Neonatology

2. NEONATOLOG
Y INTRODUCTION
Assistant Prof. Paediatics
Dr. Muhammad Sajjad Sabir
MBBS, DCH, MCPS, FCPS

3. 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)

4. 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

5. 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

6.  Preterm < 37 wks
Term 37-42 wks
Post term > 42 wks
Classification
(Gestational age)

7. Classification
(birth weight)
 Normal birth weight 2.5-3.5 Kg
 Low birth weight <2.5Kg
 Large for gestational age (LGA) > 4.2Kg

8. There is No Precious baby
There is No Precious baby
All Babies are precious
All Babies are precious

9. Neonatal
care

10. Components Of NICU

11. Warmer
Components Of NICU
Incubator Baby Crib

12. Ventilator
CPAP
Components Of NICU

13. Suction
Oxygen

14. Phototherapy Light
Biliblanket
Phototherapy Light

15. I. Respiratory Distress Syndrome
II. Neonatal Jaundice
III.Neonatal Sepsis
IV.Pre-term
V. Hemorrhagic diseases
VI.CNS problems
VII.Meconium Aspiration
VIII.Pre and post -operative cases
Common Cases of NICU Admission

16. Procedures
Procedures
1.Endotracheal tube (ET)
2.Chest Intubation
3.I.V cannula
4.Umbilical catheter
5.Blood transfusion
6.Phototherapy
7.Exchange transfusion

17. 1.Name: Mother name/ Fathers name
2. Gender : Male, Female or ambiguous genitalia!
3. Sibling: History of other siblings - IUD , Abortions ,
RH,ABO incompatibility , Metabolic, genetic diseases
4. Consanguinity : For congenital abnormalities
5. Mode of delivery? SVD or LSCS
6. Gestational age: Full term or preterm
Ballard Maturational Assessment
7. Age of the Baby
8. Maternal risk factors G.. P.. + ….
History taking

18. 5. Mode of delivery? SVD or LSCS
LSCS SVD
• Cause ?
• Anesthesia
• More Liable for RDS
• Obstructed labor
• Traumatic Labor
• Less liable for RD

19. 1- Maternal age:
<18 years or >35 years
2- Socio-demographic factors:
•Low educational status
•Cigarette smoking
•Drug addiction
•Poor nutrition
•Poverty
3- 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

20. Mortality Rates
Definitions and Measurement

21. Live Birth
Complete 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

22. Fetal Death, Stillbirth
Death 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

23. Perinatal Mortality
An important indicator of:
Maternal care
Maternal health and nutrition
Quality of obstetric and paediatric care

24. Perinatal Mortality
Perinatal 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

25. 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

26. 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

27. Post-Neonatal Mortality
Post-Neonatal Mortality Rate:
The number of deaths of infants aged 28 to
364 days, per 1000 live births
 x 1000
Post-Neonatal Deaths
___________________
Live Births

28. 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

29. Child Mortality
The most important
is
Under-5 Mortality Rate

30. 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)

31. 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

32. Hope Happiness finds
you every where !