Maternal Distress and Newborn Examination

Questions and Answers

What is the purpose of the Ballard Score in assessing newborns?

To determine the weight of the infant.

To assess respiratory function in newborns.

To measure the infant's temperature after birth.

To evaluate the gestational age of the baby in weeks. (correct)

Which of the following factors should NOT be considered when conducting a physical examination of a newborn?

Parental medical history. (correct)

Gestational age of the infant.

Postnatal condition of the baby.

Anthropometric measurements.

When can a complete physical examination of an acutely ill newborn be postponed?

After the initial resuscitation when the baby is stable. (correct)

For as long as the baby is being breastfed.

Immediately after birth regardless of condition.

Only at the time of discharge from the hospital.

What does the Fenton growth chart primarily classify?

Whether the baby is small for age or large for age. Signup and view all the answers

Which of the following is considered a common birth injury?

Cephalhematoma. Signup and view all the answers

What is the main purpose of conducting a complete physical examination of a newborn after 90 hours of life?

To detect congenital anomalies not identified at birth Signup and view all the answers

Which of the following anomalies is most commonly noted during the initial examination of a newborn?

Polydactyly Signup and view all the answers

During which time frame is the first physical examination (PE) of a newborn conducted?

Within the first 10 minutes after birth Signup and view all the answers

What is the significance of the APGAR score during the initial assessment of a newborn?

It assesses the newborn's immediate health and vital functions Signup and view all the answers

Which of the following is NOT part of the core steps of Early Initiation of Newborn Care (EINC)?

Taking parental medical history Signup and view all the answers

Study Notes

Newborn Assessment Overview

Every newborn should undergo a complete physical examination, focusing on maternal distress, familiar disorders, or problems detected during pregnancy.
The initial evaluation occurs within the first 90 hours of life, allowing early detection of congenital anomalies.

APGAR Score and Initial Examination

The first physical examination reveals a greater number of abnormalities than subsequent evaluations.
Assessment includes assigning an APGAR score within the first 10 minutes after birth, with a cursory inspection for major anomalies.

Key Physical Examination Steps

Final step in Early Initiation of Nutritional Care (EINC) is the non-separation of the newborn from the mother to promote breastfeeding.
Complete physical examination involves anthropometric measurements and Ballard's Score to assess gestational age and identify prematurity.
Fenton growth charts are used to classify newborns based on size (small for age or large for age).

Common Anomalies Detected

Skin tags and polydactyly occur in 10-15 per 1000 births.
Other anomalies include cleft lip/palate, congenital heart defects, congenital hip dislocation, Down syndrome, and talipes, all at 1-4 per 1000 births.
Rare severe anomalies like spina bifida and encephalocoele affect 1-4 in 10,000 births.

Fontanelle Assessment

Abnormalities of fontanelles can indicate potential issues:
- Large fontanelles may suggest skeletal disorders or hypophosphatasia.
- Small fontanelles may indicate hyperthyroidism or craniosynostosis.
Associated conditions like myelomeningocele and orbital encephalocele require careful evaluation.

Gender Ambiguities

Assess for ambiguous genitalia with care; inform parents about the need for further evaluation without making premature decisions.
Evaluate the size of genitalia, strength, and position of urethral meatus, alongside checking for conditions like hypospadias and undescended testis.

Extremities and Birth Injuries

Examine extremities for trauma or malformation; check hips for developmental dysplasia using Barlow and Ortolani tests.
Common birth injuries include lacerations, cephalhematoma, anencephaly, and others that can significantly impact newborn health.

Syndromes and Genetic Testing

Use pattern recognition for diagnosing dysmorphic syndromes by comparing clinical findings to a broad knowledge base.
Cytogenetic studies (karyotyping, FISH analysis) are critical for confirming diagnoses and assessing recurrence risks in families.

Management and Counseling

Accurate diagnoses of genetic disorders enhance anticipatory guidance, medical monitoring, and improve quality of life.
Understanding genetic implications is vital for the entire family, considering the potential for carrier status among parents and siblings.

Description

This quiz examines the potential problems arising from maternal distress during pregnancy and the assessment of newborns. It covers the importance of identifying congenital anomalies and the routine physical examinations newborns should undergo after birth to ensure their health.