The document discusses common breast complications in the postpartum period including breast engorgement, cracked and retracted nipples, mastitis, breast abscess, and lactation failure. It provides details on causes, signs and symptoms, prevention, and treatment for each complication. Management involves ensuring proper breastfeeding technique, treating any infections, expressing milk to relieve engorgement, and using medications as needed to increase milk production or treat infections.
Respiratory Distress Syndrome (RDS), formerly known as hyaline membrane disease, is a life-threatening lung disorder that results from underdeveloped lungs and insufficient pulmonary surfactant. It occurs most commonly in preterm infants and results in inadequate lung inflation and collapse. Management involves providing warm oxygen supplementation and potentially ventilator support. Surfactant replacement therapy is also used to reduce mortality and complications like bronchopulmonary dysplasia. With appropriate treatment, prognosis is good especially for infants weighing over 1000 grams.
Birth injuries range from minor to severe and can occur during labor and delivery. Risk factors include primiparity, fetal macrosomia, instrumental delivery, and maternal or fetal anomalies. Common birth injuries include cephalhematoma, subgaleal hematoma, intracranial hemorrhage, skull fractures, facial bone fractures, and injuries to the eyes, ears, and sternocleidomastoid muscle. Most minor injuries resolve with time and observation, while more serious injuries may require interventions like transfusions, antibiotics, or surgery. Proper nursing care includes monitoring for complications, gentle handling, and reassuring parents.
Oligohydramnios by dr alka mukherjee dr apurva mukherjee nagpur m.s.alka mukherjee
• Oligohydramnios refers to amniotic fluid volume that is less than expected for gestational age. It is typically diagnosed by ultrasound examination and may be described qualitatively (eg, reduced amniotic fluid volume) or quantitatively (eg, amniotic fluid index ≤5 cm, single deepest pocket <2 cm).
• Oligohydramnios may be idiopathic or have a maternal, fetal, or placental cause The fetal prognosis depends on several factors, including the underlying cause, the severity (reduced versus no amniotic fluid), and the gestational age at which oligohydramnios occurs. Because an adequate volume of amniotic fluid is critical to normal fetal movement and lung development and for cushioning the fetus and umbilical cord from uterine compression, pregnancies complicated by oligohydramnios from any cause are at risk for fetal deformation, pulmonary hypoplasia, and umbilical cord compression.
• Oligohydramnios is associated with an increased risk for fetal or neonatal death, which may be related to the underlying cause of the reduced amniotic fluid volume or due to sequelae of the reduced amniotic fluid volume.
• This topic will discuss issues related to oligohydramnios. Methods of amniotic fluid volume assessment are reviewed separately.
• Oligohydramnios occurs when the amniotic fluid is < 5th centile for gestational age.
• The most common causes are premature rupture of membranes (often missed by the mother) and placental insufficiency, however structural abnormalities such as renal agenesis should be considered.
• Prognosis is linked to gestation at diagnosis and likely development of pulmonary hypoplasia and premature delivery.
• Treatment is by optimising gestation of delivery
Kangaroo Mother Care (KMC) involves securing low birth weight or preterm infants skin-to-skin to the mother's chest. It promotes the health and development of these infants through improved temperature regulation, breastfeeding, and bonding with the mother. The key components of KMC are maintaining the infant in the kangaroo position, keeping them skin-to-skin on the mother's chest, securing them with a wrap, exclusive breastfeeding when possible, continuing KMC after hospital discharge with support, and benefits both the infant and mother.
eenage pregnancy, also known as adolescent pregnancy, is pregnancy in a female under the age of 20. Pregnancy can occur with sexual intercourse after the start of ovulation, which can be before the first menstrual period (menarche) but usually occurs after the onset of periods.
Kangaroo Mother Care (KMC) involves skin-to-skin contact between a mother and her newborn, especially low birth weight or preterm infants. It originated in Colombia in the 1970s as a way to improve outcomes for fragile infants born in hospitals with limited resources. KMC provides benefits to both infants and mothers, such as improved infant health, growth, and development as well as increased maternal confidence. It also benefits hospitals by reducing costs and improving quality of care. KMC is now recognized as an effective practice worldwide for newborn care.
The document discusses common breast complications in the postpartum period including breast engorgement, cracked and retracted nipples, mastitis, breast abscess, and lactation failure. It provides details on causes, signs and symptoms, prevention, and treatment for each complication. Management involves ensuring proper breastfeeding technique, treating any infections, expressing milk to relieve engorgement, and using medications as needed to increase milk production or treat infections.
Respiratory Distress Syndrome (RDS), formerly known as hyaline membrane disease, is a life-threatening lung disorder that results from underdeveloped lungs and insufficient pulmonary surfactant. It occurs most commonly in preterm infants and results in inadequate lung inflation and collapse. Management involves providing warm oxygen supplementation and potentially ventilator support. Surfactant replacement therapy is also used to reduce mortality and complications like bronchopulmonary dysplasia. With appropriate treatment, prognosis is good especially for infants weighing over 1000 grams.
Birth injuries range from minor to severe and can occur during labor and delivery. Risk factors include primiparity, fetal macrosomia, instrumental delivery, and maternal or fetal anomalies. Common birth injuries include cephalhematoma, subgaleal hematoma, intracranial hemorrhage, skull fractures, facial bone fractures, and injuries to the eyes, ears, and sternocleidomastoid muscle. Most minor injuries resolve with time and observation, while more serious injuries may require interventions like transfusions, antibiotics, or surgery. Proper nursing care includes monitoring for complications, gentle handling, and reassuring parents.
Oligohydramnios by dr alka mukherjee dr apurva mukherjee nagpur m.s.alka mukherjee
• Oligohydramnios refers to amniotic fluid volume that is less than expected for gestational age. It is typically diagnosed by ultrasound examination and may be described qualitatively (eg, reduced amniotic fluid volume) or quantitatively (eg, amniotic fluid index ≤5 cm, single deepest pocket <2 cm).
• Oligohydramnios may be idiopathic or have a maternal, fetal, or placental cause The fetal prognosis depends on several factors, including the underlying cause, the severity (reduced versus no amniotic fluid), and the gestational age at which oligohydramnios occurs. Because an adequate volume of amniotic fluid is critical to normal fetal movement and lung development and for cushioning the fetus and umbilical cord from uterine compression, pregnancies complicated by oligohydramnios from any cause are at risk for fetal deformation, pulmonary hypoplasia, and umbilical cord compression.
• Oligohydramnios is associated with an increased risk for fetal or neonatal death, which may be related to the underlying cause of the reduced amniotic fluid volume or due to sequelae of the reduced amniotic fluid volume.
• This topic will discuss issues related to oligohydramnios. Methods of amniotic fluid volume assessment are reviewed separately.
• Oligohydramnios occurs when the amniotic fluid is < 5th centile for gestational age.
• The most common causes are premature rupture of membranes (often missed by the mother) and placental insufficiency, however structural abnormalities such as renal agenesis should be considered.
• Prognosis is linked to gestation at diagnosis and likely development of pulmonary hypoplasia and premature delivery.
• Treatment is by optimising gestation of delivery
Kangaroo Mother Care (KMC) involves securing low birth weight or preterm infants skin-to-skin to the mother's chest. It promotes the health and development of these infants through improved temperature regulation, breastfeeding, and bonding with the mother. The key components of KMC are maintaining the infant in the kangaroo position, keeping them skin-to-skin on the mother's chest, securing them with a wrap, exclusive breastfeeding when possible, continuing KMC after hospital discharge with support, and benefits both the infant and mother.
eenage pregnancy, also known as adolescent pregnancy, is pregnancy in a female under the age of 20. Pregnancy can occur with sexual intercourse after the start of ovulation, which can be before the first menstrual period (menarche) but usually occurs after the onset of periods.
Kangaroo Mother Care (KMC) involves skin-to-skin contact between a mother and her newborn, especially low birth weight or preterm infants. It originated in Colombia in the 1970s as a way to improve outcomes for fragile infants born in hospitals with limited resources. KMC provides benefits to both infants and mothers, such as improved infant health, growth, and development as well as increased maternal confidence. It also benefits hospitals by reducing costs and improving quality of care. KMC is now recognized as an effective practice worldwide for newborn care.
BIRTH INJURIES IN NEWBORN: Definition of birth injuries , statistics, etiology, classification of birth injuries , head injuries: cephalhematoma and Caput succedaneum, skull fractures
, nerve injuries: erb's palsy and klumpke's palsy, bone injuries: clavicular and long bone fracture , intra-abdominal and soft tissue injuries, management and prevention of birth injuries
Antenatal care involves regular checkups during pregnancy to monitor the health of the expectant mother and baby. The goals are to reduce mortality and morbidity, identify issues, and educate mothers. Checkups are usually every 4 weeks until 28 weeks, every 2 weeks until 36 weeks, and weekly until delivery. Appointments include health history, physical exam, lab tests, ultrasound, and health advice covering hygiene, nutrition, exercise, sleep, and danger signs. The overall aim is a healthy pregnancy and delivery.
The document discusses the fetal skull. It describes the fetal skull as having thin, pliable bones that allow the skull to compress and mold during birth. The skull has three main parts: the vault of the cranium, face, and base. It discusses the sutures and fontanelles that connect the skull bones and act as landmarks for examining the fetal head. Finally, it lists the key diameters of the fetal skull that are important for determining if the skull can pass through the birth canal.
This document provides information about meconium aspiration syndrome for nursing students. It defines meconium aspiration syndrome as the aspiration of meconium-stained amniotic fluid into the lungs, occurring in 5-20% of births. The document outlines risk factors, pathophysiology involving ball valve obstruction and pulmonary hypertension, clinical features such as respiratory distress, diagnostic tests including chest x-rays, and management involving suction, oxygen, ventilation support, and medications. It also discusses nursing considerations, prognosis depending on associated conditions, and complications including brain and lung damage.
This document discusses respiratory distress syndrome (RDS) in newborns, including its definition, incidence, clinical causes, pathophysiology, clinical manifestations, diagnostic evaluations, preventive measures, complications, treatment principles, and nursing care. RDS occurs in preterm infants due to deficient surfactant production and presents as respiratory distress within hours of birth. Diagnosis is based on clinical signs and confirmed with tests like chest x-rays. Treatment involves supportive care in the NICU, surfactant replacement therapy, and careful monitoring to prevent complications.
Neonatal intensive care involves specialized care for ill or premature newborns. Conditions requiring intensive care include prematurity, low birthweight, and medical issues. Intensive care aims to stabilize infants and address physiological immaturities in organ systems like respiratory, cardiovascular, and gastrointestinal systems. Intensive care involves continuous monitoring, respiratory support like CPAP or ventilation, thermoregulation, fluid management, and nutrition until infants can maintain homeostasis independently. Surgery for conditions like gastroschisis requires optimizing all body systems before, during and after the operation.
Cardiotocography (CTG) is a technical method for recording the fetal heartbeat and uterine contractions during pregnancy using ultrasound and tocodynamometry. CTG involves using an electronic fetal monitor, commonly known as a cardiotocograph, to obtain a record of the fetal heart rate and uterine contractions. It was invented in the 1960s and refined to be more accurate. CTG is typically used in late pregnancy or labor to evaluate fetal well-being and identify any signs of hypoxia.
This document discusses factors that define high-risk newborns and various conditions that can lead to a newborn being considered high-risk. It identifies demographic, medical history, pregnancy, labor/delivery, and neonatal factors that increase risk. Common high-risk conditions include preterm birth, low birth weight, growth restriction, respiratory distress, and congenital anomalies. The document provides definitions and clinical features of conditions like preterm infants, low birth weight babies, and discusses their management and complications. Hypothermia and hyperthermia in newborns are also summarized.
This document summarizes information about intrauterine growth restriction (IUGR). It discusses normal fetal growth occurring in three stages: hyperplasia, hyperplasia and hypertrophy, and hypertrophy. Causes of IUGR include maternal, fetal, placental, and environmental factors. Maternal causes include medical conditions, malnutrition, smoking, and infections. Fetal causes include genetic abnormalities and infections. Placental causes include improper placentation and reduced blood flow. Clinical features of IUGR infants include a large head, thin skin, and scaphoid abdomen. Risk prediction methods include ultrasound and Doppler. Problems for IUGR infants include hypoxia, hypoglycemia, and immunological and metabolic issues. Management
National iodine deficiency disorders control programme (niddcp)anjalatchi
Iodine deficiencies are very common, especially in Europe and Third World countries, where the soil and food supply have low iodine levels. Your body uses iodine to make thyroid hormones. That's why an iodine deficiency can cause hypothyroidism, a condition in which the body can't make enough thyroid hormones
A small for gestational age baby is one that is smaller than normal for the number of weeks spent in the womb. They have all organs formed but they are small. Predisposing factors include maternal malnutrition, infections, and placental abnormalities. Medical investigations are done to rule out infections. The baby requires nutritional support through breastfeeding or tube feeding, monitoring to prevent hypothermia and hypoglycemia, and treatment of any infections. Complications can include hypothermia, hypoglycemia, and brain damage if not managed properly.
USAID (United states Agency for International Development)Ankita Kunwar
USAID was established in 1961 by President John F. Kennedy to administer foreign aid. It is responsible for $27 billion in civilian foreign aid annually, making it one of the largest official aid agencies globally. USAID has historically focused on development assistance, disaster relief, and achieving US foreign policy goals. It has shifted its priorities and approaches over the decades based on global events and needs, from infrastructure projects to basic human needs to promoting free markets and democracy. Today, USAID works in over 100 countries on issues like agriculture, health, education, gender equality, and the environment through bilateral missions and regional offices. In Asia, USAID supports programs in countries like Afghanistan, India, Sri Lanka, and Nepal on economic development, governance
1) Diaphragmatic hernia is a defect in the diaphragm that allows abdominal organs to protrude into the chest cavity.
2) Congenital diaphragmatic hernia (CDH) affects 1 in 2,500-4,000 births and can cause life-threatening lung issues.
3) Treatment involves surgical repair of the diaphragmatic defect and may include extracorporeal membrane oxygenation (ECMO) to support lung and heart functions.
This document discusses the emotional and physical changes that occur during pregnancy for both mothers and fathers. It covers the three trimesters of pregnancy and common feelings in each stage like anxiety, depression, and concern over weight gain or the baby's sex. Fetal development from embryo to fetus is outlined week by week. The importance of emotional support from family as well as understanding the psychological changes of pregnancy for better coping is also emphasized.
Antenatal exercises are exercises performed by the women in their antenatal period to enhance the circulation and prevent various kind of complications. It also gives a feeling of well being to the women.
1) The first 24 hours of life require immediate care of the newborn to establish respiratory function, provide warmth, and ensure safety from injury and infection.
2) Key aspects of immediate newborn care include clearing the airway, maintaining temperature, assessing with the APGAR score, and providing identification.
3) Procedures like drying, positioning, suctioning, cord clamping and eye care help support the newborn's transition to extrauterine life. Vital signs, reflexes and growth are also assessed.
Difference between adulty and child (For B.Sc Nursing)PranavSahu8
The document discusses several key differences between adults and children that are important for nurses to understand. Physiologically, children have thinner skin, more rapidly dividing cells, and different circulatory and organ systems compared to adults. Psychologically, children progress through different developmental stages and have less developed social and emotional capabilities. Pathologically, children are more susceptible to dehydration and have different disease presentations. Cognitively, children demonstrate increasing but maturing abilities with age unlike adults. Understanding these developmental differences is crucial for nurses to provide appropriate care for children.
This document discusses teenage pregnancy in Sarawak, Malaysia. It begins with definitions and background statistics on teenage pregnancy. In Sarawak, the adolescent birth rate is high at 62 per 1000 births, and many teenage mothers stop their education. The document outlines the dilemmas posed by teenage pregnancy given cultural acceptance in Sarawak. It then discusses the antenatal, birth, postpartum, social, and offspring issues related to teenage pregnancy. The final sections provide recommendations for managing teenage pregnancy through antenatal care, counseling, education support, and ensuring access to reproductive healthcare and contraception.
This document provides information on common psychiatric disorders that can occur during pregnancy, including depression, anxiety disorders, eating disorders, and psychosis. It defines each disorder, lists their signs and symptoms, and discusses their management through both psychological/non-pharmacological therapies and pharmacological treatments. Nursing responsibilities are also outlined, such as caring for patients, administering medications, organizing therapy sessions, and maintaining accurate records.
This document defines and discusses low birth weight babies, including preterm babies and small for gestational age (SGA) babies. It provides definitions for preterm babies as those born before 37 weeks gestation and low birth weight babies as those weighing less than 2500 grams. SGA babies are defined as those with a birth weight less than the 10th percentile for their gestational age. The document discusses the incidence, etiology, manifestations, management, and complications of low birth weight babies.
This document discusses various types of birth injuries including definitions, risk factors, and descriptions of specific injuries such as head and neck injuries, fractures, and nerve damage. It provides details on different types of extracranial head injuries (caput succedaneum, cephalhematoma, subgaleal hemorrhage), cranial injuries (linear skull fractures, depressed skull fractures), and various forms of intracranial hemorrhage. Signs, symptoms, risk factors, diagnosis, and management are described for each injury. Brachial plexus injuries including Erb's palsy and Klumpke's palsy as well as facial nerve palsy are also summarized.
This document discusses various types of birth injuries including:
- Head and neck injuries such as caput succedaneum, cephalhematoma, subgaleal hemorrhage, skull fractures, and intracranial hemorrhages.
- Nerve injuries including brachial plexus injuries (Erb's palsy and Klumpke's palsy) and facial nerve palsy.
- Risk factors for birth injuries include prolonged or difficult labor, fetal macrosomia, and instrument-assisted delivery. Birth injuries can cause impairments ranging from mild swelling to life-threatening hemorrhages requiring medical or surgical intervention.
BIRTH INJURIES IN NEWBORN: Definition of birth injuries , statistics, etiology, classification of birth injuries , head injuries: cephalhematoma and Caput succedaneum, skull fractures
, nerve injuries: erb's palsy and klumpke's palsy, bone injuries: clavicular and long bone fracture , intra-abdominal and soft tissue injuries, management and prevention of birth injuries
Antenatal care involves regular checkups during pregnancy to monitor the health of the expectant mother and baby. The goals are to reduce mortality and morbidity, identify issues, and educate mothers. Checkups are usually every 4 weeks until 28 weeks, every 2 weeks until 36 weeks, and weekly until delivery. Appointments include health history, physical exam, lab tests, ultrasound, and health advice covering hygiene, nutrition, exercise, sleep, and danger signs. The overall aim is a healthy pregnancy and delivery.
The document discusses the fetal skull. It describes the fetal skull as having thin, pliable bones that allow the skull to compress and mold during birth. The skull has three main parts: the vault of the cranium, face, and base. It discusses the sutures and fontanelles that connect the skull bones and act as landmarks for examining the fetal head. Finally, it lists the key diameters of the fetal skull that are important for determining if the skull can pass through the birth canal.
This document provides information about meconium aspiration syndrome for nursing students. It defines meconium aspiration syndrome as the aspiration of meconium-stained amniotic fluid into the lungs, occurring in 5-20% of births. The document outlines risk factors, pathophysiology involving ball valve obstruction and pulmonary hypertension, clinical features such as respiratory distress, diagnostic tests including chest x-rays, and management involving suction, oxygen, ventilation support, and medications. It also discusses nursing considerations, prognosis depending on associated conditions, and complications including brain and lung damage.
This document discusses respiratory distress syndrome (RDS) in newborns, including its definition, incidence, clinical causes, pathophysiology, clinical manifestations, diagnostic evaluations, preventive measures, complications, treatment principles, and nursing care. RDS occurs in preterm infants due to deficient surfactant production and presents as respiratory distress within hours of birth. Diagnosis is based on clinical signs and confirmed with tests like chest x-rays. Treatment involves supportive care in the NICU, surfactant replacement therapy, and careful monitoring to prevent complications.
Neonatal intensive care involves specialized care for ill or premature newborns. Conditions requiring intensive care include prematurity, low birthweight, and medical issues. Intensive care aims to stabilize infants and address physiological immaturities in organ systems like respiratory, cardiovascular, and gastrointestinal systems. Intensive care involves continuous monitoring, respiratory support like CPAP or ventilation, thermoregulation, fluid management, and nutrition until infants can maintain homeostasis independently. Surgery for conditions like gastroschisis requires optimizing all body systems before, during and after the operation.
Cardiotocography (CTG) is a technical method for recording the fetal heartbeat and uterine contractions during pregnancy using ultrasound and tocodynamometry. CTG involves using an electronic fetal monitor, commonly known as a cardiotocograph, to obtain a record of the fetal heart rate and uterine contractions. It was invented in the 1960s and refined to be more accurate. CTG is typically used in late pregnancy or labor to evaluate fetal well-being and identify any signs of hypoxia.
This document discusses factors that define high-risk newborns and various conditions that can lead to a newborn being considered high-risk. It identifies demographic, medical history, pregnancy, labor/delivery, and neonatal factors that increase risk. Common high-risk conditions include preterm birth, low birth weight, growth restriction, respiratory distress, and congenital anomalies. The document provides definitions and clinical features of conditions like preterm infants, low birth weight babies, and discusses their management and complications. Hypothermia and hyperthermia in newborns are also summarized.
This document summarizes information about intrauterine growth restriction (IUGR). It discusses normal fetal growth occurring in three stages: hyperplasia, hyperplasia and hypertrophy, and hypertrophy. Causes of IUGR include maternal, fetal, placental, and environmental factors. Maternal causes include medical conditions, malnutrition, smoking, and infections. Fetal causes include genetic abnormalities and infections. Placental causes include improper placentation and reduced blood flow. Clinical features of IUGR infants include a large head, thin skin, and scaphoid abdomen. Risk prediction methods include ultrasound and Doppler. Problems for IUGR infants include hypoxia, hypoglycemia, and immunological and metabolic issues. Management
National iodine deficiency disorders control programme (niddcp)anjalatchi
Iodine deficiencies are very common, especially in Europe and Third World countries, where the soil and food supply have low iodine levels. Your body uses iodine to make thyroid hormones. That's why an iodine deficiency can cause hypothyroidism, a condition in which the body can't make enough thyroid hormones
A small for gestational age baby is one that is smaller than normal for the number of weeks spent in the womb. They have all organs formed but they are small. Predisposing factors include maternal malnutrition, infections, and placental abnormalities. Medical investigations are done to rule out infections. The baby requires nutritional support through breastfeeding or tube feeding, monitoring to prevent hypothermia and hypoglycemia, and treatment of any infections. Complications can include hypothermia, hypoglycemia, and brain damage if not managed properly.
USAID (United states Agency for International Development)Ankita Kunwar
USAID was established in 1961 by President John F. Kennedy to administer foreign aid. It is responsible for $27 billion in civilian foreign aid annually, making it one of the largest official aid agencies globally. USAID has historically focused on development assistance, disaster relief, and achieving US foreign policy goals. It has shifted its priorities and approaches over the decades based on global events and needs, from infrastructure projects to basic human needs to promoting free markets and democracy. Today, USAID works in over 100 countries on issues like agriculture, health, education, gender equality, and the environment through bilateral missions and regional offices. In Asia, USAID supports programs in countries like Afghanistan, India, Sri Lanka, and Nepal on economic development, governance
1) Diaphragmatic hernia is a defect in the diaphragm that allows abdominal organs to protrude into the chest cavity.
2) Congenital diaphragmatic hernia (CDH) affects 1 in 2,500-4,000 births and can cause life-threatening lung issues.
3) Treatment involves surgical repair of the diaphragmatic defect and may include extracorporeal membrane oxygenation (ECMO) to support lung and heart functions.
This document discusses the emotional and physical changes that occur during pregnancy for both mothers and fathers. It covers the three trimesters of pregnancy and common feelings in each stage like anxiety, depression, and concern over weight gain or the baby's sex. Fetal development from embryo to fetus is outlined week by week. The importance of emotional support from family as well as understanding the psychological changes of pregnancy for better coping is also emphasized.
Antenatal exercises are exercises performed by the women in their antenatal period to enhance the circulation and prevent various kind of complications. It also gives a feeling of well being to the women.
1) The first 24 hours of life require immediate care of the newborn to establish respiratory function, provide warmth, and ensure safety from injury and infection.
2) Key aspects of immediate newborn care include clearing the airway, maintaining temperature, assessing with the APGAR score, and providing identification.
3) Procedures like drying, positioning, suctioning, cord clamping and eye care help support the newborn's transition to extrauterine life. Vital signs, reflexes and growth are also assessed.
Difference between adulty and child (For B.Sc Nursing)PranavSahu8
The document discusses several key differences between adults and children that are important for nurses to understand. Physiologically, children have thinner skin, more rapidly dividing cells, and different circulatory and organ systems compared to adults. Psychologically, children progress through different developmental stages and have less developed social and emotional capabilities. Pathologically, children are more susceptible to dehydration and have different disease presentations. Cognitively, children demonstrate increasing but maturing abilities with age unlike adults. Understanding these developmental differences is crucial for nurses to provide appropriate care for children.
This document discusses teenage pregnancy in Sarawak, Malaysia. It begins with definitions and background statistics on teenage pregnancy. In Sarawak, the adolescent birth rate is high at 62 per 1000 births, and many teenage mothers stop their education. The document outlines the dilemmas posed by teenage pregnancy given cultural acceptance in Sarawak. It then discusses the antenatal, birth, postpartum, social, and offspring issues related to teenage pregnancy. The final sections provide recommendations for managing teenage pregnancy through antenatal care, counseling, education support, and ensuring access to reproductive healthcare and contraception.
This document provides information on common psychiatric disorders that can occur during pregnancy, including depression, anxiety disorders, eating disorders, and psychosis. It defines each disorder, lists their signs and symptoms, and discusses their management through both psychological/non-pharmacological therapies and pharmacological treatments. Nursing responsibilities are also outlined, such as caring for patients, administering medications, organizing therapy sessions, and maintaining accurate records.
This document defines and discusses low birth weight babies, including preterm babies and small for gestational age (SGA) babies. It provides definitions for preterm babies as those born before 37 weeks gestation and low birth weight babies as those weighing less than 2500 grams. SGA babies are defined as those with a birth weight less than the 10th percentile for their gestational age. The document discusses the incidence, etiology, manifestations, management, and complications of low birth weight babies.
This document discusses various types of birth injuries including definitions, risk factors, and descriptions of specific injuries such as head and neck injuries, fractures, and nerve damage. It provides details on different types of extracranial head injuries (caput succedaneum, cephalhematoma, subgaleal hemorrhage), cranial injuries (linear skull fractures, depressed skull fractures), and various forms of intracranial hemorrhage. Signs, symptoms, risk factors, diagnosis, and management are described for each injury. Brachial plexus injuries including Erb's palsy and Klumpke's palsy as well as facial nerve palsy are also summarized.
This document discusses various types of birth injuries including:
- Head and neck injuries such as caput succedaneum, cephalhematoma, subgaleal hemorrhage, skull fractures, and intracranial hemorrhages.
- Nerve injuries including brachial plexus injuries (Erb's palsy and Klumpke's palsy) and facial nerve palsy.
- Risk factors for birth injuries include prolonged or difficult labor, fetal macrosomia, and instrument-assisted delivery. Birth injuries can cause impairments ranging from mild swelling to life-threatening hemorrhages requiring medical or surgical intervention.
This document discusses birth injuries, including definitions, risk factors, types, and descriptions of specific injuries. Some key points:
- Birth injuries occur in about 0.7% of births and account for under 2% of neonatal deaths. Factors like difficult delivery or fetal positioning can increase risk.
- Types of injuries include head/neck trauma, nerve injuries, fractures, and internal organ damage. Specific injuries discussed include brachial plexus injuries, skull fractures, intracranial hemorrhages, and others.
- Injuries are described in detail, along with typical presentations, diagnostic methods, and treatment approaches depending on severity. Head injuries commonly involve skull fractures or bleeding, while nerve injuries often affect the
This document discusses various types of birth injuries including definitions, risk factors, and clinical features. It covers injuries to the head such as cephalhematoma and subgaleal hemorrhage. It also discusses other types of injuries like brachial plexus injuries, facial nerve palsy, and spinal cord injuries. For each type of injury, the document provides details on symptoms, diagnosis, and treatment approaches.
This document discusses the management of common neonatal disorders, focusing on birth injuries. It describes various types of birth injuries including soft tissue injuries, skull injuries like caput succedaneum and cephalohematoma, intracranial hemorrhages, and nerve injuries like facial palsy, Erb's palsy, and Klumpke's palsy. For each type of injury, the document outlines signs and symptoms as well as treatment approaches like observation, splinting, massage, and in severe cases surgery. Overall it provides an overview of different birth injuries, how to diagnose them, and their typical management in newborns.
Fetal birth injuries can be avoidable or unavoidable and affect the infant during labor and delivery through mechanical, hypoxic or ischemic means. Common injuries include skull fractures, intracranial hemorrhage, brachial plexus injuries, and fractures or injuries to the spine or spinal cord. Diagnosis may involve ultrasound, CT scan or MRI. Treatment depends on the specific injury but may include supportive care, antibiotics, anticonvulsants, transfusions, or surgery in rare cases. Prevention focuses on careful delivery management and treating any underlying maternal or fetal conditions.
Cranial hemorrhage in newborns can be extracranial (e.g. cephalhematoma) or intracranial (e.g. subdural hemorrhage). Intracerebral hemorrhage, especially germinal matrix and intraventricular hemorrhage, is the most common type seen in preterm infants. Risk factors include prematurity, fluctuations in blood pressure, and hypoxic events. Intraventricular hemorrhage is graded based on its extent using cranial ultrasound or CT scan. Most hemorrhages occur within 3 days of birth and management involves supportive care though progressive ventricular dilation may require ventricular shunting. Outcomes depend on the grade of hemorrhage
Fetal birth injuries can be avoidable or unavoidable, occurring during labor and delivery. They may result from inappropriate medical care or despite skilled care. Common injuries include skull fractures, cephalohematomas, and intracranial hemorrhages. Intracranial hemorrhages can occur from birth trauma, asphyxia, or vascular issues and often involve the ventricles in premature infants. Symptoms may include apnea, lethargy, and bulging fontanel. Diagnosis is via ultrasound, CT scan, or lumbar puncture. Treatment focuses on stabilization, antibiotics if needed, and managing increased intracranial pressure. Prevention strategies include judicious delivery management and antenatal steroids for premature
Birth injuries can occur due to mechanical forces during delivery. Soft tissue injuries like abrasions and lacerations are common. Skull injuries such as cephalohematomas and subgaleal hematomas can result from pressure on the head. Nerve injuries, including brachial plexus injuries and facial palsy, are typically caused by excessive stretching or compression of nerves. Musculoskeletal issues like clavicle fractures may also occur. It is important to carefully examine newborns for any signs of trauma and potential additional injuries from the birthing process.
This document discusses various types of birth injuries that can occur in infants. It describes soft tissue injuries, skull injuries like cephalohematomas and fractures, and intracranial hemorrhages. It also covers facial injuries like subconjunctival hemorrhages and brachial plexus injuries. Risk factors for birth injuries include primiparity, fetal macrosomia, and mechanical forces during delivery. Diagnosis involves physical examination, imaging, and assessment of neurologic function. Management depends on the type and severity of injury but may include wound care, splinting, ventilation support, or surgery.
This document discusses birth injuries, their causes, presentations, and management. It covers common injuries like fractures of the clavicle, femur, and skull. Neurological injuries like brachial plexus injuries and facial nerve injuries are also discussed. Various types of hemorrhages are outlined, including extracranial hemorrhages like cephalohematomas and subgaleal hemorrhages, as well as intracranial hemorrhages such as subdural and subarachnoid hemorrhages. Risk factors, signs, and treatment approaches are provided for different injuries. Overall, the document provides an overview of birth injuries, their etiologies, and clinical management.
This document provides guidance on performing a newborn examination. It discusses examining the baby's history, vital signs, appearance, major body systems and reflexes. The examination is conducted in a warm, well-lit room and includes assessing temperature, heart rate, respiratory rate, blood pressure, color, muscle tone, reflexes, measurements and a full physical exam from head to toe. The exam evaluates the skin, fontanelles, eyes, ears, heart, lungs, abdomen, genitals, limbs and neurological function through assessing tone and primitive reflexes. The goal is to identify any abnormalities and ensure healthy development.
- Birth trauma can cause scalp injuries like caput succedaneum, subgaleal hematoma, and cephalohematoma. Skull fractures including linear, depressed, and occipital osteodiastasis fractures can also occur.
- The most serious complication is intracranial hemorrhage which can present as epidural hematoma, subdural hematoma, subarachnoid hemorrhage, or intraparenchymal hematoma.
- Risk factors include macrosomia, breech presentation, and forceps or vacuum assisted delivery. Imaging like CT is important to evaluate skull fractures and hemorrhages, while management depends on severity and symptoms.
This document discusses various types of birth injuries that can occur in newborns, including soft tissue injuries, cranial injuries, nerve injuries, fractures, and intra-abdominal injuries. It identifies risk factors for birth injuries such as prematurity, large baby size, breech presentation, and traumatic delivery methods. Each type of injury is defined and examples are provided, along with typical signs, symptoms, and treatment approaches. Nursing management focuses on close physical assessment, monitoring, consultation, and supporting feeding when appropriate.
"Mastering the Basics: General Physical Examination in Neurology with Dr. Ganeshgouda"
🌟 Greetings, aspiring healthcare professionals! Dr. Ganeshgouda here, and today, we're delving into the fundamentals of neurological assessment through General Physical Examination (GPE). Whether you're a medical student, a resident, or anyone eager to understand the essentials of examining the nervous system, this discussion is tailored just for you.
This document discusses birth asphyxia, including its definition, causes, classification, complications, diagnosis, and treatment. It defines birth asphyxia as the incapacity of a newborn to begin or support spontaneous respiration after delivery due to a lack of oxygen during labor and delivery, with an Apgar score of less than 4 at 1 minute. Asphyxia can be mild, moderate, or severe depending on factors such as metabolic acidosis, Apgar score, and neurological symptoms. Complications of asphyxia include hypoxic-ischemic encephalopathy and other organ injuries. Diagnosis involves clinical evaluation, blood tests, imaging, and EEG monitoring. Resuscitation follows the ABC approach of establishing airways, breathing,
This document provides an overview of syringomyelia, including:
- It is a spinal cord cavity filled with cerebrospinal fluid, with a prevalence of 9 per 100,000 people.
- It can be caused by traumatic injury, Chiari malformation, or other craniovertebral junction anomalies.
- Symptoms depend on the location and extent of the syrinx and can include sensory loss, weakness, pain, and autonomic dysfunction.
- Magnetic resonance imaging is the best way to diagnose and assess syringomyelia.
- Treatment may involve surgery to decompress the craniovertebral junction, open the syrinx, or place a shunt
This document discusses various types of birth injuries that can occur during labor and delivery. It begins by defining birth injuries and noting their prevalence. It then covers predisposing risk factors and provides a classification system for birth injuries involving soft tissue, the head/neck, facial structures, nerves, fractures, and internal organs. The remainder of the document delves into specific injury types like brachial plexus palsy, skull fractures, retinal hemorrhages, and clavicle fractures, describing their causes, signs/symptoms, diagnosis, and management.
Similar to birthinjuries-131020004916-phpapp01.pptx (20)
Salpingitis is an infection and inflammation of the fallopian tubes, often caused by sexually transmitted infections like gonorrhea or chlamydia. It can be acute or chronic. Symptoms include abnormal vaginal discharge, pelvic pain, and fever. Risk factors include STIs, menstruation, and sexual intercourse. It is diagnosed through examination, tests, and treated with antibiotics to prevent complications like infertility and ectopic pregnancy.
Retained placenta is defined as the placenta not being expelled within 30 minutes of birth. There are three causes of retained placenta: interference in the normal separation and descent of the placenta, poor voluntary expulsion, and uterine atonicity from factors like multiparity or prolonged labor. The diagnosis is made based on the time since delivery and assessing signs of separation. Risks of a retained placenta include hemorrhage, shock, and infection. Management depends on whether the placenta is separated or not - separated placentas are expressed by controlled cord traction while unseparated require manual removal under anesthesia.
Antenatal care is care provided by healthcare professionals to pregnant women to monitor the health of the mother and fetus. The goals of ANC include detecting health problems, preventing or treating complications, educating mothers on pregnancy and newborn care, and preparing mothers for childbirth. During visits, healthcare providers conduct physical exams and assessments, order tests, provide health education on nutrition, exercise, danger signs, and conduct screenings. Common models of ANC include focused and comprehensive care, with comprehensive care involving multiple visits that include physical exams, tests, immunizations, and health education.
The document discusses the structure and features of the fetal skull. It describes that the fetal skull is made of thin, compressible bones that form the vault. It identifies three main areas - the vertex, brow, and face. It then explains key features like the fontanelles, sutures, and diameters. The anterior fontanelle is formed by four sutures and allows for brain growth and molding of the head during birth. Molding refers to the alteration of the skull shape to pass through the birth canal. The biparietal diameter is an important transverse measurement between the parietal eminences.
This document outlines the purposes and procedures for a newborn examination. The goals are to identify any abnormalities, complications from delivery, or diseases in the newborn. The examination involves assessing vital signs, appearance, measurements, and examining each body system from head to toe. The APGAR score is also determined to evaluate the newborn's condition at 1 and 5 minutes after birth. A thorough physical exam is important for the health and survival of the newborn.
Fertilization is the fusion of an egg and sperm to form a single cell called a zygote. This initiates embryonic development and restores the chromosome number. The sperm must travel through the fallopian tubes to reach the egg within 12-24 hours. Upon contact, the sperm penetrates the egg's layers and its genetic material combines with the egg's to form a single pronucleus with a full chromosome count. Implantation of the blastocyst then occurs around 6 days after fertilization, as it adheres to the uterine wall and infiltrates the endometrium in a multi-stage process culminating in full invasion.
The document provides information on the development of the placenta and fetus. It discusses that the placenta develops from the trophoblastic layer of the blastocyst starting at 3 weeks after fertilization. The placenta establishes maternal-fetal circulation by 17 days and reaches maturity by the third trimester. It functions to transport oxygen, nutrients, and waste between the mother and fetus. Fetal development proceeds rapidly from the embryonic stage through the fetal stages, with all major organ systems developed by 8 weeks and the fetus gaining weight and physical features through the second and third trimesters.
This document provides information about anaemia, including its definition, classification, causes, symptoms and treatment. It defines anaemia as a reduction in red blood cells or haemoglobin below the normal range. Anaemia can be classified based on red blood cell morphology (microcytic, normocytic, macrocytic) or etiology (blood loss, impaired production, increased destruction). Common causes include iron deficiency, vitamin B12/folate deficiency, sickle cell disease, aplastic anaemia, and haemolytic anaemia. Symptoms vary depending on the type but can include fatigue, pale skin, shortness of breath. Treatment depends on the underlying cause but may include iron supplementation, vitamin supplements, blood transfusions, and
This document outlines the criteria for a normal pregnancy and details the schedule and procedures for antenatal visits. It describes physical examinations including measurements of height, weight, and vital signs. Conditions of the mouth, neck, legs, and breasts are examined. The position of the fetus within the uterus and pelvis is also assessed. Potential causes of edema during pregnancy are listed.
This document defines ectopic pregnancy and outlines its risk factors, clinical presentation, diagnosis, and treatment. Key points include:
- Ectopic pregnancies most commonly implant in the fallopian tubes. Risk factors include previous PID, ectopic pregnancy, tubal surgery or ligation, and IUD use.
- Clinical presentation varies but can include abdominal pain, vaginal bleeding, and symptoms of internal bleeding such as shoulder pain or fainting from blood tracking to the diaphragm.
- Diagnosis involves pregnancy testing, ultrasound to locate the pregnancy, and sometimes laparoscopy.
- Treatment depends on stability but may involve methotrexate injection if the criteria are met or laparoscopy
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
2. DEFINITION
• An impairment of the infants body function
or structure due to adverse influences that
occur at birth
• (National vital statistics report)
3. RISK FACTORS
• Primiparity
• Small maternal stature
• Maternal pelvic anomalies
• Prolonged or unusually rapid labor
• Oligohydramnios
• Malpresentation of the fetus
4. • Use of mid forceps or vaccum
extraction
• Versions and extractions
• Very low birth weight or extreme
prematurity
• Fetal macrosomia or large fetal head
• Fetal anomalies
9. CAPUT SUCCEDANEUM
• A caput succedaneum is a
serosanguinous fluid collection above the
periosteum. It presents as a soft tissue
swelling with purpura and ecchymosis
over the presenting portion of the scalp. It
may extend across the midline and across
suture lines.
10. Contd..
• The edema disappears within the 1st few
days of life.
• Molding of the head and overriding of the
parietal bones disappear during the 1st
weeks of life.
• Rarely, a hemorrhagic caput may result in
shock and require blood transfusion.
11. MANAGEMENT
• No specific treatment is needed
• But if extensive ecchymoses are present,
hyperbilirubinemia may develop
• Shock – Blood transfusion
13. Clinical features
• Swelling, usually over a parietal or
occipital bone
• Swelling does not cross a suture line and
is often not associated with discoloration
of the overlying scalp.
• Limited to the surface of one cranial bone.
15. • If infection is suspected, aspiration of the
mass
• If sepsis, antibiotics
• hyperbilirubinemia – photo therapy
16.
17. SUBGALEAL HEMORRHAGE
• A subgaleal hemorrhage is bleeding
between the galea aponeurosis of the
scalp and the periosteum.
18. FEATURES
• A subgaleal hemorrhage presents as a
firm-to-fluctuant mass that crosses suture
lines.
• The mass is typically noted within 4 hours
of birth.
19. LABORATORY FINDINGS
• serial hemoglobin and hematocrit
monitoring,
• coagulation profile to investigate for the
presence of a coagulopathy.
• Bilirubin levels also need to be monitored
20. TREATMENT
• Supportive
• Transfusions may be required if blood loss
is significant.
• In severe cases, surgery may be required
to cauterize the bleeding vessels.
• These lesions typically resolve over a 2–3
week period
22. LINEAR SKULL FRACTURES
• Usually affect the parietal bones.
• The pathogenesis is related to
compression from the application of
forceps, or from the skull pushing against
the maternal symphysis or ischeal spines.
• Rarely, a linear fracture may be
associated with a dural tear, with
subsequent development of a
leptomeningeal cyst.
23. DEPRESSED SKULL FRACTURES
• Indications for surgery include
• radiographic evidence of bone
fragments in the cerebrum
• presence of neurologic deficits
• signs of increased intracranial pressure
• signs of cerebrospinal fluid beneath the
galea
• failure to respond to closed manipulation.
24. • Indications for nonsurgical management
include
• Depressions less than 2 cm in width and
depressions over a major venous sinus
• Without neurologic symptoms
27. INTRACRANIAL HAEMORRHAGE
• Bleeding can occur
– External to the brain into the epidural,
subdural or subarachnoid space
– In to the parenchyma of the cerebrum or
cerebellum
– Into the ventricles from the subependymal
germinal matrix or choroid plexus
28. RISK FACTORS
• forceps delivery
• vacuum extraction
• precipitous deliver
• prolonged second stage of labor
• macrosomia
30. EPIDURAL HEMORRHAGE
• Epidural hemorrhage primarily arises from
injury to the middle meningeal artery, and
is frequently associated with a
cephalhematoma or skull fracture.
35. • Laceration of the tentorium, with rupture of
the straight sinus, vein of Galen transverse
sinus, or infratentorial veins causing a
posterior fossa clot and brainstem
compression
• Laceration of the falx, with rupture of the
inferior sagittal sinus resulting in a clot in
the longitudinal cerebral fissure
36. • Laceration of the superficial cerebral vein,
causing bleeding over the cerebral
convexity
• Occipital osteodiastasis, with rupture of
the occipital sinus, resulting in a posterior
fossa clot
37. CLINICAL FEATURES
• Respiratory symptoms such as apnea
• Seizures
• Focal neurologic deficits
• Lethargy
• Hypotonia
• Other neurologic symptoms
43. INTRAPARENCHYMAL
HAEMORRHAGE
• TYPES
• Intra cerebral
Causes:
• rupture of an av malformation or aneurysm
• coagulation disturbances
• extracorporeal membrane oxygenation
therapy
• secondary to a large ICH in any other
compartment
44. • Intracerebellar :
more common in preterm than the
term babies. May be a primary
haemorrhage or may result from venous
hemorrhagic infarction or from extension
of GMH/ IVH
45. CLINICAL FEATURES
• In the preterm infant
– IPH is often clinically silent in either
intracranial fossa , unless the hemorrhage is
quite large
• In the term infant, manifestations are
– Seizures
– Hemiparesis
– Gaze preference
– Irritability
– Depressed level of consciousness
49. FACTORS IN THE PATHOGENESIS
• Intra vascular factors
– Ischemia / reperfusion
– Fluctuating cerebral blood flow
– Increase in CBF
– Increase in cerebral venous pressure
– Platelet dysfunction
– Coagulation disturbances
50. • Vascular factors
– Tenuous involuting capillaries with large
diameter lumen
• Extra vascular factors
– Deficient vascular support
– Excessive fibrinolytic activity
51. CLINICAL FEATURES
In the preterm newborn
• Usually clinically silent
• Decreased levels of consciousness and
spontaneous movement
• Hypotonia
• Abnormal eye movement
• Skew deviation
52. In term newborns
• Seizures
• Irritability
• Apnea
• Lethargy
• Vomiting with dehydration
• Full fontanels
58. ERB-DUCHENNE PARALYSIS
• 5th and 6th cervical nerves injury
• The infant loses the power to abduct the
arm from the shoulder, rotate the arm
externally, and supinate the forearm
• Erb’s palsy may also be associated with
injury to the phrenic nerve,
which is innervated with
fibers from C3–C5
59. • Adduction and internal rotation of the arm
with pronation of the forearm.
• Biceps reflex is absent
• Moro reflex is absent on the affected side.
• The involved arm is held in the ‘‘waiter’s
tip’’ position, with adduction and internal
rotation of the shoulder, extension of the
elbow, pronation of the forearm, and
flexion of the wrist and fingers.
60. KLUMPKE’SPALSY
• Involves the C8 and T1 nerves, resulting in
weakness of the intrinsic hand muscles
and long flexors of the wrist and fingers
61. • The grasp reflex is absent but the biceps
reflex is present.
• Flaccid extremity with absent reflexes.
62. ASSOCIATED LESIONS
• Hematomas of the sternocleidomastoid
muscle, and fractures of the clavicle and
humerus.
• Ipsilateral Horner’s syndrome (ptosis,
miosis, and anhydrosis) when there is
accompanying injury to the sympathetic
fibers of T1.
63. TYPES
• Neuropraxia with temporary conduction
block
• Axonotmesis with a severed axon, but with
intact surrounding neuronal elements
• Neurotmesis with complete postganglionic
disruption of the nerve
• Avulsion with preganglionic disconnection
from the spinal cord
65. MANAGEMENT
• Initial treatment is conservative.
• The arm is immobilized across the upper
abdomen during the first week
• Physical therapy with passive range-of-
motion exercises at the shoulder, elbow
and wrist should begin after the first week.
• Infants without recovery by 3 to 6 months
of age may be considered for surgical
exploration
67. Clinical manifestations
• weakness of both upper and lower facial
muscles.
• At rest, the nasolabial fold is flattened and
the eye remains persistently open on the
affected side.
• During crying, there is inability to wrinkle
the forehead or close the eye on the
ipsilateral side, and the mouth is drawn
awayfrom the affected side.
69. TREATMENT
• protection of the involved eye by
application of artificial tears and taping to
prevent corneal injury.
• neurosurgical repair of the nerve should
be considered only after lack of resolution
during 1 year of observation
70. PHRENIC NERVE INJURY
• The phrenic nerve arises from the third
through fifth cervical nerve roots.
• Injury to the phrenic nerve leads to
paralysis of the ipsilateral diaphragm.
71. CLINICAL MANIFESTATIONS
• respiratory distress, with diminished breath
sounds on the affected side.
• Chest radiographs show elevation of the
affected diaphragm, with mediastinal shift
to the contralateral side.
• Ultrasonography or fluoroscopy can
confirm the diagnosis by showing
paradoxical diaphragmatic movement
during inspiration
72. TREATMENT
• Initial treatment is supportive
• Oxygen
• Respiratory failure may be treated with
continuous positive airway pressure or
mechanical ventilation.
• Gavage feedings.
• Plication of the diaphragm
75. Treatment
• Small frequent feedings may be required
to decrease the risk of aspiration.
• Intubation
• Tracheostomy
• Bilateral paralysis tends to produce more
severe distress, and therefore requires
intubation and tracheostomy placement
more frequently
76. SPINAL CORD INJURY
• Clinical findings
• decreased or absent spontaneous
movement
• absent deep tendon reflexes
• absent or periodic breathing
• lack of response to painful stimuli below
the level of the lesion.
77. • Lesions above C4 are almost always
associated with apnea
• Lesions between C4 and T4 may have
respiratory distress secondary to varying
degrees of involvement of the phrenic
nerve and innervation to the intercostal
muscles
78. MANAGEMENT
• If cord injury is suspected in the delivery
room, the head, neck, and spine should be
immobilized.
• Therapy is supportive.
80. NASAL SEPTAL
DISLOCATION
• Nasal septal dislocation involves
dislocation of the triangular cartilaginous
portion of the septum from the vomerine
groove
81. CLINICAL FEATURES
• airway obstruction.
• deviation of the nose to one side
• The nares are asymmetric, with flattening
of the side of the dislocation (Metzenbaum
sign).
• Application of pressure on the tip of the
nose (Jeppesen and Windfeld test) causes
collapse of the nostrils, and the deviated
septum becomes more apparent.
82. MANAGEMENT
• Definitive diagnosis can be made by
rhinoscopy
• manual reduction performed by an
otolaryngologist using a nasal elevator.
• Reduction should be performed by 3 days
of age
83. OCULAR INJURIES
• Rupture of Descemet’s membrane of the
cornea
• lid lacerations
• hyphema (blood in anterior chamber)
• vitreous hemorrhage
• Purtscher’s retinopathy
• corneal edema,
• corneal abrasion
84. CONGENITAL MUSCULAR
TORTICOLLIS
• atrophic muscle fibers surrounded by
collagen and fibroblasts.
• tearing of the muscle fibers or fascial
sheath with hematoma formation and
subsequent fibrosis.
85. CLINICAL FEATURES
• The head is tilted toward the side of the
lesion and rotated to the contralateral side,
• chin is slightly elevated.
• If a mass is present, it is firm, spindle-
shaped, immobile, and located in the
midportion of the sternocleidomastoid
muscle, without accompanying
discoloration or inflammation.
86. DIAGNOSIS
• physical examination
• Radiographs should be obtained to rule
out abnormalities of the cervical spine.
• Ultrasonography may be useful both
diagnostically and prognostically.
90. Risk factors
• higher birth weight
• prolonged second stage of labor
• shoulder dystocia
• instrumented deliveries
91. MANAGEMENT
• Asymptomatic incomplete fractures require
no treatment.
• Complete fractures are treated with
immobilization of the arm for 7 to 10 days
95. TREATMENT
• immobilization and splinting
• Closed reduction and casting are required
only when the bones are displaced.
• Proximal femoral fractures may require a
spica cast or use of a Pavlik harness
96. INTRA-ABDOMINAL INJURY
Liver injury is the most common
• Three potential mechanisms lead to intra-
abdominal injury:
• (1) direct trauma,
• (2) compression of the chest against the
surface of the spleen or liver
• (3) chest compression leading to tearing of
the ligamentaous insertions of the liver or
spleen
97. CLINICAL MANIFESTATIONS
• With hepatic or splenic rupture, patients
develop sudden pallor, hemorrhagic
shock, abdominal distention, and
abdominal discoloration.
• Presentation of a liver rupture with scrotal
swelling and discoloration has been
described.
98. • Subcapsular hematomas may present
more insidiously, with anemia, poor
feeding, tachypnea, and tachycardia.
• Adrenal hemorrhage may present as a
flank mass
99. DIAGNOSIS
• abdominal ultrasound
• Computed tomography
• Abdominal radiographs may show
nonspecific intraperitoneal fluid or
hepatomegaly.
• Abdominal paracentesis is diagnostic if a
hemoperitoneum is present
100. TREATMENT
• volume replacement and correction of any
coagulopathy.
• If the infant is hemodynamically stable,
conservative management is indicated.
• With rupture or hemodynamic instability, a
laparotomy is required to control the
bleeding.
• Patients with adrenal hemorrhage may
require hormone replacement therapy.
101. SOFT TISSUE INJURIES
• Petechiae and ecchymoses
• Lacerations and abrasions
• Subcutaneous fat necrosis