Neonatal sepsis Made Easy to understand all the students DR ATIQUR RAHMAN KHAN MBBS,MD,DCH,MRCPS(GLASCOW),FRCP(UK) Msc Counselling and Psychotherapy Member American Academy of Paediatrics(AAP) Member British Association of Perinatal Medicine(BAPM) Member British Association for Parenteral and Enteral Nutrition(BAPEN) Associate Member Royal College of Paediatrics and Child Health(RCPCH)

1. NEONATAL SEPSIS
 DR ATIQUR RAHMAN KHAN
 SPECIALIST PAEDIATRICS
 NNGH

2. Objectives
 After completion of this session the
participants will be able to understand:
Definition of HELLP Syndrome.
Etiology and clinical manifestations.
Prevention and management.
Complications.
Nursing management.

3. Introduction
 It is a life threatening complication in a
pregnant due to eclampsia and
preeclampsia during antenatal period and
sometime in postnatal period.

4. Pre-eclampsia
It is characterized by the presence of ;
Hypertension
Proteinuria
Eclampsia
It include :
Convulsion

5. DEFINITION
 HELLP Syndrome is a series of symptoms
that make up a syndrome that can affect a
pregnant women.

6. •The reported incidence 0.2-0.6%
•Approximately 4 to 12 percent of patients with
preeclampsia develop superimposed HELLP syndrome.
•Maternal Mortality 35%.

7. Clasification of the HELLP Syndrome
based on the platelet count .
 Class 1 – Platelet count <50
000/mm3.
 Class 2 - Platelet count between
50 000 - 100 000/mm3.
 Class 3 - Platelet count between
100 000 - 150 000/mm3.

8. Etiology
 HELLP syndrome has not been found, it is
an idiopathic.

9. We can also observe
Alternation in biomarkers
Increase in ;
-Maternal alfa-fetal protein
-LDH
Decrease in ;
-Hematocrit

10. Clinical Presentation
Approximately 90 percent of
patients present with
generalized malaise
65 percent with epigastric
pain
30 percent with nausea and
vomiting
31 percent with headache.

12. MANAGEMENT OF THE HELLP
SYNDROME

13. In early stage
1. Regular prenatal visit.
2. Inform your care provider about and
previous eclampsia and preeclampsia,
hypertension, HELLP syndrome.
3. Understand the warning sings and report
to your health care provider.

19. In late stage
 Bed rest and close monitoring
 Hypertensive drugs are used for severe
hypertension. Usually controlled with
labetalol ,hydralizine and nefedipine.
 Platelet transfusion 1 unit per every 10 kg
weight( if platelet count is too low
<50,000/mm3).
 Corticosteroid (to help babies lung

20. Preventing Convulsions
 MgSO4:loading dose of 4-5g ,
:maintenance dose of 1- 2g/hr.
Measure serum magnesium every
4-6hours inorder to avoid
magnesium toxicity.
 If contraindications of MgSO4 exist, use
Phenytoin.

21. Management of labor and
delivery
When considering termination of
gestation in a patient with HELLP,
determine:
 Gestational age.
 Maternal and fetal conditions.
 Fetal presentation.
 Cervical maturity

22. Postpartum Intensive Care.
 Admission in an obstetrical intensive
care unit until:
(1) Sustained increase in the platelet
count and a maintained decrease in
LDH.
(2) Diuresis >100ml/h for 2 consecutive
hours without duiretics.

23. (3) Well controled BP with systolic pressure
130-150 mmHg and diastolic pressure 80-
100 mmHg.
(4) Obvious clinical improvement and absence
of complications.
The absence of improvement of the
thrombocytopenia within 72-96 hours
postpartum indicates severe compromise
of compensatory mechanisms and possible
MULTIPLE ORGAN FAILURE.

24. Thanks
 From Department Of Pediatrics
 NNGH