Contents Chapter Topic Page Neonatology Respiratory Cardiology

Definition
Premature infant: < 37 weeks gestation
THE PREMATURE INFANT
Low Birth Weight (LBW): < 2500 g
Very Low Birth Weight (VLBW): < 1500 g
Extremely Low Birth Weight (ELBW): < 1000 g
Small for Gestational Age: < 10th centile of Birth Weight for age.
Complications in premature infants
a) Perinatal Asphyxia
b) Hypothermia
c) Respiratory (RDS and apnoea)
d) CVS (Hypotension, PDA)
e) Neurological: Intraventricular haemorrhage and Periventricular leukomalacia
f) Gastrointestinal (Paralytic ileus, NEC)
g) Hypoglycaemia and hyperglycaemia
h) Neonatal Jaundice
i) Hypoprothrombinaemia
j) Fluid and Electrolyte imbalance (hyponatraemia, hyperkalemia, metabolic acidosis)
k) Anaemia
l) Neonatal Sepsis
m) Rickets
n) Oxygen therapy: ROP, CLD
o) Neuro-developmental disabilities
p) Psychosocial problems
Management
A. Before and During Labour
Prewarmed incubator and appropriate equipment for neonatal intensive care
should always be kept ready in NNU.
B. Adequate Resuscitation
C. Transfer from Labour Room (LR) to NNU (Neonatal Unit)
a) Use prewarmed transport incubator if available. If not the baby must be wiped dry
and wrapped in dry linen before transfer.
b) If the infant's respiration is inadequate, keep the infant INTUBATED and
AMBUBAGGED with oxygen during the transfer.
D. Admission Routine
- Ensure thermoneutral temperature for infant. An incubator or radiant warmer is
necessary for more premature and ill babies.
- Ventilation is often necessary if ventilated during transfer.
- If oxygen saturation is < 90%, oxygen therapy should be given.
- Head circumference (OFC), length measurements and bathing can be omitted.
- Quickly and accurately examine and weigh the infant.