Obstetrics and Neonatal Period Quiz

Neonatal Period

• The neonatal period includes the early neonatal period (from birth to 7th day of life) and late neonatal period (from 7th to 28th day of life).
• The early neonatal period is also known as the critical period.

Intranatal Period

• The intranatal period is from 28 weeks of pregnancy until birth.

Premature Babies

• Premature babies are born before 37 weeks of pregnancy.
• Premature babies are at risk of developing respiratory distress syndrome, hypothermia, and infection.
• Premature babies weighing less than 2000g are at risk of developing cerebral hemorrhage.

Post-term Babies

• Post-term babies are born after 42 weeks of pregnancy.
• Post-term babies are at risk of developing fetal distress and meconium aspiration syndrome.

Physical Development

• Physical development of a newborn is assessed by gestational age, body weight, and body length.
• The body weight of a newborn is normally 2.5-4 kg.

Neuromuscular Status

• The neuromuscular status of a newborn is assessed using the Apgar scale.

Prevention of Conjunctivitis

• Conjunctivitis in newborns can be prevented by applying antibiotic ointment or eye drops in the first hour of life.

Morphological Characteristics

• Morphological characteristics of a newborn include skin transparency, ear shape, and breast formation.

Initial Weight Loss

• Initial weight loss in premature infants depends on the birth weight, gestational age, and fluid intake.

Transient Hyperbilirubinemia

• Transient hyperbilirubinemia of prematurity is not characterized by the development of kernicterus even with low levels of indirect bilirubin.

Regulation of Body Temperature

• The regulation of body temperature in newborns is important for preventing hypothermia and hyperthermia.
• Brown adipose tissue plays a crucial role in regulating body temperature in newborns.

Seizures

• Seizures in newborns are most rarely observed when the reason is subarachnoid hemorrhage.

Pathological Acidosis

• Pathological acidosis in newborns can be caused by intrauterine pneumonia, progressive asphyxia, and hypoxic-traumatic damage to the central nervous system.

Activities in the Delivery Room

• Activities in the delivery room immediately after birth include sanitation of the respiratory tract, assessment of the newborn's condition using the Apgar scale, drying the newborn, and umbilical cord treatment.

Cephalohematoma

• Cephalohematoma is a hemorrhage between the skull bone and the periosteum, limited to the boundaries of one skull bone.

CNS Lesions

• CNS lesions in newborns are most common in full-term newborns born with severe asphyxia.

Intracranial Hemorrhage

• The most common location of intracranial hemorrhage in premature infants with low and extremely low body weight is the subarachnoid region.

Clonic-tonic Convulsions

• Clonic-tonic convulsions in newborns are observed with increased intracranial pressure, hypoglycemia, and hypomagnesemia.

Cerebral Edema

• Cerebral edema in newborns can be treated with osmotically active substances, saluretics, and barbiturates.

Toxoplasmosis

• Toxoplasmosis in newborns can cause meningoencephalitis and eye damage.

Herpes

• Herpes in newborns can be treated with acyclovir.

Chlamydia

• Chlamydia in newborns can cause purulent conjunctivitis, rhinitis, and interstitial pneumonia.

Pemphigus

• Pemphigus in newborns is a benign form of pemphigus, characterized by numerous flaccid blisters, mostly large in size.

Development of Premature Newborns

• Premature newborns reach their peers in psychomotor development in 1-2 years.
• Children with extremely low body weight reach their peers in psychomotor development in 2-3 years.

Sepsis

• Sepsis in newborns can be caused by Streptococcus aureus, Staphylococcus, Klebsiella, and Escherichia coli.
• The etiology of sepsis does not include Bordet-Gengou stick.

Osteomyelitis

• Osteomyelitis in newborns most often affects the femur and humerus.

Septic Shock

• Septic shock in newborns is characterized by a three-stage process.

Neonatal Sepsis

• Neonatal sepsis can be caused by Streptococcus aureus, Staphylococcus, Klebsiella, and Escherichia coli.
• The most common localization of Figner's pseudofurunculosis is the skin of the buttocks, limbs, and axillary area.

Umbilical Vessels

• Diseases of the umbilical vessels are often observed in children with prematurity, umbilical fistulas, and umbilical hernias.

Neonatal Infections

• Neonatal infections can be caused by bacteria, viruses, and fungi.

Predisposing Factors

• Predisposing factors for the development of neonatal sepsis include chronic fetal hypoxia, asphyxia during childbirth, and Caesarean section.

Osteomyelitis

• Osteomyelitis in newborns can be caused by Staphylococcus aureus, Staphylococcus, and Klebsiella.

Jaundice

• Jaundice in newborns can be caused by immaturity of the newborn's enzyme system, presence of glucuronyltransferase system inhibitors, and hypogalactia.

Bilirubin

• Bilirubin in newborns is normally broken down into stercobilin in the intestines.

Hemolytic Jaundice

• Hemolytic jaundice in newborns can be caused by violation of the synthesis and structure of hemoglobin, incompatibility of maternal and fetal blood for erythrocyte antigens, and breakdown of red blood cells with fetal hemoglobin.- Laboratory Triad for Minkowski-Choffard Anemia*
• Increased osmotic resistance of red blood cells, erythropenia, poikilocytosis
• Erythrocyte Enzymopathies in Newborns*
• Develop due to enzyme deficiency, specifically: • Phosphohexoisomerase, AST, G-6PD • G-6PD, glutathione reductase, lactate dehydrogenase
• G6PD Enzyme Deficiency*
• Clinical forms do not include: • Hypoplastic anemia
• Signs of thalassemia do not include: • Hyperchromic anemia
• In congenital G-6PD deficiency: • Decreased osmotic resistance of red blood cells • (-) Coombs reaction
• Hemolytic Disease of the Newborn*
• Symptoms of bilirubin intoxication: • Tremor of the upper extremities, convulsions • "Setting sun" symptom, "brain scream"
• In full-term infants, indication for exchange blood transfusion: • Indirect bilirubin level more than 340-340 µmol/l, hourly increase more than 6 µmol/l
• Pneumonia in Newborns*
• Causative agent of congenital transplacental pneumonia: • Listeriosis
• Risk factors for developing pneumonia: • Long water-free period • Endocrine pathology in the mother
• Types of pneumonia in newborns: • One and bilateral bronchopneumonia, small and large focal • Pleuropneumonia, bronchopneumonia, small and large focal, interstitial
• Vitamin B12 Deficiency*
• Main symptom: • Atrophy of the papillae of the tongue
• Respiratory Failure*
• Ratio of pulse to respiration number: • 1st degree: 1.5-1.0 : 1 • 2nd degree: 2-1.5 : 1
• Megaloblastic Anemia*
• Not applicable: • Iron deficiency (due to lack of iron)
• Characteristics: • Iatrogenic (medicinal) • Vitamin B12 deficient • Folate deficiency (malnutrition or malabsorption) • Anemia associated with impaired DNA and RNA synthesis
• Erythropoiesis*
• Hematopoietic blood in the bone marrow appears in the prenatal period: • 3-4 weeks
• Erythrocytes in the fetus at 5-6 weeks of intrauterine development are formed in: • Yolk sac
• Lifespan of erythrocytes in peripheral blood on the first day of life of a full-term baby: • 30-40 days### Conjugated Jaundice of Newborns
• Does not apply to:
  • Transient jaundice of newborns
  • Kligler-Nayjar syndrome
  • Alagille syndrome
  • Gilbert–Meulengracht syndrome
  • Breast milk jaundice

Hemolytic Disease of Newborns

• Develops with conflict according to the ABO system:
  • Mother has B (III) blood type, child has 0 (I)
  • Mother has A (II) blood type, child has 0 (I)
  • Child has AB (IV) blood type
  • Mother has 0 (I) blood group, child has A (II) or B (III) blood group
• Characteristic sign of edematous form of hemolytic disease of newborn based on Rh conflict during ultrasound examination:
  • Buddha pose
• Indication for exchange blood transfusion in full-term newborns:
  • Level of indirect bilirubin in the blood: more than 340 µmol/l

Pneumonia

• Pulmonary complications:
  • Cardiovascular failure
  • Adult respiratory distress syndrome
  • Infectious-toxic shock
  • Disseminated intravascular coagulation syndrome (DIC)
  • Pneumothorax
• Pathogens:
  • Leading role in etiology of hospital-acquired pneumonia: E. coli
  • Leading role in etiology of community-acquired pneumonia: Pneumococci
• Antibiotics:
  • Macrolides: first line antibiotic prescribed for chlamydia pneumonia
  • Amphotericin B: used for children with pneumonia of fungal etiology
• Classification of acute pneumonia:
  • Lobar, interstitial, focal, segmental
• Main clinical signs:
  • Hyperthermia, shortness of breath, local crepitation on auscultation

Respiratory Failure

• Sequence of stages:
  • Compensated, subcompensated, decompensated, asphyxia

Vitamins and Nutritional Deficiencies

• Vitamin deficiency:
  • Beri-Beri disease: caused by vitamin B1 deficiency
  • Bitot spots on the conjunctiva of the eye: caused by vitamin A deficiency
  • Megaloblastic anemia: caused by folic acid deficiency
• Rickets:
  • Characteristic changes in the skeletal system:
    • Periarticular thickening
    • "Rachitic rosary" formation
  • Initial period signs:
    • Functional changes in the nervous system
    • Retarded physical development
  • Treatment:
    • Vitamin D administration
    • Nutrition correction
  • Long-term use of phenobarbital may cause development of rickets in children
• Hypovitaminosis:
  • In infants, endogenous causes do not include:
    • Feeding the child low-quality food
  • Vitamin D deficiency:
    • Prone to development of rickets

Spasmophilia

• Signs:
  • Hypocalcemia
  • Carpopedal spasm
  • Laryngospasm
  • Eclampsia
  • Convulsions
• Treatment:
  • Anticonvulsant drugs:
    • Seduxen
    • Vitamin E
• Age of children at which spasmophilia is most often observed:
  • 6-18 months

Malnutrition

• Uniform retardation in body weight and height from age norms:
  • Hypostatura
• Signs:
  • Stage I malnutrition:
    • Slight decrease in subcutaneous fat
    • Body weight deficiency: 5-10%
  • Stage II malnutrition:
    • Decreased appetite
    • Body weight deficiency: 11-20%
  • Stage III malnutrition:
    • Thinning of the subcutaneous fat layer
    • Body weight deficiency: more than 30%
• Diet therapy:
  • Initial stage:
    • Determining food tolerance
  • Period of detecting food tolerance:
    • Stage I malnutrition: 3-7 days
    • Stage II malnutrition: 10-14 days
    • Stage III malnutrition: 1-2 months

Hydration and Dehydration

• Oral rehydration:
  • Solution used: rehydron
• Dehydration:
  • Mild dehydration: loss of body weight: 5%
  • Moderate dehydration: loss of body weight: 10-15%
  • Severe dehydration: loss of body weight: more than 21%

Dyspepsia

• Causes:
  • Unfavorable premorbid background
  • Qualitative imbalance of food ingredients
  • Incorrect prescription of complementary foods
  • Eating low-quality baby food
• Signs:
  • Intestinal dysfunction
  • Flatulence
  • Sleep disturbance
  • Vomiting
• Stool analysis:
  • Characteristic signs:
    • Soaps of simple fatty acids
    • Presence of a large amount of neutral fats
    • Presence of free fatty acids