SLIDE 1
6/29/2011 1
Pediatrics
Fernando Vega, MD HIHIM 409
Neonatal Medicine
- Fetal Assessment
- Gestational Age: obstetrical interventions
- –amniocentesis, c‐section, inevitable premature
delivery delivery
- LMP, quickening, first fetal heart tones,
- Physical exam,
- Ultrasound
– 1st trimester: crown‐rump – 2nd and 3rd trimester: BPD
Neonatal Medicine
- Functional maturity
- Fetal Growth
- IUGR
- Hydrocephalus
- macrosomia
- Fetal well being
- Fetal well being
- Lungs
- Fetal movement
- Non stress test
- Fetal activity is accompanied by a
reflex acceleration of fetal heart rate‐ a reflex present by 32 weeks of gest.
Neonatal Medicine
- Specific Fetal diseases
– Alpha‐fetoprotein (AFP) – maternal and fetal – Anencephaly, congenital nephrosis, duodenal atresia, encephalocele, esophageal atresia, fetal blood contamination, fetal death, gastroschisis, hydrocephalus, , , g , y p , Myelomeiningocele, Necrosis of fetal liver 2o to HSV infection, Nuchal bleb, omphalocele, Rh isoimmune disease, sacroccygeal teratoma, spontaneous abortion, – Trisomy 13, Turner’s syndrome, Twins, urinary obstruction
- Amniotic fluid: liquid and cellular elements.
- Percutaneous umbilical blood sampling
Neonatal Medicine
- Timing of delivery
– Fetal well being – Maternal well being
Neonatal Medicine
- Labor and Delivery
– Stages of Labor:
- 1st ,is from onset of labor to 10 cm dilation
- 2nd,passage through the birth canal
2 ,passage through the birth canal
- 3rd,from delivery of baby to passage of placenta
– Fetal well being
- Fetal heart monitors