Neonatology

DR ROUNAK JAHAN
MBBS (SSMC)
FCPS PART 1 (PAEDIATRICS)
MD PHASE B (PAEDIATRICS)
MEDICAL OFFICER (BSMMU)
MENTOR (SYNAPSE MEDICAL ACADEMY)
Neonatal mortality assay
Healthy newborn baby features

 Weight : 2500 to 4000 grams

 Length : around 50 cm
 OFC : 35 cm approx
 Colour : pink, acrocyanosis may be present
 Breathing : spontaneous and regular with r/r 30-60 br/min
 Heart rate : 120-160 bt/min
 Blood pressure : Avg 65/40 mmhg
 Temp : 97.5 – 99 degree F
 Muscle tone : flexed
 Sucking : present
Healthy newborn baby features

 Urine : passed within 24-48 hrs

 Meconium : passed within 24 hrs
 Sleep : around 18 hrs/day
 Congenital anomalies : absent
 Primitive reflex : good and stable
 Vision : near sighted having a fixed focal length of 8-12 inches
 Hearing : well developed
 Interaction : present
 SPO2 : should be > 95%
Neonatal reflexes

/Months
Neonatal reflexes
Neonatal reflexes
Neonatal reflexes
APGAR score

Sign 0 1 2

Heart rate absent Below 100 Over 100

Respiratory effort absent Slow and irregular Good crying

Muscle tone limp Some flexion active

Reflex irritability No response Grimace Cough or sneeze

Colour Blue/pale acrocyanosis Pink all over

APGAR score

 Assessed at 1 minute and 5 minute

 Predict outline for resuscitation, mortality and morbidity
 Also indicator of future neurological deficit or outcome
 Score 10: normal
 Score 7 to 9 : mild depression
 Score 4 to 6 : moderate depression
 Score 0 to 3 : severe depression
Preterm and low birth weight
Preterm and low birth weight
Preterm and low birth weight
Preterm and low birth weight
Preterm and IUGR
Preterm and IUGR
Preterm and IUGR (complications)
Preterm and IUGR (suppliments
given)
Preterm and IUGR (Also read)

 MR Molla page no. 164 table 8.14 and table 8.15

 MR Molla page 165 ( immediate complications of prematurity)
 MR Molla Page 169 (late complications of prematurity)
Post maturity/Post term

 Babies born after 42 weeks of gestation

 Major pathological event includes utero-placental
insufficiency which leads to oligohydramnios, MAS and
PPHN
Perinatal Asphyxia
Perinatal Asphyxia (risk factors)
Perinatal Asphyxia (effects of
hypoxia)
Perinatal Asphyxia (clinical
features)
Perinatal Asphyxia (complications)
Perinatal Asphyxia (complications)
Perinatal Asphyxia (complications)
Perinatal Asphyxia (complications)
Respiratory Distress Syndrome
Respiratory Distress Syndrome
Respiratory Distress Syndrome
Respiratory Distress Syndrome (c/f)
Respiratory Distress Syndrome
(CXR)
ROP
IDM
IDM
Neonatal Sepsis
Neonatal Sepsis (organisms)
Neonatal Sepsis (Risk factors)
Neonatal Sepsis (clinical features)
Neonatal sepsis (clinical features)
Neonatal sepsis (investigations)
Neonatal meningitis
CSF of a healthy neonate
Neonatal seizure
Neonatal hypoglycemia (MRM 180)
Neonatal jaundice
Neonatal Jaundice (MRM 186)
Neonatal Jaundice(physiological)
Neonatal Jaundice (pathological)
Neonatal Jaundice (evaluation)
Neonatal Jaundice (evaluation)
Neonatal Jaundice
(phototherapy)
Neonatal Jaundice (phototherapy)
Neonatal Jaundice (phototherapy MRM 199)
Neonatal Jaundice (exchange transfusion indications
MRM 200 )
Neonatal Jaundice (exchange transfusion
complications MRM 201)
ABO incompatibility
Rh incompatibility
Breast feeding jaundice
Jaundice of prematurity
Also read

 Breast milk Jaundice MRM 191

 Breast feeding jaundice MRM 192
 Rh incompatibility pathophysiology MRM 189
 ABO incompatibility MRM 191
Newborn Screening (MRM 104
page)
Caput Succedaneum
Cephal hematoma
Erb’s palsy
TORCH infection
Congenital CMV infection
Congenital Rubella syndrome
Congenital Toxoplasmosis
Congenital syphilis
Some sample SBA

1. Characteristic feature of preterm baby is-

A. More alert
B. Thin and shiny skin
C. Breast bud properly developed
D. Vigorous movement
E. Limbs are semi flexed
 Ans : B
2. Which of the following reflexes persists
beyond infancy ?

A. Moro reflex
B. Parachute reflex
C. Steeping reflex
D. Palmar grasp
E. Rooting reflex
 Ans : B
3. Early onset neonatal sepsis is caused by –

A. Staphylococcus aureus
B. Pseudomonas
C. Acinatobacter
D. Listeria monocytogens
E. Neisseria meningitidis
 Ans : D
Thank You