Other Neonatal problems - Paediatrics

Other Neonatal problems

Infant Drug Withdrawal Syndrome *

·        For first 2 weeks after delivery if mother is abusing heroin, methadone, other narcotics:

o   Jitteriness

o   Sneezing

o   Yawning

o   Poor Feeding

o   Vomiting

o   Diarrhoea

o   Weight loss

o   Seizures

Child of Diabetic Mother *

·        Maternal complications: polyhydramnios, preterm labour, still birth near term 

·        Fetal: ­malformations, macrosomic, growth retarded 

·    After birth: hypoglycaemia, hypocalcaemia, respiratory distress (surfactant doesn‟t ­ till later in gestation) , polycythaemic (venous haematocrit > 0.65, looks plethoric. May require exchange transfusion to remove RBCs)

Transient Tachypnoea of the Newborn *

·        Occurs in both term and prem babies

·        ?Delayed absorption of amniotic fluid from lungs

·        Risk factors: C-section, perinatal asphyxia, excessive analgesia, hypothermia

·        Presentation: subcostal recession, grunting, and cyanosis all seen but not prominent 

·        CXR: inflated lung fields, perihilar opacities, ­vascular markings

·        Treatment: O2 for several days, respiratory failure uncommon.  Penicillin if ?congenital pneumonia

Meconium Aspiration *

·        Hypoxia during labour ® gasp ® aspirate meconium (+/- vernix, meconium, blood)

·        ®Patchy lung collapse and over inflation (ball valve effect) 

·        Complications: pneumothorax and pneumomediastinum (® angel wing appearance on CXR due to air under the thymus) 

·        Treatment: suction via ET tube