CARE OF PRETERM

BABIES
CAUSES

Fetal
Placental
Uterine
Maternal
Others
Fetal

 Fetal distress
 Multiple gestation
 Congenital abnormalities
Placental

 Placental dysfunction
 Placenta previa
 Abruptio placenta
Uterine factors

 Bicornuate uterus
 Incompetent cervix
Maternal

 Pre eclampsia
 Chronic medical illness
 Infections
 Drug abuse
 Maternal malnutrition
Other

 Premature rupture of membranes(PROM)

 Polyhydramnios
Scarf sign
Heel to ear
Respiratory problems

 Respiratory distress
syndrome
 Bronchopulmonary
dysplasia
 Pneumothorax
 Pneumonia
 Apnea
Cardiovascular problems

 Patentductus
arteriosus
 Hypotension
 Bradycardia
Gastrointestinal problems

 Poor gestational function

 Necrotising enterocolitis
 Hyperbilirubinemia
 Incompetent
cardioesophageal
sphincter
Central nervous system

 Intraventricular haemorrhage
 Seizures
 Retinopathy of prematurity
 Deafness
 Hypotonia
Renal system

Hyperkalemia
Renal glycosuria
Other problems

 Hypothermia
 Nutritional deficiencies
 Increased susceptibility to infections
Management measures
 Oxygen therapy by nasal cannula/prongs or oxygen hood when saturation
 Early phototherapy to avoid complications
 Good episiotomy to prevent intracranial haemorrhage
Fluid requirement

 Fluidrequirement for term infants

is 60 -70 ml/kg on day 1 and
increased to 100 -120 ml/kg by day
2-3
 Preterm need to start with 70 -80
ml/kg on day 1 and advanced
gradually to 150 ml/kg/day
 Feeding guidelines
Age Categories of neonates

Birth weight Less 1200grm 1200 -1800 gm More than 1800 gm

Less 30 weeks 30 – 34 weeks More than 34 weeks

Initial IV fluids and try gavage if Gavage Breast feed or katori

baby is well spoon feed

After 1 -3 days Gavage feed Katori spoon Breast feed

2 -4 weeks Katori spoon Breast feed Breast feed

4 – 6 weeks Breast feed Breast feed Breast feed

Discharge advice
 Evaluate for any complications
 Nutrition supplements including multivitamins, iron,
calcium and vitamin D are started
 Immunized with BCG, OPV & Hep B
 Instruct for regular feeding
 Routine care to prevent hypothermia
 Proper feeding
 Personnel hygiene
 Growth monitoring
 Kangaroo mother care