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High Risk Newborn 2
High Risk Newborn 2
High Risk Newborn 2
CLASS # 11
Linares
9/22/17
➤ Any baby born with a higher
than normal chance of morbidity
➤ Viability is at 23 weeks
gestation. Still a lot of issues,
difficult to sustain life
TERMINOLOGY
➤ According to size (chart in Wong, 338)
➤ AGA: weight falls b/t 10th and 90th
percentiles on intrauterine growth
curves
➤ IUGR: intrauterine growth restriction
➤ SGA: weight falls below 10th
percentile
➤ LGA: weight falls above 90th
percentile
➤ According to gestational age:
➤ Premature: born before completion of
37 weeks. Highest rate of mortality in
first 72 hours
➤ Full term: born b/w 38-42 weeks
➤ Postmature: born after 42 weeks
NICU UNITS
➤ Some hospitals have no capacity
to care for premature babies and
have to send them to other
facilities. Try to ship inutero
➤ Level 1: 35 weeks and over that
isn’t high risk. Generally send
high risk to other facilities
➤ Level 2: moderately ill infants 32
weeks or more. Can do short
term ventilator support,
medications, stabilization
➤ Level 3: highest skilled in NICU
care. Extremely preterm babies.
Have ECMO and surgeons on
hand
NEONATAL MEDICINE ADVANCEMENTS
➤ In premature babies
➤ Vessels can rupture and bleed into the
ventricles
➤ Can be silent or very severe, long term,
cognitive impairment, mobility
impairment
➤ Prevention: prevent increases in
intracranial pressure(position with head
midline and elevated 30 degrees, no
crying, no rapid IV fluids, daily head
circumference measurements), maternal
steroids, magnesium sulfate to mother
during labor
➤ Sx: odd eye movements, any subtle
changes in assessments
➤ Tx: not many things to be done, depends
on how severe it is