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Introduction to Neonatal Medicine Assoc. Prof Alex Tang Monash University School of Medicine and Health Sciences Johor Bahru

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Page 1: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Introduction to Neonatal Medicine

Assoc. Prof Alex Tang

Monash University

School of Medicine and Health Sciences

Johor Bahru

Page 2: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Objective

• Describe an overview

of neonatal medicine

• Define possible

problems faced by

preterm, term and

post-term babies

• Discuss the

complications and

management of these

problems

Page 3: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty
Page 4: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Assessment of

gestational age

Page 5: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Assessment of Gestational Age

• EDD

• Ultrasound

• Crown-rump

• Biparietal diameter (BPD)

• Fetal femur length

• Clinical

• Ballard score

Page 6: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Cloherty et al, Manual of

Neonatal Care, 43

Page 7: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Gestational Age

• Preterm

• Term

• Post-term

Page 8: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Problems in the Neonatal Period

• Growth Factors

Page 9: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty
Page 10: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Problems of Intra Uterine Growth

Retardation

Page 11: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Problems in the Neonatal Period

• Growth Factors

• Prematurity

• Risk factors

Page 12: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Risk Factors for Prematurity

Page 13: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Problems in the Neonatal Period

• Growth Factors

• Prematurity

• Risk factors

• Complications

Page 14: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Complications of Prematurity

Page 15: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty
Page 16: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Picture source: Pediatrics in Review

Page 17: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Problems in the Neonatal Period

• Growth Factors

• Prematurity

• Jaundice

Page 18: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Common Types of Neonatal Jaundice

Page 19: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Causes of Hemolytic Jaundice

Page 20: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Causes of Physiological Jaundice

Page 21: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty
Page 22: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Problems in the Neonatal Period

• Growth Factors

• Prematurity

• Jaundice

• Respiratory Problems

Page 23: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Picture source: Pediatrics in Review

Page 24: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

MAS

Page 25: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty
Page 26: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty
Page 27: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Respiratory Disorder in Newborns

• Respiratory distress

• Transient Tachypnea of Newborn (TTN)

• Respiratory Distress Syndrome (RDS)

• Pneumonia

• Meconium Aspiration Syndrome (MAS)

• Pneumothorax

• Diaphragmatic hernia

• Upper respiratory obstruction

• Apnea, bradycardia

Page 28: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty
Page 29: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Problems in the Neonatal Period

• Growth Factors

• Prematurity

• Jaundice

• Respiratory Problems

• Infections

• Intrauterine

Page 30: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Congenital and Perinatal Infections

Page 31: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Picture source: Pediatrics in Review

Page 32: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Picture source:Pediatrics in Review

Page 33: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Problems in the Neonatal Period

• Growth Factors

• Prematurity

• Jaundice

• Respiratory Problems

• Infections

• Intrauterine

• Neonatal sepsis

Page 34: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Neonatal Sepsis

• respiratory distress, tachypnoea, apnoea

• temperature instability, irritability

• feeding difficulty, vomiting, diarrhoea

• neutrophilia or neutropenia

• increased proportion of immature

neutrophils

• thrombocytopenia

• coagulopathy.

Page 35: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

GBS

Page 36: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Problems in the Neonatal Period

• Growth Factors

• Prematurity

• Jaundice

• Respiratory Problems

• Infections

• Cardiac Problems

Page 37: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Ventricular Septal Defect (VSD)

Page 38: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Atrial Septal Defect (ASD)

Page 39: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Coarctation of Aorta

Page 40: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Hypoplastic Left Heart Syndrome

Page 41: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Fallot’s Tetralogy

Page 42: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Transposition of the Great Arteries

(TGA)

Page 43: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Problems in the Neonatal Period

• Growth factors

• Prematurity

• Jaundice

• Respiratory problems

• Infections

• Cardiac problems

• GIT problems

Page 44: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty
Page 45: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty
Page 46: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Picture source: Pediatrics in Review

Page 47: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty
Page 48: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty
Page 49: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Problems in the Neonatal Period

• Growth factors

• Prematurity

• Jaundice

• Respiratory problems

• Infections

• Cardiac problems

• GIT problems

• Birth problems

Page 50: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Apgar Score Heart rate 0 no heart rate

1 < 100 beats/min

> 100 beats/min

Respiratory effort 0 no resp. effort

1 irregular, poor effort

2 regular, crying

Reflex irritability 0 no response

1 weak grimace

2 grimace or withdrawal

Muscular tone 0 floppy

1 partial flexion

2 active

Colour 0 cyanosed

1 central pink, peripheral cyanosed

2 pink

Page 51: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Perinatal Asphyxia

• Neonatal Depression

• Neonatal encephalopathy

• Hypoxic-ischemic encephalopathy (HIE)

• Hypoxic-ischemic brain injury

• Biochemical (CK-BB)

• EEG

• U/S head (HUS)

• MRI or CT

• Post mortem

Page 52: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Problems in the Neonatal Period

• Growth factors

• Prematurity

• Jaundice

• Respiratory problems

• Infections

• Cardiac problems

• GIT problems

• Birth problems

• Congenital Abnormalities

Page 53: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Picture source:Pediatrics in Review

Page 54: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Picture source :Pediatrics in Review

Page 55: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Picture source:Pediatrics in

Review

Page 56: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Picture source:Pediatrics in

Review

Page 57: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Picture source:Pediatrics in Review

Page 58: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Picture source: Pediatrics in

Review

Page 59: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Picture source: Pediatrics in

Review

Page 60: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Picture source:Pediatrics in

Review

Page 61: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Picture source: Pediatrics in

Review

Page 62: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Picture source: Pediatrics in

Review

Page 63: Introduction to Neonatal Medicine - Kairos Spiritual …kairos2.com/IntroNeonatal Medicine.pdf · problems faced by preterm, term and ... • Clinical •Ballard score . Cloherty

Contact me

• My email : [email protected]

[email protected]

• My website:

www.kairos2.com/medical_notes.html

• My blog: www.draltang01.blogspot.com

• Mobile: 012 7880812