1. RESPIRATORY
PROBLEMS AND
INFECTION

2.  Asphyxia neonatorum means non
establishment of satisfactory pulmonary
respiration at birth.
or
 Clinically defined as failure to initiate and
maintain spontaneous respiration following
birth.

3.  continuation of intra uterine hypoxia
 Prenatal and intranatal medication
 Birth trauma
 Postnatal

4.  Low Apgar score
 PaO2 80-95 mmHg
 PaCO2 35-45 mmHg
 HCO3 24-26 mEq/L

5. PATHOPHYSIOLOGY
Hyperapnea
primary apnea
gasping attempt
secondary apnea
bradycardia and shock

6. diminished cerebral flow
Cerebral haemorrhage
Hypoxic ischemic encephalopathy
Death or handicapped

7. MANAGEMENT

8. RESPIRATORY DISTRESS SYNDROME
 Termed as Hyaline membrane disease
 It occurs due to diminished surfactant
production
 Pathologic feature is a hyaline like
membrane formed from an exudate of an
infants blood that begin to line the terminal
bronchioles, alveolar ducts and alveoli.

9. RISK FACTORS
 Preterm babies
 Infants of diabetic mothers
 Ceaserian section
 Breech delivery

10. PATHOPHYSIOLOGY
deficient surfactant production
hypoinflation of the alveoli
pulmonary resistance increased
poor oxygen exchange
release of lactic acid

11. CLINICAL FEATURES
 Low body temperature
 Nasal flaring
 Sternal subcostal retraction
 Tachypnea
 Cyanotic mucus membrane
 Expiratory grunt
 Seesaw respiration

12.  Pale gray skin
 Periods of apnea
 pneumothorax

13. MANAGEMENT
 Surfactant therapy
 Oxygen administration
 Ventilation
 prevention

14. MECONIUM ASPIRATION SYNDROME
 Management include
 proper intrapartum monitoring
 amino infusion
 pulmonary toileting
 liberal oxygen supply
 antibiotic coverage

15. OPTHALMIA NEONATORUM
 Inflammation of conjunctiva during first three
weeks oflife
 Causes-
bacterial
chemical
viral

16.  Mode of infection is by contaminated vaginal
discharge
 Clinical pictures include watery discharge,
muco purulent to frank purulent in one or
both eye,sticky or markedly swollen eyelid
and cornea may involve

17. PREVENTION
 Treat in antenatal period
 Obstetrical asepsis
 Newborns eyelid is thoroughly cleaned and
dried
 Investigation include gram stain smear,
c@s,scraping material from lower
conjunctiva and culture in special viral media

18. TREATMENT
 Bacterial: irrigate with sterile isotonic
solution, topical gentamycin eye drops, in
severe culture positive cases ceftriaxone and
cefotaxime
 Chlamydia: erythromycin suspension and
ophthalmic ointment
 Herpes simplex: acyclovir, topical use of
Idoxuridine

19. SKIN INFECTION
 Due to staphylococcus aureas
 Superficial pustules, singleor scattered form
on face, axilla and scalp
 1% gentian voilet

20. Pemphigus neonatorum
 It is a serious form of skin infection caused
by staphylococcus
 Causes septicemia and pyaemia
 Superficial blisters occurs at any part of the
skin becomes pustules and then burst
 Kept in isolation
 Avoid baby bath in hospital
 Blisters are pricked by sterile needles
 1% gentian violet
 Erythromycin and cloxacillin

21. ORAL THRUSH
 Infection of the buccal mucos membrane and
the tongue by the fungus candida albicans
 Milky white patches resembling milk curd
 Spread to GI and Respiratory tract
 1% gentian violet
 Nystatin oral suspension

22. UMBILICAL SEPSIS
 Staphylococcus, e coli and other pyogenic
organs
 Serous purulant umbilical discharge may
offensive
 Stump looks moist
 Periumbilical area become red and swollen
 Delay in falling of cord

23. TETANUS NEONATORUM
 Clostridium tetani
 5-10 days after birth
 Inable to suck followed by marked
trismus,rigidity of the body,
 Pyrexia
 Convulsions
 opisthotonus

24. TREATMENT
 Isolation
 Tetanus immunoglobin
 Anti tetanus serum
 Antibiotics
 Sedation
 Antiepileptic
 Intubation and ventilation
 Nutrition by intragastric feed