Pediatrics II

Diseases of the Newborn

Dra. Alabastro
shar, maqui, viki
2nd Shifting/September 8, 2008

COMMON NEWBORN PROBLEMS e) Infarction

• Deviation/ aberration in intrauterine growth f) Umbilical vessel thrombosis
• Feeding difficulties g) Aberrant cord insertion
• Cyanosis. Respiratory distress and apnea h) hemangioma
3. FETAL
• Sensorial problems
a) Fetal distress
• Temperature instability b) Multiple gestation
• Meconium related problems c) Erythroblastosis; non-immune hydrops
• Vomiting, diarrhea, abdominal distention d) Genetic; congenital anomalies
• Abnormal secretions discharge e) Congenital infections
• Pallor and bleeding f) Chromosomal disorders
• Jaundice g) Inborn errors of metabolism

CONDITIONS THAT INCREASE THE RISK FOR DEFINITION OF TERMS

NEONATAL MORBIDITY AND MORTALITY • FULL TERM = 37-42wks
• Availability of skilled resuscitation at delivery • PRETERM = before 37wks AOG
1. Fatal distress • POSTERM = after 42weeks 1hour after 42weeks AOG
2. Operative delivery • ADEQUATE FOR GESTATIONAL AGE (AGA) = within
3. Third trimester bleeding percentile range
4. Multiple births • SMALL FOR GESTATIONAL AGE(SGA) = below 10th
5. Estimated births(BW)=/ 1500g
percentile, not necessary premature
6. Estimated gestational age (GA) = or <34weeks
=2Types:
7. Breech
a) Symmetric
8. Prolonged, unusual or difficult labor
- Head length & width are affected equally
9. Insulin dependent diabetes
- Recognizes earlier
10. Severe isoimmunization
b) Asymmetric
11. Obstetrician’s / pediatrician’s request
- Sparing the head
• Immediate assessment and initiation of care plan
1. Major anomalies • LARGE FOR GESTATIONAL AGE(LGA) = above 90th
2. Respiratory distress percentile
3. APGAR scare of 5 at 5 minutes • INTRAUTERINE GROWTH RESTRICTION(IUGR)
4. Signs of sedation in the neonates =retarded growth inside the uterus
5. Maternal infection = deprivation of IU nutrition and oxygen
6. Severe hypertensive case of mother
7. Suspected intrauterine fetal growth retardation
HANDICAPS ASSOCIATED WITH PREMATURE
or excessive size
INFANTS
8. Class A diabetes
I. RESPIRATORY
9. Maternal drug addiction
1. Respiratory distress
10. Oligohydramnios or polyhydramnios
2. Chronic lung disease
11. Prematurity/ postmaturity
3. Pneumothorax
12. No prenatal care
4. Pneumomediastinum
13. Previous fetal wastage or neonatal death
5. Interstitial emphysema
6. Congenital pneumonia
FACTORS AFFECTING INTRAUTERINE GROWTH
7. Pulmonary hypoplasia
1. MATERNAL 8. Pulmonary hemorrhage
a) Pre-eclampsia 9. Apnea
b) Chronic medical illness II. CVS
c) Infection 1. PDA
d) Drug abuse/heavy smoking 2. Hypotension/Hypertension
e) Malnutrition 3. Bradycardia
f) Age high altitude 4. Congenital malformation
2. PLACENTAL III. HEMATOLOGIC
a) Placental dysfunction 1. Anemia
b) Placenta previa; abruption placenta; single 2. Indirect hyperbilirubinemia
umbilical artery 3. Subcutaneous organ damage
c) Infarction 4. DIC
d) Single umbilical artery 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
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IV. GIT
1. Poor GI function/ nutrition
V. METABOLIC
1. Hypocalcemia
2. Hypoglycemia
VI. CNS
1. Intraventricular hemorrhage
2. Drug withdrawal
3. Seizures
VII. RENAL
1. Hyponatremia
2. Hypernatremia
3. Hyperkalemia
4. Renal tubular acidosis
5. Renal tubular glycosuria
6. Edema

HANDICAPED WITH SGA

1) Hypoglycemia, hypocalcemia (metabolic d/o)
2) Hypothermia
3) Hyperviscosity, polycythemia (hematologic)
4) Hypoxia
5) Congenital malformation

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