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GESTATIONAL AGE AND SIZE (NEONATOLOGY)

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INFANT MORTALITY

  1. 9-10/1,000 births
  2. causes

  3. • congenital
    • prematurity (RDS, intracranial hemorrhage)
    • asphyxia
    • infections
    • sudden infant death syndrome


NORMAL BABY AT TERM

  1. HR 120-160/per min
  2. RR 40-60/per min
  3. weight 2500-4500 g
  4. glucose > 2.2
  5. BP systolic 50-80, diastolic 30-40 (dependent on GA)

GESTATIONAL AGE AND SIZE


Definitions
  1. gestational age
    • pre-term: <37 weeks
    • term:  37-42 weeks
    • post-term: > 42 weeks
  2. SGA: measurements < 2 SD below mean for gestational age (GA)
  3. AGA: within 2 SD of mean for GA
  4. LGA: > 2 SD above the mean for GA
  5. GA can be estimated using the Ballard Score

 

Infant Maturity

 

Sites

< = 36 Weeks

37-38 Weeks

> = 39 Weeks

skin

pale, translucent

pinker, smoother

pink, thick

sole creases

smooth progresses to anterior creases

anterior progresses to heal creases

increasing depth of sole creases

breast nodule diameter

<2 mm

4 mm

5-10 mm

scalp hair

fine and fuzzy

fine and fuzzy

thick and silky

ear lobe

flat, pliable, no cartilage

some cartilage

stiffened by thick cartilage

testes and scrotum

testes in lower canal, small scrotum, few rugae

intermediate scrotum full

pendulous, covered with rugae

labia and clitoris

prominent clitoris, small labia

clitoris nearly covered by prepuce

clitoris covered by prepuce large labia

 

Abnormalities of Gestational Size and Maturity Features

 

 

Features

Causes

Problems

pre-term infants < 37 weeks

infection (TORCH) maternal pathology drugs/EtOH chromosomal smoking

multiple pregnancy infections placental causes

RDS, respirator}' diseases

recurrent apnea

feeding difficulties

hypocalcemia,

hypoglycemia

anemia

jaundice

intracranial hemorrhage,

cerebral anoxia

hypothermia edema

retinopathy of prematurity

SGA infants

• asymmetric undergrowth: late onset, growth arrest

extrinsic causes:

diabetes,

nutrition,

hypertension,

multiple pregnancies, drugs.

EtOH,

smoking

asphyxia

hypoglycemia

hypocalcemia

• symmetric undergrowth: early onset, lower growth potential

intrinsic causes: infections (TORCH)

meconium aspiration, chromosomal,

genetic,

congenital abnormalities, synaromal.

idiopathic

hypothermia

hyperviscosity (polycythemia)

NEC

PDA

LGA infants - large features

maternal DM.

racial or familial factors

asphyxia,

meconium aspiration,

respiratory distress,

TTN,

PPH

jaundice,

hypoglycemia,

hypocalcemia

polycythemia,

congenital abnormalities

post-term infants

• wisened looking, leathery skin

• meconium staining

 

severe asphyxia,

meconium aspiration

hypoglycemia

birth trauma if large infant

GESTATIONAL AGE AND SIZE (NEONATOLOGY) GESTATIONAL AGE AND SIZE (NEONATOLOGY) Reviewed by Radiology Madeeasy on October 08, 2010 Rating: 5
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