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A preterm infant is a baby born before 37 weeks of pregnancy.
A preterm infant is a baby born before 37 weeks of pregnancy.
True (A)
What are some factors that can be used to determine a baby's gestational age?
What are some factors that can be used to determine a baby's gestational age?
A baby born at 38 weeks is considered a preterm infant.
A baby born at 38 weeks is considered a preterm infant.
False (B)
What is the gestational age range for full term babies?
What is the gestational age range for full term babies?
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What are the categories of preterm births?
What are the categories of preterm births?
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A baby born at 28 weeks is considered what type of preterm birth?
A baby born at 28 weeks is considered what type of preterm birth?
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What is the main reason preterm infants need intensive care?
What is the main reason preterm infants need intensive care?
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According to the reading, what is a major determinant of neonatal death rates?
According to the reading, what is a major determinant of neonatal death rates?
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The exact cause of premature labor and early birth is known.
The exact cause of premature labor and early birth is known.
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What is the name of the condition that involves high blood pressure during pregnancy and may cause complications?
What is the name of the condition that involves high blood pressure during pregnancy and may cause complications?
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The American College of Obstetricians and Gynecologists (ACOG) recommends late preterm delivery for twins.
The American College of Obstetricians and Gynecologists (ACOG) recommends late preterm delivery for twins.
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Spontaneous preterm delivery always has an obvious trigger.
Spontaneous preterm delivery always has an obvious trigger.
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Toxoplasmosis is a type of infection that can affect pregnant women and potentially lead to preterm birth.
Toxoplasmosis is a type of infection that can affect pregnant women and potentially lead to preterm birth.
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What is the name of the infection that affects the placenta and amniotic fluid?
What is the name of the infection that affects the placenta and amniotic fluid?
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The biggest risk factor for premature birth is prior premature births.
The biggest risk factor for premature birth is prior premature births.
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What is the name of the condition that occurs when the cervix weakens and opens too early, potentially leading to preterm birth?
What is the name of the condition that occurs when the cervix weakens and opens too early, potentially leading to preterm birth?
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What are some of the risk factors for preterm birth during pregnancy?
What are some of the risk factors for preterm birth during pregnancy?
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Fetuses with structural congenital heart defects are more likely to be born preterm than fetuses without congenital heart defects.
Fetuses with structural congenital heart defects are more likely to be born preterm than fetuses without congenital heart defects.
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Socioeconomic factors do not play a role in preterm birth rates.
Socioeconomic factors do not play a role in preterm birth rates.
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The skin of a preterm infant is usually smooth and well-hydrated with plenty of subcutaneous fat.
The skin of a preterm infant is usually smooth and well-hydrated with plenty of subcutaneous fat.
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Preterm infants have a higher risk of developing anemia.
Preterm infants have a higher risk of developing anemia.
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Jaundice is a condition that is only found in preterm infants.
Jaundice is a condition that is only found in preterm infants.
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Phototherapy is a treatment used to help reduce jaundice in newborns.
Phototherapy is a treatment used to help reduce jaundice in newborns.
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If preterm infants don't have enough surfactant in their lungs, it is harder for them to breathe.
If preterm infants don't have enough surfactant in their lungs, it is harder for them to breathe.
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Periventricular hemorrhage occurs primarily in full-term infants.
Periventricular hemorrhage occurs primarily in full-term infants.
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What is the name of the highly vascularized region in the brain where bleeding often originates during periventricular hemorrhage?
What is the name of the highly vascularized region in the brain where bleeding often originates during periventricular hemorrhage?
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The significance of periventricular hemorrhage decreases after 34 weeks of gestation.
The significance of periventricular hemorrhage decreases after 34 weeks of gestation.
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What is the term for very low birth weight, usually considered less than 1500 grams?
What is the term for very low birth weight, usually considered less than 1500 grams?
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How many grades of periventricular hemorrhage are there?
How many grades of periventricular hemorrhage are there?
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What is the recommended timing for a head ultrasound for a high-risk preterm baby?
What is the recommended timing for a head ultrasound for a high-risk preterm baby?
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What is the recommended timing for a head ultrasound for a baby born at less than 32 weeks gestation and less than 1500 grams?
What is the recommended timing for a head ultrasound for a baby born at less than 32 weeks gestation and less than 1500 grams?
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If a baby is born at 30 weeks gestation and weighs 1200 grams, when should the head ultrasound be done?
If a baby is born at 30 weeks gestation and weighs 1200 grams, when should the head ultrasound be done?
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What is the recommended frequency of cranial ultrasounds for premature neonates?
What is the recommended frequency of cranial ultrasounds for premature neonates?
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Study Notes
Preterm Infant Definition
- A preterm infant is a baby born alive before 37 weeks of pregnancy are completed.
- Full-term gestation is typically 40 weeks (range 37 to 42 weeks).
- A preterm infant is traditionally defined as a live-born infant born before the end of week 37 of gestation.
Determining Gestational Age
- Neonatal assessment (Ballard Scoring) is used to determine gestational age.
- This involves examining sole creases, skull firmness, ear cartilage, and neurologic development.
- Mothers' last menstrual period and sonographic estimation of gestational age are also helpful.
Newborn Evaluation
- Newborns should be evaluated immediately after birth to determine weight, height, head circumference, and gestational age.
- This helps to determine immediate healthcare needs and anticipate possible future problems.
- Preterm birth occurs in approximately 11% of live births worldwide.
Preterm Infant Needs
- Preterm infants require intensive care from the moment of birth to maximize survival chances.
- They are more prone to complications like hypoglycemia, intracranial hemorrhage, and Respiratory Distress Syndrome (RDS).
- Limited glycogen and fat stores and undeveloped blood vessels increase their vulnerability.
- Lack of lung surfactant is a significant factor for preterm infants.
Categories of Preterm Birth
- Late Preterm: Born between 24 and 34 weeks.
- Early Preterm: Born between 34 and 37 weeks.
- Moderate Premature: < 37 weeks.
- Very Premature: < 34 weeks
- Extremely Premature: < 32 weeks
- Preterm: <28 weeks
Non-Premature Infant Categories
- Early Term: 37 to 38 6/7 weeks.
- Full Term: 39 to 40 6/7 weeks.
- Late Term: 41 to 41 6/7 weeks.
- Post Term: ≤42 weeks.
Etiology of Premature Labor and Birth
- The exact cause of premature labor and early birth is currently unknown.
- Premature rupture of membranes (PROM) and other infections are possible causes.
- Gestational age is a major determinant of neonatal death rates.
- Infant mortality due to preterm birth accounts for 80-90% of infant mortality in the first year of life.
- Possible causes include multiple pregnancies, pre-eclampsia, placenta abnormalities.
Elective Preterm Delivery
- ACOG recommends late preterm delivery in pregnancies with complications (multiple gestation, preeclampsia, placenta abnormalities, PROM).
- Delivery may be as early as 32 weeks in selected cases involving multiple gestation with complications.
Spontaneous Preterm Delivery
- Spontaneous preterm delivery often has no clear, immediate trigger;
- Infections (intra-amniotic infection), infectious diseases, placental abruption and other issues are probable causes.
Risk Factors for Preterm Birth
- Past obstetric history (previous premature births, multiple pregnancies, abortions)
- Current pregnancy-related factors (poor nutrition, smoking, certain medical conditions, race, age, order of birth)
- Socioeconomic factors (low socioeconomic status, less formal education)
Signs and Symptoms of Preterm Infants
-
General: Head appears disproportionately large, skin is often unusually ruddy and translucent, extremities may not hold flexed; delivered at greater than 28 weeks of gestation; and covered with vernix caseosa.
- Early induction of labor, elective cesarean section.
- Ear: Immature ear cartilage; ears may appear large relative to the head.
- Eyes: Varying degrees of myopia (nearsightedness); ophthalmoscopic examination is challenging due to hazy vitreous humor.
- Reflexes: Spontaneous and provoked muscle movements may be present, but coordination of sucking, swallowing, and breathing might be absent, and reflexes like the Achilles tendon reflex may be reduced.
- Neurologic: Less active than a mature infant, and cries, if any, may be weak and high-pitched.
- Other: Presence of few or no rugae (folds) in the scrotum, female labia might not cover the minor labia.
- Feet: Flat soles are often present in preterm newborns at 28 weeks.
- Other: Presence of creases in the feet.
Potential Complications of Prematurity
- Anemia
- Acute bilirubin encephalopathy
- Persistent patent ductus arteriosus
- Periventricular hemorrhage
Anemia of Prematurity
- Immaturity of the hematopoietic system may occur in infants <32 weeks of age.
- Destruction of red blood cells (low levels of Vit E); Normochromic, Normocytic Anemia,
- Pale, Lethargic, and Anorexic; Delaying cord clamping may improve blood entry into the newborn
Acute Bilirubin Encephalopathy
- Excessive breakdown of red blood cells at birth leads to high bilirubin concentrations in the bloodstream; high serum bilirubin may result in jaundice.
- Jaundice can lead to brain tissue damage.
- Preventative measures such as phototherapy are used.
- Further measure include an Exchange Transfusion
Persistent Patent Ductus Arteriosus
- Lack of surfactant, difficulty moving blood, pulmonary hypertension, closure of the ductus arteriosus are issues in preterm infants.
- Preventive measures include administering IV medication such as indomethacin or ibuprofen.
Periventricular/Intraventricular Hemorrhage
- Periventricular hemorrhage occurs in the tissue surrounding the ventricles of the brain.
- Premature infants are at high risk for bleeding; the prevalence increases with immaturity.
- The risk of brain anoxia increases with injury distal from the rupture.
Cranial Ultrasound Scheduling
- Scheduling cranial ultrasound, for VLBW or infants born early ( <32 weeks), varies by facility/hospital.
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Description
This quiz covers the definition and characteristics of preterm infants, focusing on gestational age determination and newborn evaluation. Learn about the importance of immediate healthcare needs for preterm infants and the assessment methods used to evaluate their condition after birth.
