Updated obstetrical and gaynacolpgy PPT

1. college of health science Department
of midwifery
Post graduate program
Presentation on Neonatology
by: Mehari Girmay

2. Objectives
At the end of this session we will able to:
 Define Pulmonary stenosis, Atrial septal defect and coarctation
of the aorta
 Identify the cause of Pulmonary stenosis, Atrial septal defect and
coarctation of the aorta
 Identify the clinical manifestations of Pulmonary stenosis, Atrial
septal defect and coarctation of the aorta
 Manage Pulmonary stenosis, Atrial septal defect and coarctation
of the aorta

3. Pulmonary stenosis
Definition - Narrowing at the entrance to the pulmonary
artery (stricture of the pulmonic valve).
Cause – An obstructive lesion on the leaflets of the valve.
Clinical manifestations
 Signs of congestive heart failure
 Murmur
 Cardiomegaly

5. Treatment
Treatment- Surgical
 In infants (valvotomy).
 In children valvotomy with cardiopulmonary bypass.
 Balloon angiography (inserting a catheter in to the
pulmonic valve and inflate the balloon

6. Coarctation of the aorta
Definition:- It is a localized malformation of the aorta that
results in a narrowing of the lumen of the vessel.
Cause – Abnormal embryonic development.
Clinical manifestations
 High blood pressure and bounding pulse in arms and low
blood pressure in lower extremities.
 Week or absent femoral pulses

7. Con…
 Cool lower extremities.
 Signs of congestive heart failure.
 Dizziness, head ache, fainting and epistaxis.
 Complications include aortic aneurism, stroke and ruptured
aorta.
• Treatment
Mechanical ventilation.
Antihypertensives.
Surgical correction

9. Atrial septal defect (ASD)
Definition- Abnormal opening between the right and left atria
allowing blood to flow from higher pressure left atrium to lower
pressure right atrium.
There are three types of ASD
1. Ostium premium- Opening at lower end of septum.
2. Ostium secundum- Opening near the center of septum.
3. Sinus venosus defect – Opening near junction of superior vena
cava and right atrium.

10. Cause- Failure of the septal opening to close after birth
spontaneously.
Clinical manifestations
patients may be asymptomatic if small defect
Signs of congestive heart failure
murmur
Treatment. Surgical closure of the defect.
Nursing management – pre and post operative care

12. Reference
1. Merenstein GB, Gardner SL. Handbook of Neonatal Intensive
Care, 6th Ed. Mosby Company 2006.
2. American Heart Association and American Academy of
Pediatrics. 2005 American Heart Association Guidelines for
Cardiopulmonary Resuscitation (CPR) and Emergency
Cardiovascular Care of Pediatric and Neonatal Patients: Neonatal
Resuscitaon Guidelines. Pediatrics 2006; 117: e1029-e1038