newbornphysiology-pathology-1

newbornphysiology-pathology-1 - Newborn physiology...

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Newborn physiology
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Definition •Gestat iona l age • Term newborn (37-41 GW) • Preterm newborn (AGA) (<37. GW) • Post-term newborn (>41. GW) • Intrauterin retarded newborn (IUGR, or SGA) (<10 percentile) •Norma l b irth we ight : 3250±700 g
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Anthropometric characteristics of term and preterm infants
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I U G R
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I U G R
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• Menstruation calendar • Intrauterine anthropometry • Semi-objective score system using physical examination of the newborn Estimation of gestational age
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Estimation of the gestational age according to Dubowitz
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Preterm - postterm
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Characteristics of preterm skin. Estimation of the gestational age
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Estimation of the gestational age
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Muscle tone and posture
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Maneuvers for the estimation of gestational age
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Scarf signs and heel-to ear maneuver
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Basic definition characterizing the quality of pregnancy care, neonatal and pediatric care in a country • Infant mortality rate (6.6 % o ) Mortality per mille in a period of 0-365 day • Neonatal mortality (3.4 % o ) Mortality between birth and 7th day of life • Perinatal mortality (8.3 % o ) Mortality from 24. gest. week until the 7th day of life
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Infant mortality rate (IMR) and neonatal mortality rate (NMR) in Hungary and in the USA 0 5 10 15 20 25 30 35 1970 1975 1980 1990 1995 1999 IMR H NM H IMR USA NMR USA
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Infant mortality rate in different countries 0 2 4 6 8 10 S N CH D I UK USA H
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Percentage of premature babies in Hungary =BW<1000g 0 2 4 6 8 10 12 1970 1975 1980 1990 1995 1999 2000
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Main causes of death in developed countries Adults Infants Children Malignancies Cardiovascular diseases GI diseases Accidents, drugs, terror Perinatal diseases Malformations Malignancies Accidents, drugs, terror Accidents, drugs, terror Malignancies
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Physiology of organ adaptation after birth Postnatal adaptation
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Early contact to the mother
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Adaptation of vital organs • Cardiac adaptation Î minutes • Pulmonary adaptation Î minutes Disturbed adaptation in the function of these organs will result in a serious, life-threatening sequences of event
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Re-organization of the fetal circulation
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Fetal circulation Characterized by the presence of parallel circulation, shunts in order to prevent overperfusion of “non-used” organs i.e. lung. The major shunt is the ductus arteriosus Botalli
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Neonatal circulation In healthy newborns the shunts close functionally and later morphologically. The most important shunt is the ductus arteriosus.
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Circulation in asphyxiated newborn • Asphyxia causes vaso- constriction in pulmonary arteries. • PDA (L to R shunt) •Congest ive±heart , ± pulmonary edema • Hypoxia maintains pulm.
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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newbornphysiology-pathology-1 - Newborn physiology...

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