Neonate

 Neonate:

                Is the period of life from the 28th week of gestational age to the 28th day after birth.

Fetal assessment:

                This means a determination of well well-being of the fetus.

The fetus:

                 The end of the eighth week of conception is when the major structures have formed until birth.



this assessment needs some common procedures:

* Medical history and examination of the mother. 

* Chemical assessment of placental function.

*Amniocentesis for assay of amniotic fluid assay of bilirubin in Rh incompatibility &assay of respiratory distress syndrome by lecithin and sphingomyelin ratio and assay of surfactant production.




*Chorionic villus sampling for genetic abnormalities.

* Electronic and ultrasonic fetal H.R.monitoring,

* Precautions umbilical blood sampling (cordocentesis).

* Ultrasonography: a non-invasive technique used for :

1- Determination of pregnancy viability, Fetal heart motion can be detected at 6 weeks gestation.

2- Calculation of gestational age by measuring CRL (crown-rump length) between 6 weeks and 14 weeks gestation.

3-Diagnosis of multiple pregnancies and determination of chorionic.

4- Anatomic survey to detect congenital anomalies for example e.g. hydrocephalus & congenital heart diseases & diaphragmatic hernia and fetal gender.

5- Assessment of growth and fetal weight ( IUGR & macrosomia ).

6- Assessment of amniotic fluid volume: 

                                                   # Oligohydrominos which are associated with increased fetal morbidity and

                                                                                  mortality with spontaneous rupture of membranes.

                                                                                  most common causes:(placental insufficiency &chronic 

                                                                                   hypertension & post dates gestation & some fetal 

                                                                                   anomalies as karyotypic abnormalities).

                                                    # Polyhydrominos which caused by *Idiopathic

                                                                                                              *Diabetic mother 

                                                                                                               *Multiple gestations with twin 

                                                                                                                 transfusion syndrome.

                                                                                                               *Non-immune hydrops fetals.

                                                                                                                *Some fetal anomalies as 

                                                                                                                  diaphragmatic hernia& 

                                                                                                                  oesophageal atresia.

7- Assessment of placental location and presence of retroplacental hemorrhage.


References:

Macones GA, Hankins GD, Spong CY, Hauth J, Moore T. The 2008 National Institute of Child Health and Human Development Workshop report on electronic fetal monitoring: update on definitions, interpretation, and research guidelines. Obstet Gynecol.2008;112:661-666.

 Malone FD, CanickJA, Ball RH, et al.First-trimester or second-trimester screening, or both. N Engl J Med.2005;353:2001-2011.

Comments

Post a Comment

Popular posts from this blog

Congenital anomalies examples:

Image
 We Will review some of the most common congenital anomalies examples in brevity: *Cleft lip /palate: most common head and neck anomalies. leads to recurrent chest and ear infections. must engorgement breastfeeding (may need breastfeeding consultant to prevent aspiration) surgical closure before phonation to prevent hypernasality. * Choanal atresia: Congenital blockage of the posterior nares due to the persistence of the bony septum in 90% of cases or soft tissue septum in 10% of cases. Inability to pass catheter in the resuscitation room. Respiratory distress due to upper airway obstruction. Must use oral airway if bilateral closure detected until a surgical correction occurs. *Tracheal-esophageal fistula (TOF): It May happen isolated or with VATER syndrome. Esophageal atresia with distal TOF occurs in 85% Suspected in polyhydramnios. A lot of secretions with cough and choking with feeding. Failure to pass the nasogastric tube beyond the proximal esophagus. Do an X-ray to diagnose...
Read more

Neonatal examination

 HISTORY taking and Neonatal examination: Perinatal history: Prenatal: ( maternal history during pregnancy): -Age. -Blood group. -Illness. -Drugs, X-rays. -Trauma. Natal: _Anathesthesia. -Site of labor. -Type of labor. -Duration. -Premature rupture of the membrane. Postnatal: _Condition of the baby. -resuscitation. Past history: -History of abortions. -IUFD or premature. Family history: -Number of kids. -Similar condition. -Consanguinity. -Inherited diseases. ** Newborns are examined immediately after birth to check for major abnormalities and then should be examined with a complete physical examination within 24 hours of delivery. EXAMINATION: Quick examination. Detailed examination. Special examination. Quick examination : (in the delivery room). Agar score : -At 1 and 5 minutes. -At 10 and 20 minutes if the score at 5 minutes <7. -Check the baby's activity, pulse, grimace, appearance, and respiratory rate. -Placed on the servo with neck baby. Color: -An indicator of cardiopul...
Read more

Post-term and low birth weight:

 Post-term: Baby born after 42 weeks of gestation. Post-mature : Baby born after 40 weeks gestation by 7 days or more. Etiology: Unknown (large-size parent, multi-gravity, or diabetic mother ). Association with Anencephaly due to defect pituitary adrenal axis or with trisomies. Cinical manifestation: *Mostly increase the birth weight with normal length and head for gestational age. *Exception syndromes and degenerative changes in the placenta. *small for gestational age. 1st stage: ➤ Pale wrinkled dry skin with absent lanugo hairs, and long nails.                ➤ decrease subcutaneous fat.                 ➤ open-eyed baby. 2nd stage: with the above:                   ➤ meconium stain skin.                  ➤perinatal depression. 3rd stage: with the above:             ...
Read more