Neonatal Gestational Age Assessment.ppt
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The Ballard scale (BS) is a set of procedures developed by Dr.Jeanne L Ballard, to determine Gestational Age through neuromuscular and External physical assessment of a newborn
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Abruptio placentae ppt
A serious pregnancy complication in which the placenta detaches from the womb (uterus).
Placental abruption occurs when the placenta detaches from the inner wall of the womb before delivery. The condition can deprive the baby of oxygen and nutrients.
Symptoms include vaginal bleeding, stomach pain and back pain in the last 12 weeks of pregnancy.
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Abruptio placentae ppt
A serious pregnancy complication in which the placenta detaches from the womb (uterus).
Placental abruption occurs when the placenta detaches from the inner wall of the womb before delivery. The condition can deprive the baby of oxygen and nutrients.
Symptoms include vaginal bleeding, stomach pain and back pain in the last 12 weeks of pregnancy.
Depending on the degree of placental separation and how close the baby is to full-term, treatment may include bed rest or a Caesarean (C-section).
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This document discusses uterine malformations, which result from abnormal development of the Mullerian ducts in utero. It describes the 7 classes of uterine anomalies in the American Fertility Society classification system, including septate, bicornuate, and didelphys uteri. For each class, it covers defining features, incidence, diagnosis, associated reproductive risks like miscarriage and preterm birth, and potential treatment options like surgical resection. Complications from uterine anomalies can include abortion, placenta problems, and difficult labor.
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1. Pelvimetry involves measuring the pelvis through external, internal, and radiographic methods to determine suitability for birth. Key pelvic measurements include transverse and superior-inferior diameters.
2. Common pelvic abnormalities include an upright pelvis, goose rumps, exaggerated lowness to the ground, and rickets, which can cause a narrowing of the pelvis.
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forceps delivery
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This document discusses cephalopelvic disproportion (CPD) and contracted pelvis. It defines CPD as a disparity between the fetal head and the mother's pelvis. Contracted pelvis occurs when one or more pelvic diameters is reduced below normal. The document describes various classifications of contracted pelvis and discusses diagnosis, effects, and management approaches for CPD and contracted pelvis which may include a trial of labor or cesarean section depending on the degree of disproportion. Complications of CPD can include maternal and fetal injuries as well as increased morbidity and mortality.
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This document provides guidance on the management of respiratory distress and hemodynamic instability in pregnant patients. It outlines the following steps: initial assessment and resuscitation, taking history and physical exam, sending investigations, making a differential diagnosis, admitting the patient to the ICU for close monitoring, managing severe preeclampsia, watching for complications, and managing complications. Specific guidance is provided on airway management, fluid resuscitation, seizure control with magnesium, blood pressure control, fluid management, indications for delivery, and management of HELLP syndrome and acute pulmonary edema.
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Different Rh protein factors of the mother and the fetus, this condition is called Rh incompatibility.
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Breech presentation for 4th year med.students
1. Breech presentation occurs in 3-4% of full term deliveries and is when the fetus presents buttocks, feet or knees first instead of head first.
2. It can increase risks for both mother and baby due to difficulties in delivery.
3. Vaginal delivery is considered for multiparous women with adequate pelvis size and average sized fetus, but 85-90% of breech presentations result in c-section.
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This document describes the Ballard Score, an examination used to assess gestational age in newborns. It compares the original Ballard Score to the new Ballard Score. The new score is more accurate, assessing gestational age from birth to 96 hours rather than 26-44 weeks. It also includes additional assessments of the eyes. The Ballard Score considers neuromuscular maturity and physical maturity. Studies show the new Ballard Score has high inter-rater reliability and is generally valid for assessing gestational age, though it may overestimate age in some populations.
Newborn and infants
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The document discusses the structure and abnormalities of the umbilical cord. It notes that the cord normally measures 50-60 cm in length and contains two umbilical arteries and one vein embedded in Wharton's jelly. Abnormalities include short or long cord length, abnormal diameter, single umbilical artery, knots, cysts, and abnormal cord insertion or coiling. Certain abnormalities like short cords or single umbilical artery can increase risks of fetal distress, preterm delivery, or growth restriction.
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This document discusses polyhydroamnios, which is an excess of amniotic fluid during pregnancy. It defines polyhydroamnios as amniotic fluid exceeding 2000 ml or an amniotic fluid index greater than 24 cm. Potential causes include fetal anomalies, multiple pregnancies, or idiopathic cases. Signs and symptoms range from abdominal pain and difficulty breathing with acute cases to leg swelling and discomfort with chronic cases. Ultrasound and amniocentesis are used for diagnosis. Complications include preterm labor and cord prolapse. Management may involve medications, monitoring, and in severe cases, early delivery.
Assessment of Fetal Well being - Dr Padmesh - Neonatology
This document discusses the assessment of fetal well-being through various antenatal monitoring techniques. It outlines the objectives of fetal monitoring as avoiding fetal death and ensuring growth. Common indications requiring monitoring include pregnancies with obstetric or medical complications. Components of assessment include clinical monitoring of maternal weight, blood pressure, uterine size and liquor volume. Antenatal tests described are fetal movement monitoring, the non-stress test (NST), contraction stress test (CST), biophysical profile, and Doppler ultrasonography of the umbilical artery blood flow. The NST and CST assess fetal heart rate patterns in response to movement or contractions respectively.
Pelvimetry, pelvic abnormalities,congenital defects of female rep.tract
1. Pelvimetry involves measuring the pelvis through external, internal, and radiographic methods to determine suitability for birth. Key pelvic measurements include transverse and superior-inferior diameters.
2. Common pelvic abnormalities include an upright pelvis, goose rumps, exaggerated lowness to the ground, and rickets, which can cause a narrowing of the pelvis.
3. Congenital defects of the female reproductive tract include abnormalities of the ovaries, uterine tubes, uterus, and cervix, such as unicornis uterus and uterus didelphys. Extra-uterine pregnancy can also occur if the uterus ruptures.
IUGR
Intrauterine Growth Restriction (IUGR) is defined as failure of the fetus to reach growth potential and is associated with increased morbidity and mortality. It affects 3-10% of pregnancies and increases perinatal mortality rate by 5-20 times. Causes include fetal, placental and maternal factors like infections, structural anomalies, vascular diseases, nutritional deficiencies, and thrombophilias. Diagnosis involves assessing risk factors, fetal measurements and Doppler ultrasound. Management focuses on treating underlying causes, fetal monitoring, timing of delivery and neonatal care. Complications include stillbirth, fetal distress, hypoglycemia and long term risks of metabolic and neurological disorders. Prognosis depends on gestational age and prematurity, with increased
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Gestational age is a key piece of data used by healthcare providers to determine the timing of various screening tests and assessments of the fetus and mother throughout pregnancy. Gestational age may be assessed at any time during pregnancy, and several modes of assessment exist, each requiring different equipment or skills and with varying degrees of accuracy. Obtaining more accurate estimates of gestational age through better diagnostic approaches may initiate more prompt medical management of a pregnant patient.
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This document discusses small for gestational age (SGA) babies, including the definition, implications, causes, diagnosis, and management. SGA refers to babies that fail to reach weight thresholds by certain gestational ages. Left undetected and unmonitored, SGA can lead to stillbirth, birth complications, and long-term health issues. Common causes include chromosomal abnormalities. Diagnosis involves ultrasound scans, fundal height measurements, and Doppler tests. Management includes determining causes, surveillance with Doppler ultrasound, and deciding on delivery timing and method based on test results.
Cpd & contracted pelvis
This document discusses cephalopelvic disproportion (CPD) and contracted pelvis. It defines CPD as a disparity between the fetal head and the mother's pelvis. Contracted pelvis occurs when one or more pelvic diameters is reduced below normal. The document describes various classifications of contracted pelvis and discusses diagnosis, effects, and management approaches for CPD and contracted pelvis which may include a trial of labor or cesarean section depending on the degree of disproportion. Complications of CPD can include maternal and fetal injuries as well as increased morbidity and mortality.
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This topic contains definition, types, etiology, associated factors, diagnosis, management of cord prolapse.
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This document provides guidance on the management of respiratory distress and hemodynamic instability in pregnant patients. It outlines the following steps: initial assessment and resuscitation, taking history and physical exam, sending investigations, making a differential diagnosis, admitting the patient to the ICU for close monitoring, managing severe preeclampsia, watching for complications, and managing complications. Specific guidance is provided on airway management, fluid resuscitation, seizure control with magnesium, blood pressure control, fluid management, indications for delivery, and management of HELLP syndrome and acute pulmonary edema.
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Different Rh protein factors of the mother and the fetus, this condition is called Rh incompatibility.
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1. Breech presentation occurs in 3-4% of full term deliveries and is when the fetus presents buttocks, feet or knees first instead of head first.
2. It can increase risks for both mother and baby due to difficulties in delivery.
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- 1. Dr.Khadiga Abd-Elgayed Gomea Hassan Asst.Prof. Pediatric Health Nursing
- 2. As a pediatric nurse, what will you do to determine if the newborn is mature or not?
- 4. Understand GA assessment tool. Classify neonate according to GA. Conduct neonatal GA assessment. Apply neonatal GA assessment.
- 5. Definition The Ballard scale (BS) is a set of procedures developed by Dr.Jeanne L Ballard, to determine Gestational Age through neuromuscular and External physical assessment of a newborn .
- 6. Classification of Newborn According to G.A: Term :completed 37 wks till 42 wks Premature: less than 37 wks gestation. Post term: after 42 wks. According to weight LBW: <2500gm. VLBW: <1500gm. ELBW: <1000gm.
- 7. • Assessment methods of GA include: – Menstrual history of mother. – Prenatal ultrasonography. – Evaluation of obstetric parameters. – Postnatal maturational examination as Ballard Scale.
- 8. Tool to assess GA. ◦ Optimal accuracy within 12 hours. ◦ Most accurate 28 wks and under 43 wks. ◦ Physical more accurate than neurological. ◦ GA affected by mother medical problems.
- 9. Precaution
- 10. Hand washing
- 12. Less than 5minutes examination time
- 13. GA Assessment • Two parts – External physical assessment. – Neurological assessment.
- 16. Neuromuscular Maturity 1- Posture. How does the baby hold his or her arms and legs. 2- Square window. How far the baby's hands can be flexed toward the wrist. 3- Arm recoil. How much the baby's arms "spring back" to a flexed position. 4- Popliteal angle. How far the baby's knees extend. 5- Scarf sign. How far the baby’s elbows can be moved across the baby's chest. 6-Heel to ear. How close the baby's feet can be moved to the ears.
- 17. 1- posture
- 18. Well term infant showing typical well flexed posture Note the abduction of the hips in this partially flexed preterm infant (“froglike” posture)
- 19. 2-Square Window
- 20. 3. Arm Recoil
- 22. 5-Scarf sign
- 23. 6- Heel to ear
- 27. parchment, deep cracking, no vessels leathery, cracked, wrinkled Skin Sticky, friable, transparent gelatinous, red, translucent smooth pink, visible veins superficial peeling &/or rash, few veins
- 28. Sticky Skin
- 29. friable Skin
- 31. wrinkled
- 33. 2- Lanugo fine non pigmented hair all over 27-28 wks disappears gradually
- 35. 3-Plantar surface: presence or absence of creases
- 39. 6- External genitalia Descend tests Prominent labia majora
- 41. Thank you