Prematurity

Question 1

History

Answer 1

1. Risk factors
Young maternal age
Maternal illness
Infection
Incompetent cervix
APH
Smoking
Alcohol
2. Complete obstetric history
3. Condition at birth, resuscitation required
4. Birthweight, appropriate for gestation
5. Accurate gestational age and associated problems: twins, congenital and infection
6. Antenatal steroids

Question 2

Long term complications

Answer 2

1. Survival: 45% infants born at 24 weeks survive, 80% at 27 weeks, >32 weeks excellent.
2. Bronchopulmonary dysplasia (chronic lung disease)
3. Neurological sequelae: hydrocephalus due to intraventricular hemorrhage, hypotension->leukomalacia and cerebral palsy
4. Blindness->retinopathy
5. Poor growth

Question 3

Complications acute

Answer 3

1. Retinopathy
2. RDS, apnea & bradyC, pneumothorax, CLD
3. Hypotension, PDA
4. Temperature instability-> +SA, Xretain, -ve SC fat
5. Hypoglycemia, hypocalcemia, electrolyte imbalance, osteopenia
6. IVH, posthemorrhagic hydrocephalus, periV leukoamalacia (ischemic damage to white matter), cerebral palsy, neurodevelopmental delay
7. Parenteral nutrition, NGT until sucking reflex at 32-34 weeks
8. NEC, GOR, inguinal hernia w/ +risk strangulation
9. +risk of sepsis, GBS, pneumonia, line infection
10. Anemia, neonatal jaundice