Most useful tool in prediction of neurodevelopmental outcomes in baby with moderate encephalopathy secondary to HIE
MRI
Only protective factor for DDH
Prematurity
Type of CP caused by kernicterus
Choreoathetoid CP (+ deafness, learning problems)
Complication associated with surfactant administration
Pulmonary Heamorrhage
Late onset hypocalcaemia causes (> 7/7)
Hypoparathyroidism, maternal anticonvulsant use, vitamin D deficiency.
Early onset hypocalcaemia causes (first three days, premature)
Perinatal asphyxia, uncontrolled diabetes in mother
Percentage of babies with periventricular leukomalacia that devevelop CP
At least 50%
Type of CP caused by Periventricular Leukomalacia
Spastic Diplegia
Clubfeet risk factors
FHx, uterine crowding (multiple geastations, position of baby in uterus, oligohydramnios)
Why do preterm infants require higher plasma concentrations of morphine for analgesia than older children
Preterm infants have decreased metabolism of morphine to more active metabolite morphine-6-glucuronide
What happens to morphine metabolism in therapeutic cooling?
Affinity for u receptors is reduced
Contraindications to suxamethonium during neonatal intubation
Hyperkalaemia, FHx maligant hyperthermia, raised ICP
Medication for treatment of malignant hyperthermia
Dantrolene
Klumpke’s Palsy
C8/T1 - lower lesion
Deficit of all small muscles of hand (ulnar and median nerves)
“Claw hand” - wrist in extreme extensions, hyperextension of MCP, flexion of IP
Prognosis: poor prognosis for spontaneous recovery
Klumpke’s Palsy associated conditions
Horner’s syndrome, preganglionic injury
Upper limit % blood volume that can be lost into subgaleal space (subaponeurotic)
Up to 80% ( ~ 250 - 275mL)
Most common musculoskeletal birth defect & what % associated with other conditions
Club feet - 1:1000
M:F 2:1
Half cases bilateral
20% associated with other genetic / congenital conditions
Antenatal corticosteroids reduce the risk of (7)
Perianatal death, neonatal death, RDS, IVH, childhood developmental delay, NEC, infection
Antenatal corticosteroids have no significant effect on
Chorioamnionitis, endometritis, maternal death, birth weight, chronic lung disease
Antenatal magnesium suphate reduces risk of
Cerebral palsy (RR 0.68), substantial gross motor dysfunction (RR 0.61), NNT = 63
Protective factors for NEC
Breast milk feeds, probiotics
Most common organism in neonatal LOS in NICU
CONS
2 changes to improve ventilation on HFOV
Decrease frequency, increase amplitude
Types of CP caused by PVL
Symmetrical spastic diplegia or quadriplegia CP
