Diseases Of The Newborn Part1

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COMMON NEWBORN PROBLEMS Deviation/ aberration in intrauterine growth Feeding difficulties Cyanosis. Respiratory distress and apnea Sensorial problems Temperature instability Meconium related problems Vomiting, diarrhea, abdominal distention Abnormal secretions discharge Pallor and bleeding Jaundice

CONDITIONS THAT INCREASE THE RISK FOR NEONATAL MORBIDITY AND MORTALITY • Availability of skilled resuscitation at delivery 1. Fatal distress 2. Operative delivery 3. Third trimester bleeding 4. Multiple births 5. Estimated births(BW)=/ 1500g 6. Estimated gestational age (GA) = or <34weeks 7. Breech 8. Prolonged, unusual or difficult labor 9. Insulin dependent diabetes 10. Severe isoimmunization 11. Obstetrician’s / pediatrician’s request • Immediate assessment and initiation of care plan 1. Major anomalies 2. Respiratory distress 3. APGAR scare of 5 at 5 minutes 4. Signs of sedation in the neonates 5. Maternal infection 6. Severe hypertensive case of mother 7. Suspected intrauterine fetal growth retardation or excessive size 8. Class A diabetes 9. Maternal drug addiction 10. Oligohydramnios or polyhydramnios 11. Prematurity/ postmaturity 12. No prenatal care 13. Previous fetal wastage or neonatal death FACTORS AFFECTING INTRAUTERINE GROWTH 1. MATERNAL a) Pre-eclampsia b) Chronic medical illness c) Infection d) Drug abuse/heavy smoking e) Malnutrition f) Age high altitude 2. PLACENTAL a) Placental dysfunction b) Placenta previa; abruption placenta; single umbilical artery c) Infarction d) Single umbilical artery

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Pediatrics II Diseases of the Newborn Dra. Alabastro shar, maqui, viki Shifting/September 8, 2008

e) Infarction f) Umbilical vessel thrombosis g) Aberrant cord insertion h) hemangioma FETAL a) Fetal distress b) Multiple gestation c) Erythroblastosis; non-immune hydrops d) Genetic; congenital anomalies e) Congenital infections f) Chromosomal disorders g) Inborn errors of metabolism DEFINITION OF TERMS FULL TERM = 37-42wks PRETERM = before 37wks AOG POSTERM = after 42weeks 1hour after 42weeks AOG ADEQUATE FOR GESTATIONAL AGE (AGA) = within percentile range

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SMALL FOR GESTATIONAL AGE(SGA) = below 10th percentile, not necessary premature =2Types: a) Symmetric Head length & width are affected equally Recognizes earlier b) Asymmetric Sparing the head

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LARGE FOR GESTATIONAL AGE(LGA) = above 90th percentile

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INTRAUTERINE GROWTH RESTRICTION(IUGR) =retarded growth inside the uterus = deprivation of IU nutrition and oxygen HANDICAPS ASSOCIATED WITH PREMATURE INFANTS I. RESPIRATORY 1. Respiratory distress 2. Chronic lung disease 3. Pneumothorax 4. Pneumomediastinum 5. Interstitial emphysema 6. Congenital pneumonia 7. Pulmonary hypoplasia 8. Pulmonary hemorrhage 9. Apnea II. CVS 1. PDA 2. Hypotension/Hypertension 3. Bradycardia 4. Congenital malformation III. HEMATOLOGIC 1. Anemia 2. Indirect hyperbilirubinemia 3. Subcutaneous organ damage 4. DIC 5. Vitamin K deficiency

MARY YVETTE ALLAIN TINA RALPH SHERYL BART HEINRICH PIPOY KC JAM CECILLE DENESSE VINCE HOOPS CES XTIAN LAINEY RIZ KIX EZRA GOLDIE BUFF MONA AM MAAN ADI KC PENG KARLA ALPHE AARON KYTH ANNE EISA KRING CANDY ISAY MARCO JOSHUA FARS RAIN JASSIE MIKA SHAR ERIKA MACKY VIKI JOAN PREI KATE BAM AMS HANNAH MEMAY PAU RACHE ESTHER JOEL GLENN TONI

Pediatrics II Diseases of the Newborn Page 2 of 2

IV. 1. V. 1. 2. VI. 1. 2. 3. VII. 1. 2. 3. 4. 5. 6.

GIT Poor GI function/ nutrition METABOLIC Hypocalcemia Hypoglycemia CNS Intraventricular hemorrhage Drug withdrawal Seizures RENAL Hyponatremia Hypernatremia Hyperkalemia Renal tubular acidosis Renal tubular glycosuria Edema

1) 2) 3) 4) 5)

HANDICAPED WITH SGA Hypoglycemia, hypocalcemia (metabolic d/o) Hypothermia Hyperviscosity, polycythemia (hematologic) Hypoxia Congenital malformation

1) 2) 3) 4)

POSTTERM INFANTS Meconium aspiration(pneumonia) Fetal distress (hypoxic encepholpathy) Problem of placental insufficiency metabolic