnoea

24
Q

premature births fell 10% after which ban?

A

the smoking ban

25
Q

over a quarter of deaths in childhood occur during first year of childs life and are strongly influenced by pre-term delivery and low birth weight - true or false?

A

false - over a half

26
Q

which babies are more at risk of stillbirths and neonatal deaths?

A

black or asian families
teenage mothers and mothers >40
mothers in poverty (highest risk)

27
Q

what is thought to be the reason behind the rise in number of preterm babies?

A

increased maternal age
increasing rate in pregnancy related complications
greater use of infertility treatments
more caesarean deliveries before term

28
Q

what are some of the many causes of preterm birth?

A 
spontaneous preterm labour 
multiple pregnancy 
preterm prelabour rupture of membranes 
pregnancy associated hypertension
IUGR
antepartum haemorrhage 
cervical incompetence / uterine malformation
29
Q

what are the risk factors for a preterm birth?

A

interval of <6 months between pregnancies
conceiving through IVF
smoking, drinking alcohol and using ilicit drugs
poor nutrition
some chronic conditions (high BP, diabetes)
multiple miscarriages or abortions

30
Q

what is the difference between managing a preterm infant and one born at term?

A 
need more help to stay warm
have more fragile lungs
don't breathe effectively 
have fewer reserves 
delay cord clamping if possible
31
Q

how is a preterm baby kept warm?

A

using a plastic bag under a radiant heater

32
Q

what are the common problems as a result of prematurity?

A 
temperature control 
feeding / nutrition 
sepsis 
system immaturity / dysfunction 
other - metabolic, ROP
33
Q

what conditions are often caused by system immaturity / dysfunction?

A

respiratory distress syndrome
patent ductus arteriosus
intraventricular haemorrhage
necrotising enterocolitis

34
Q

why is thermal regulation ineffective in premature babies?

A

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

35
Q

why is there an increased risk of nutritional compromise in premature babies?

A

limited nutrient reserves
gut immaturity
immature metabolic pathways
increased nutrient demands

36
Q

what is the difference between early onset (EOS) and late onset sepsis (LOS)?

A

early = mainly due to bacteria acquired before and during delivery

late = acquired after delivery (nosocomial or community sources)

37
Q

what organisms cause early onset neonatal sepsis?

A

gp B streptococcus

gram negatives

38
Q

what organisms cause late onset neonatal sepsis?

A

coagulase negative staph
gram negatives
staph aureus

39
Q

how is neonatal sepsis managed?

A 
prevention 
hand washing 
super vigilant and infection screening 
judicious use of antibiotics 
supportive measures
40
Q

what are the respiratory complications of prematurity?

A

RDS
apnoea of prematurity
bronchopulmonary dysplasia

41
Q

what is respiratory distress syndrome in newborn commonly known as?

A

hyaline membrane disease

42
Q

what causes RDS in newborn?

A

primary pathology - surfactant deficiency, structural immaturity

secondary pathology

alveolar damage - formation of exudate from leaky capillaries, inflammation

43
Q

how common is RDS in newborn?

A

75% of infants born before 29 weeks

10% in infants born after 32 weeks

44
Q

what is the clinical features of RDS?

A

respiratory distress

tachypnoea - grunting, intercostal recessions, nasal flaring, cyanosis

worsening over minutes to hours

natural history (gradual worsening to a nadir at 2-4 days then gradual improvement)

45
Q

what is the management of RDS?

A

maternal steroid
surfactant
ventilation (invasive / non invasive ventilation)

46
Q

how are intraventricular haemorrhages graded?

A

1-4

grade 1 and 2 = neurodevelopmental delay up to 20%, mortality 10%

grade 3 and 4 = neurodevelopmental delay up to 80%, mortality 50%

47
Q

what are the main symptoms of NEC?

A

poor feeding, bloating, blood in stool, vomiting of bile

48
Q

when does retinopathy of prematurity usually occur?

A

6-8 weeks after delivery

49
Q

what are the early and late metabolic complications?

A

early - hypoglycaemia and hyponatraemia

late - osteopenia of prematurity

Reproduction (45 decks)

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