What you have to look for…..Lecture for medical undergraduates
ObjectivesAt the end of lecture, the student• should understand the importance of new-born examination.• Should be aware of some normal conditionsthat cause parental anxiety.• Should be able to do a new born examinationsystematically and detect congenital andacquired abnormalities.
Why is it necessary ?1. To detect congenital anomalies.3- 5% of newborns2. To detect some acquired abnormalities.E.g: umbilical sepsis3. Reassure parents when normal findings aredetected.Eg: erythema toxicum
• 4. Identifies familial conditions– DDH• 5. Analysis of findings will identify theproblems specific to regions/ ethnic/age groups– This is particularly important in policymaking & preventive strategies
When would you do it ?• As soon as possible after delivery• Before discharge• At 6/52
Important..• Wash your hands first & dry them• Examination of newbornsrequires patiencegentlenessprocedural flexibility• If the baby is quiet auscultate the heart first• Disturbing manipulations to be done last
New born examination is done from head totoe.Observe the baby• General posture• ColourPinkAcrocyanosisPallor• Appearance of skinVernixLanugo hairNails• ActivityNormal or diminishedTremulous movements
Head* Size and shape to be noted1. Fontanellewidebulging - tensionclosed2. Suturesoverridingwidely separated > 5 mm3. Cephalhaematomableeding under periosteum on the parietal bonesdoes not cross the midline
• Asymmetrical tonicneck reflex- Appear at 2- 4/12- Disappear by 6/12
You CAN’T miss1. Red reflex: Cataract2. Femoral pulse: coarctation of aorta3. DDH• As missing any of the above in new borne examination doesmuch harm than missing anything else.
Summary•New born examination is important in all babies toexclude congenital abnormalities & acquired infections.•All babies should be examined before discharge.•Thorough examination should be done from head to toe.•If abnormalities were detected, can take early actions tocorrect them. Eg: DDH,CTEV•Parents can be reassured if normal variations werefound. Eg: Erythema toxicum