Studydroid is shutting down on January 1st, 2019
Cloned from: NEONATAL



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↑AFP
R - renal (nephrosis, agenesis, old)
A - abd wall defects
I - incorrect dates
N - (neuro) anencephaly/spinabifida
Non Stress Test (NST)
most unreliable (low specificity) test of fetal well-being

spontaneous fetal movement & HR under normal intrauterine conditions

fetal autonomic system integrity
first trimester screen
11-13 weeks
nuchal translucency
B HcG
pregnancy-related proteins
Contraction Stress Test
measures fetal tolerance to uterine contraction (labor)

early decels → fetal head compression
variable decels → cord compression
late decels → uteroplacental insufficiency
BPP
8-10 NML
4-6 worried
0-2 bad
second trimester screen
15-22 weeks
triple or quad screen
75-80% detection for trisomy
get amnio next
most accurate GA measure
crown rump length 8-12w
choroid plexus cyst
< 24w do nothing
echogenic cardiac focus
seen on utz → think downs
echogenic bowel
if seen on utz → think aneuploidy, cf, torch
most turn out to be normal
enlargement/asymmetric ventricles
cranial utz after birth
single umbilical artery
low birth weight
cardiac & renal anomaly
trisomy 18
hydronephrosis
> 4mm in 2nd trimester or > 7mm in 3rd trimester get utz after delivery & vcug next
periventricular leukomalacia
bilaterAL periventricular echodensities
management sequence for apnea of prematurity
reposition → stim → caffeine → high flow → nc → cpap→ intubate
wide anterior fontanelle
hypothyroidism
osteogenesis imperfecta
hypophosphatemia
macroglossia
beckwidth weideman
folate deficiency
pompe\'s dz
erbs palsy
c5 c6 (more common)
waiters tip
can grasp
phrenic n injury/diaphragmaric injury
klumpke's
c7 c8 t1 (worse prognosis)
claw/flaccid hand
no grasp
association w horners (T1 - pitosis, miosis, exopthalmos)
mom w lupus
Brady/heart block
get EKG
thrombocytopenia
hepatomegaly
rash
maternal hypothyroidism
mon's synthroid doesn't cross placenta
minimal effect on baby
maternal hyperthyroidism
thryoid stimulating antibodies → baby
neonatal thyrotoxicosis (irritable, tremor, tachy, svt)
1st trimester fetal tachycardia
goiter (can be large)
usually self resolving in 2-4 months
terbutaline
hypoglycemia
maternal cocaine use
IUGR
gastroschisis
cerebral infarcts
tachycardia
hypertension
limb shortening
maternal hypertension
IUGR
SGA
maternal renal insufficiency
mom's creatinine > 1.6 → incr risk of fetal mortality
Azatioprine & isotretinoin
thymic hypoplasia
Maternal HIV
Zidovudine within 12 hours of deliveru x 12 weeks

HIV PCR diagnositic if baby < 18 months
Maternal asthma
TTN
low birth weight
prematurity
Maternal CF
all babies are heterogenous carriers
RDS CXR
Air bronchograms
symmetric
reticulogranular ground glass appearance
Babies at risk for RDS
IDM
C-section
Birth asphyxia
Decreased risk for RDS
PROM
prenatal steroids
maternal HTN
maternal steroid use
BPD CXR
diffuse opacities
cystic areas with streaky infiltrates
TTN CXR
fluid in intralobar fissure (right)
hyperinflation
perihilar streaking
cardiomegaly
MAS CXR
asymmetric
hyperinflation
patchy atelectasis/infiltrates
ECMO eligibility criteria
reversible lung disease < 10-14 days
no systemic or intracranial bleed
no CHD
Wilson-Mikity Syndrome
no hx RDS
no hx prolonged ventilator usage
xray → small cystic changes, fine lacy infiltrates
no inflamatory changes
Early onset GBS
pneumonia
meningitis
sepsis
Late onset GBS
within 1st month
not increased w prematurity
meningitis most common
toxoplasmosis
early in pregnancy → risk low, infx bad
late in pregnancy → risk higher, infx not so bad

maternal LAD
majority of babies asymptomatic
diagnose w immunoflorescence
toxoplasmosis symptoms at birth
G - greatly reduced head (microcephaly)
H - hydrocephalus, hepatosplenomegaly
A - asymptomatic
D - diffuse calcifications
E - eyes (chorioretinitis, cataracts)
Y - yellow (jaundice)
toxoplasmosis also affects whom
immunocompromised, HIV, chemo

Tx → pyrimethamine, sulfadiazine, folinic acid
Neonatal congunctivitis
C - chemical ≤ DOL 2 (irrigate)
G - gonorrhea D2-7 (CTX/cefotax)
C - ≥ DOL 7 (PO erythromycin)
Congenital CMV
Diagnose → urine culture
Periventricular/intracerebral calcifications
Low birth weight
hepatomegaly
jaundice
petechiae
thrombocytopenia
TX → ganciclovir
Congenital Rubella
Cataracts
SNHL
PDA
(hard to distinguish from Toxo/CMV)
Mom w Genital HSV
NSVD/active lesions/baby asymptomatic
surveillance cultures < 24 hours →colonization
CSF PCR after 24-48 hours
contact isolation
defer circ
pulmonary hypoplasia vs CCAM
pulomary hypoplasia → oligo, small lungs

CCAM → poly, depressed diaphragm on affected side
No stool > 48 hours
  • imperforate anus → PE
  • MEC ileus → CF, maternal cocaine usage, get ABD Xray if calcifications get UGI
  • Hirsprungs → Downs, ABD XRAY shows air/fluid level, get barium enema
  • MEC Plug → IDM, ABD XRAY show air/fluid level, get gastrografin enema
NB vomiting

  • Duodenal atresia → poly, bilious in 1st 24 hours, ABD XRAY no distal air

  • Malro/volvulous → bilious, abd xray & ugi

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