Monday, July 18th 2021

 Intensive Observation

Neo-Int
1. By. I/♂/15d/2.630 gr Term Infant/AGA
07/07/2021 (D-12)
+ Hyperleukocytosis + s. Congenital ALL
O2 CPAP PEEP 5 + Large PDA
FiO2 30% Flow 8
HR 150 bpm; RR 50 tpm + Moderate Secundum ASD
T 36.9oC SpO2 97%
+ Severe Tricuspid Regurgutation
+ Severe Pulmonary Hypertension
+ Anemia
+ Septicemia
+ Hyperkalemia
+ Hypocalcemia
BOBO-I
 BOBO-II

1. AQ/ ♀/6y/16kg ALL SR

2. MI/ ♂ /7y3m/25kg ALL SR
3. CA/♀/4y9m/15kg ALL SR
4. AA/♀/2y8m/12 kg Retinoblastoma
Thank You
TERIMA KASIH
MAR Classification
Infantile Spasm
IS involves a sudden, generally bilateral and symmetric contractions of muscles
of the neck, trunk, and extremities, can be classified into focal IS and diffuse. IS
most commonly develops between 3 and 8 months of age

ISs have multiple causes, and their mechanism is at best, incompletely

understood(1). Although the unifying epileptogenic mechanism is unknown,
various underlying disorders cause Iss
Causes:
CNS malformations (focal cortical dysplasia, lissencephaly, holoprosencephaly,
hemimegalencephaly, Callosal agenesis/Aicardi syndrome), chromosomal
abnormalities (trisomy 21, Miller-Dieker syndrome), single-gene errors,
neurocutaneous syndrome (TS, NF1, incontinentia pigmenti), congenital central
nervous system infections (TORCH), and rarely, in-born error of metabolism.
Perinatal precipitants include hypoxic ischemic encephalopathy and
hypoglycemia.
postnatal factors include intracranial infections, hypoxic-ischemic insults, and
brain tumors. Overall, cortical malformations, hypoxic-ischemic, and tuberous
sclerosis are the most common known associated disorders
Respiratory distress in the newborn is recognized as one or more
signs of increased work of breathing, such as tachypnea, nasal
flaring, chest retractions, or grunting.
Risk Factors- Respiratory Distress Syndrome
Certain factors may increase the risk that your newborn will have
RDS. These factors include:
•Infection
•Premature delivery. The earlier your baby is born, the greater his
or her risk for RDS. Most cases of RDS occur in babies born before
28 weeks of pregnancy.
•Problems with your baby’s lung development
•Stress during your baby's delivery, especially if you lose a lot of
blood
•You having diabetes
Modified Bell’s Staging for NEC
 Pathophysiology of NEC
• Risk factors  prematurity, formula feeds, ischemia,
and altered intestinal microbiota, interact to initiate
mucosal damage via a final common pathway
involving activation of the inflammatory cascade.
Pathophysiology of NEC
 Risk Factors of NEC
• Prematurity  immature mucosal barrier,
mucosal enzymes, various GI hormones,
immature bowel motility and function
• Abnormal intestinal Microbiome
• Hypoxia- ischemia
Prevent NEC

Grave et al, 2009; Neu J, 2005

GESTASIONAL
AGE
Gestational Age
• Dari Gomella
< 37 minggu Preterm
? Late preterm 34 0/7 – 36 6/7
? Term 37 0/7 – 41 6/7
? Early term 37 0/7- 38 6/7
? Full term 39 0/7 – 41 6/7
? Post term > 42 0/7
BIRTH
WEIGHT
Birthweight Classification
• <800 g = Micropreemie
• < 1000 g = ELBW / BBLASR
• < 1500 g = VLBW / BBLSR
• < 2500 g = LBW /BBLR
• 4000 g = High Birthweight
• > 4500 g = Very High Birthweight
LUBCHENCO
GROWTH CHART
DOWN
SCORE