Preterm Problems

Question 1

Common organisms causing infection in preterms

Answer 1

Gram + (S. aureus, CONS, GBstrep)
Gram - (E.coli, Klebsiella, pseudomonas)
Fungal (candida)
Viral (RSV)

Question 2

What is a normal BP for a preterm

Answer 2

MAP = gestational age

Question 3

Common causes of hypotension in the preterm

Answer 3

• acute blood loss
• sepsis, NEC
• hypoxia
• IVH
• extreme prematurity

Question 4

Causes of hypertension in the preterm

Answer 4

• iatrogenic
• vascular
• renal
• endocrine
• neurologival

Question 5

How to treat hypotension in preterms

Answer 5

• replace fluid losses using saline or blood as indicated by the underlying cause
• inotropes (dopamine, adrenaline)
• steroids (hydrocortisone)
• treat underlying cause

Question 6

Causes of hypoxia in preterms

Answer 6

Pre-partum
- placental failure, GPH, hypertension

Intra-partum
- abruption, cord prolapse, obstructed labour,

Post-partum
- apnoea, severe RD, fits, sepsis, hypothermia

Question 7

Clinical presentation of hypoxia in preterms

Answer 7

• central cyanosis
• bradycardia
• apnoea/ respiratory distress
• limp, poor responses
• poor perfusion
• low BP