Neonatology intro
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NEONATOLOGY INTRODUCTION
Assistant Prof. Paediatics Dr. Muhammad Sajjad
SabirMBBS, DCH, MCPS, FCPS
Neonatology Neonatology is a subspecialty of Paediatrics that consists of the medical care of newborn infants, especially the ill or premature newborn (up to 28 days after birth)
neo, "new", natal, "pertaining to birth or origin“
It is a hospital-based specialty, and is usually practiced in Neonatal Intensive Care Unit (NICUs)
Neonatal period
The neonatal period commences at birth and ends 28 completed days after birth
Early Neonatal Period: first seven days
Late Neonatal Period: 7-28days of life
Perinatal period
The perinatal period commences at 22
completed weeks (154 days) of gestation
(the time when birth weight is normally 500 g), and
ends seven completed days after birth
Preterm < 37 wks
Term 37-42 wks
Post term > 42 wks
Classification (Gestational age)
Classification (birth weight)
Normal birth weight 2.5-3.5 Kg Low birth weight <2.5Kg
Large for gestational age (LGA) > 4.2Kg
There is No Precious babyThere is No Precious baby All Babies are precious All Babies are precious
Neonatal care
Components Of NICU
Warmer
Components Of NICU
Incubator Baby Crib
Ventilator CPAP
Components Of NICU
Suction
Oxygen
Phototherapy Light
Biliblanket Phototherapy Light
I. Respiratory Distress SyndromeII.Neonatal JaundiceIII.Neonatal Sepsis IV.Pre-termV.Hemorrhagic diseasesVI.CNS problemsVII.Meconium Aspiration
VIII.Pre and post -operative cases
Common Cases of NICU Admission
ProceduresProcedures
1.Endotracheal tube (ET)
2.Chest Intubation
3.I.V cannula
4.Umbilical catheter
5.Blood transfusion
6.Phototherapy
7.Exchange transfusion
1.Name: Mother name/ Fathers name2. Gender : Male, Female or ambiguous
genitalia!3. Sibling: History of other siblings - IUD ,
Abortions , RH,ABO incompatibility , Metabolic, genetic diseases
4. Consanguinity : For congenital abnormalities5. Mode of delivery? SVD or LSCS6. Gestational age: Full term or preterm
Ballard Maturational Assessment7. Age of the Baby8. Maternal risk factors G.. P.. + ….
History taking
5. Mode of delivery? SVD or LSCS
LSCS SVD• Cause ?
• Anesthesia
• More Liable for RDS
• Obstructed labor
• Traumatic Labor
• Less liable for RD
1- Maternal age: <18 years or >35 years2- Socio-demographic factors:•Low educational status•Cigarette smoking•Drug addiction•Poor nutrition•Poverty3- Obstetric factors:• Previous cesarean section• Multiple pregnancies• Prior infertility•Blood transfusion
Maternal risk factors
4- Medical conditions:•Diabetes mellitus•Hypertension•Pregnancy induced hypertension (PIH)•Pre-eclamsia•Congenital heart disease•Auto-immune diseases•Infections
Mortality RatesDefinitions and Measurement
Live BirthComplete expulsion or extraction from its mother of a product of conception, irrespective of the duration of the pregnancy, which, after such separation, breathes or shows any other evidence of life, such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached; each product of such a birth is considered liveborn
Fetal Death, StillbirthDeath prior to the complete expulsion
or extraction from its mother of a product of conception, irrespective of
the duration of pregnancy; the death is indicated by the fact that after such
separation the fetus does not breathe or show any other evidence of life,
such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles
Perinatal Mortality
An important indicator of:Maternal careMaternal health and nutritionQuality of obstetric and paediatric care
Perinatal MortalityPerinatal Mortality Rate:The number of deaths of fetuses (according
to the reporting criteria) plus the number of early neonatal deaths, per 1000 total births
x 1000
Pakistan 40.7 per 1000 live births(2012)
Fetal and Early Neonatal Deaths___________________________Total Births
Neonatal Mortality
Neonatal Mortality Rate:The number of deaths of infants during the
neonatal period, per 1000 live births
x 1000
Pakistan 42 per 1000 live births.(
Neonatal Deaths_______________Live Births
Neonatal Mortality
Early Neonatal Mortality Rate:The number of early neonatal deaths during
a given year per 1,000 live births in the same year.
x 1000
Pakistan__?_ no rate calculated
Early Neonatal Deaths____________________Live Births
Post-Neonatal Mortality
Post-Neonatal Mortality Rate:The number of deaths of infants aged 28 to
364 days, per 1000 live births
x 1000Post-Neonatal Deaths___________________
Live Births
Infant Mortality
Infant Mortality Rate:The number of deaths of infants aged less
than one year, per 1000 live births
x 1000
Pakistan 53.9 per 1000 live births (2016)
Deaths under 1 yr of age_____________________Live Births
Child Mortality
The most importantis
Under-5 Mortality Rate
Under-5 Mortality Rate
A leading indicator of the level of child health and overall development in countries.
The fourth indicator of 8 MDGs (Millennium Development Goals)
Under-5 Mortality Rate
Under-5 Mortality Rate:The number of deaths of children aged less
than 05 year, per 1000 live births
x 1000
Pakistan 86 per 1000 live births (2016)
Deaths under 5 yr of age_____________________Live Births
Hope Happiness finds you every where !