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High Risk NB
SGA, LGA, IDM, MAS
| Question | Answer |
|---|---|
| SGA is defined as | Birth wt. > 2SD BELOW mean or less than 10th percentile |
| 2 types of SGA: | Symmetrical, asymmetrical |
| Which type of SGA is better? Why? | Asymmetrical because head has fairly normal growth pattern, meaning brain has been developing at normal pace |
| SGA babies should be able to feed well if they are ____ and ______ | term and stabilized |
| SGA babies weigh less _______ if term | 2500 grams |
| Symmetrical SGA refers to | Brains + body are small and underdeveloped; abnormal brain growth bad sign |
| What are discordant twins? | One twin gets all blood/nutrients while other twin has to fight for it. SGA twins are very hardy. |
| List causes of symmetrical SGA (4) | Intrinsic fetal causes, intrauterine infection (TORCH), severe placental insufficiency, constitutionally small infant |
| TORCH stands for | Toxoplasmosis, Other, Rubella, Cytomegalovirus, Herpes |
| There potential for ___, ______ infections for babies | Multiple, massive |
| Want mother to avoid infection by | Maintaing good hygiene, updated immunizations, staying away from infectious sources (sushi, litter boxes) |
| List causes of asymmetric SGA | Caused by interference with placental function or maternal health in 3rd trimester |
| LGA babies weigh > _____ and are ____ of the growth curve | 4500 grams (9 lbs 15 oz); top 10% of growth curve (90% above) |
| LGA babies have increased risk of | ADHD, learning difficulties, developing DM later in life, socializing issues |
| Infant of Diabetic Mother has a primary risk of ____ | Hypoglycemiaa |
| Common cause of macrosomia/LGA is _____ | Hyperinsulinemia |
| IDM have increased ____ issues and potential for ____ injury during birth | Respiratory; mechanical injury (shoulder dystocia) |
| How can we avoid severe hypoglycemia? | Tightly maintain mom's BG |
| Management in labor of IDM | Put mom on insulin drip, carefully monitor mom's BG = less complications |
| IDM babies have a HCT of ___ | > 65, polycythemia |
| Polycythemia leads to _____ and _____ feeding | Hypoxia, poor feeding |
| IDM often look | Ruddy |
| MAS stands for | Meconium aspiration syndrome |
| Mortality of significant MAS is ____ | 20% |
| Thin meconium is a ____ color and indicates | Off-color green; baby has been swimming in meconium longer |
| Terminal meconium refers to | Baby pooping as baby is born |
| Chunky meconium indicates | Baby just pooped |
| Meconium stained | Baby's body looks greenish since baby has been swimming in meconium for a while |
| ___ is not better in amniotic fluid. ___ fluid is more easily aspirated. | Trace; thinner fluid |
| Thicker meconium in AF leads to worse _____ | Obstruction |
| How do we prevent MAS? | Set up all deliveries with resuscitation equipment, check vocal cords and DO NOT agressively suction. Use bulb syringe. |
| What happens if we over-suction a baby with MAS? | Oral airway overstimulated --> heart rate goes down |
| MAS monitoring and treatment includes close respiratory assessment for _____ | First 48 hours |
| If baby is sx of MAS, then we manage using | CXR, antibiotics, O2, mechnical support, IV hydration, nutrition |
Created by:
lapio-obgyn
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