Neonatal Issues | Cheat Sheet - Edubirdie

University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

214

Pages:

2
Author:

Mariam A. A.

Neonatal Issues Premature Rupture of Membranes Definition Rupture of the amniotic sac before labour Happens at or after 37 weeks of gestation Causes Infections Cervical insufficiency Mechanical overdistention Polyhydramnios or multiple gestations -> increase tension on membranes Maternal factors Term membrane vulnerabilities Stratified Management Protocol Neonate Category Maternal Factors Management Observation / Disposition Asymptomatic, term ? 4 h of maternal Routine clinical observation; no ROM < 18 h with adequate IV antibiotics empiric antibiotics before birth intrapartum antibiotic prophylaxis Monitor 24–48 h before discharge Asymptomatic term, < 4 h or no maternal antibiotics Single “stat” IM dose of amoxicillin Observe at 12 h, 36 h; (30 mg/kg) and gentamicin (5 discharge at 48–72 h mg/kg), or none if mother received with follow-up intrapartum dosing Clinical signs of sepsis or additional risk factors Full sepsis work-up (blood culture, CBC, CRP); start empiric IV antibiotics (e.g., ampicillin + gentamicin) ROM > 12 h without adequate intrapartum antibiotics Symptomatic or high-risk neonates (respiratory distress, fever, poor feeding) Other info Admit to NICU for continuous monitoring Serial assessment at 12 to 24 hours and 36 to 48 hours Temperature, respiratory effort, perfusion and feeding tolerance Discharge if asymptomatic by 48 to 74 hours, culture negative at 36h and reliable outpatient follow up arranged

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