Circulatory Shock, types and stages, compensatory mechanisms
high risk newborns followup NEW.pptx
1. FOLLOW UP OF HIGH
RISK NEWBORNS
By Dr SANDRA MARY JOSE
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6. • Birth weight <1.5 kg
• Gestation < 32 weeks
• Infants with BW of 1. 5 kg or more OR gestation 32
weeks or more AND
1. IUGR
2. Meningitis
3. Received mechanical ventilation for 48 hours or more
4. HIE stage 2 or higher
5. Major malformation
6. IEM / chromosomal /genetic /Intrauterine infections
7. Symptomatic hypoglycemia
8. Symptomatic polycythemia
9. Retropositive mother
7. • Hyperbilirubinemia requiring exchange transfusion
OR Rh isoimmunisation/cholestasis
• Abnormal neurologic examination at discharge /
seizures
• Major morbidities such as chronic lung disease , IVH
grade III or more (Papiles classification) and
periventricular leucomalacia
43. • In infants with no risk factors OAE
• In infants with risk factors AABR ; if fail repeat ;if repeat
fail – Diagnostic BERA
• Infants born < 34 weeks after they reach 34 weeks post
menstrual age
• Readmissions in the first month in high risk infants
Repeat hearing screen before discharge
• Missing the screen return after 6 weeks
45. • Preterm neonates < 32 weeks – Routine NSG at 7 – 14 days
and between 36- 40 weeks
• Term infants with asphyxia
1. Prognosis – MRI from day 3- 14
2. Prediction of outcome at 1 year of age - MRI at day 8 – 30
• Term neonates with bilirubin encephalopathy MRI in the
newborn period once infant is clinically stable
At 32 weeks of PMA or 4 weeks of PNA .For imfants less than 28 weeks screen at 3 weeks postnatal age to detect APROP
CPAP or ventilation for any duration , O2 therapy fpr 24 hours or more, inotropic support,anaemia needing blood transfusion,culture positive sepsis
