NEONATAL DISORDERS NEONATAL DISORDERS Prematurity Hypothermia Hypoglycaemia Asphyxia

NEONATAL DISORDERS

NEONATAL DISORDERS � � � Prematurity Hypothermia Hypoglycaemia Asphyxia neonatorum Respiratory infections Jaundice Transient tachypnoea of newborn Birth injuries RDS & SIDS Malnutrition Genetic and congenital anomalies

NEONATAL TESTING : � The Apgar Scale: The Apgar Scale is used within the first five minutes after birth; the infant's heart rate, respiratory effort, muscle tone, body color, and reflexes are analyzed. � Results should be: seven to 10 = normal or good condition; five = may have developmental difficulties; three or below = high or increased risk of death.

DIAGNOSTIC THERAPIES � Ultrasound: An ultrasound exam is a procedure that uses high-frequency sound waves to scan a woman's abdomen and pelvic cavity, creating a picture (sonogram) of the baby and placenta. � Fetal Echocardiography: Fetal echocardiography ultrasound waves assess the baby's heart anatomy and function and check for congenital heart defects.

AMNIOCENTESIS � Amniocentesis involves extracting and examining DNA and chromosomes from the mother in order to determine if the baby has a chromosome disorder or fetal lung maturity. � This is done mainly to determine if the fetus has Down's syndrome, which is more prevalent among children with older mothers. � Amniocentesis is best performed at 15 -17 weeks of gestation, but occasionally as early as the 14 th or as late as the 20 th week. � Amniocentesis can also be performed in the last trimester to assess the maturity of the fetal lungs.

CHORIONIC VILLI SAMPLING � Chorionic villi sampling (CVS) is done to determine if the child has a chromosomal disorder, such as sickle-cell anemia, most types of cystic fibrosis, or Down's syndrome. � Chorionic villi sampling involves placing a small needle or catheter either through the abdomen or through the vagina near the uterus in order to collect a small sample of placental tissue called chorionic villi. � Ultrasound is used at the same time in order to guide the needle or catheter away from the baby and the placenta. The test can be done as early as 10 weeks and is most commonly done between the 10 th and 13 th weeks of pregnancy.

GLUCOSE SCREENING � With good medical care, women with preexisting or gestational diabetes can have an uncomplicated pregnancy and a healthy baby, as long as blood sugar levels are well controlled. A glucose screening can let the woman know if she is at risk. Most practitioners check for gestational diabetes at about 28 weeks.

APHA-FETO PROTEIN: � The alpha-fetoprotein test (AFP test) is where a blood sample is drawn from the mother to check the levels of AFP is a protein secreted by the fetal liver and excreted in the mother's blood. � It is generally used to provide a screening for neural tube defects like spina bifida and ancephaly. � It can also indicate: abdominal wall defects, esophageal and duodenal atresia, some renal and urinary tract anomalies, Turner syndrome, some low birth-weight fetuses, placental complications, and the presence of Down's syndrome.

TRIPLE SCREENING � The triple screen, also known as a maternal serum screening test or MSS, is a simple and completely safe blood test that measures not only AFP, but h. CG and estriol as well. These are all hormones produced by the fetus and passed into the mother's bloodstream. � The test is performed between the 15 th and 18 th weeks, with the results usually available within one week. Elevated levels of AFP in the mother's blood can indicate a neural tube defect in the baby such as a deformity of the spinal canal known as spina bifida. � Lower levels of AFP suggest a possible child with Down's syndrome or other chromosomal defects.

QUADRUPLE SCREENING: � Again, using a sample of the mother's blood, a quadruple screen measures a woman's levels of alpha-feto protein, h. CG, estriol, and inhibin to indicate her baby's risk of Down's syndrome. � The quadruple test is about 81% effective and is usually performed around the 16 th week of pregnancy. If a risk of Down's syndrome is indicated, amniocentesis can be performed to confirm the diagnosis.

TREATMENT � General: Nutrition is a fundamental pillar of human life, health, and development across the entire life span. � From the earliest stages of fetal development, at birth, and through infancy, childhood, adolescence and on into adulthood, proper food and good nutrition are essential for survival, physical growth, mental development, performance, productivity, health, and well-being.

SUDDEN INFANT DEATH SYNDROME (SIDS): � Individuals can take steps to help reduce the risk of sudden infant death syndrome SIDS in the infant. First and foremost, put the infant to sleep on his or her back if the baby is younger than one year old. � place the baby on a firm mattress to sleep, never on a pillow, waterbed, sheepskin, or other soft surface.

� To prevent re-breathing, do not put blankets, comforters, stuffed toys, or pillows near the baby. � Make sure the baby does not get too warm while sleeping. � Keep the room at a temperature that feels comfortable for an adult in a short-sleeve shirt.

� It is recommended not to smoke, drink, or use drugs (unless prescribed by a doctor) while pregnant. Pregnant mothers and newborns should not be exposed to secondhand smoke. � Infants of mothers who smoked during pregnancy are three times more likely to die of SIDS

� Breastfeeding is important, if possible. There is some evidence that breastfeeding may help decrease the incidence of SIDS. Substances found in breast milk may help protect babies from infections that increase the risk of SIDS.

NEONATAL JAUNDICE: � Treatment is usually unnecessary. � Treatment involves phototherapy with artificial or natural sunlight. � if phototherapy is not successful, exchange transfusion in which the infant's blood is exchanged for normal blood from blood donors. � Artificial lights work by helping to break down bilirubin in the skin. The eyes are protected from the light.

� keep the baby well-hydrated (breast milk and formula are preferable to glucose water) and encourage frequent bowel movements by feeding frequently. � This is because broken down bilirubin is carried out of the body by the intestines in the stools (bilirubin is what gives stools their brown color).

PREVENTION � Vaccinations: Healthcare professionals recommend that parents immunize children according to healthcare authorities in their area � Diarrhea can be prevented by good hygiene and sanitary practices. � Sudden infant death syndrome (SIDS): Getting medical care early in pregnancy, preferably within the first three months, followed by regular checkups at the doctor's office or health clinic, is important

RESPIRATORY ILLNESSES: � Preventing respiratory illnesses, such as colds and influenza, in children is difficult. One contributing factor is indoor air pollution; air quality may be monitored with the use of various devices, such as radon detectors. � Home owners may also wish to improve heating and ventilation systems. � Children should wash hands frequently with soap and water. Surfaces prone to the growth of germs should also be washed frequently; examples include doorknobs, toys, and kitchen and bathroom counters and sinks.

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