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Scenario 2
GROUP 10
Scenario 2
A girl baby, 3 days old, referred from
midwife to hospital with face and
body looked yellow. From
alloanamnesis the baby was born 3
days ago by midwife with birth eight
1500 gr and gestational age 8
months when she was born. Her
mother smokes tobacco regularly.
Keywords
A girl baby, 3 days old
Jaundice
Birth weight 1500 gr
Gestional age 8 months
Mother smokes tobacco regularly
Clarification of words
Questions
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Nutrition
Prenatal Care
Smoking
Multiples pregnancy
Previous premature
birth
Short period between
pregnancies
Pre-eclampsia
HELLP Syndrome
Smoking
Uterine or cervical
abnormalities
Recurring infections
Chronic illnesses
Abortion
Mothers age
PPROM Preterm Premature Rupture of
Membranes
Placental risks & causes Placenta
Previa and Placental Abruption
Effects on
mother
Effects on babies
Fetal death
Infant death
Miscarriage
Cleft lip/palate
Clubfoot
Gastroschisis
Some heart defects
Crypyorchidism
Jaundice in Infant
Infant
jaundice is a yellow
discoloration in a newborn babies
skin and eyes
Common cause : immature liver of
the babies to get rid of bilirubin in
bloodstream
Physiological
jaundice:
occurring in most
newborns
due to immaturity of
the baby's liver
slow processing of
bilirubin
2 to 4 days of age
disappears by 1 to 2
weeks of age
Pathological jaundice:
Criterias :
Breastfeeding
jaundice:
not enough breast milk
- difficulty with
breastfeeding
in 1% to 2%
ofbreastfedbabies
caused by substances
produced in the
mother's breast milk
that cause
hyperbilirubinemia
starts after the first 3
to 5 days
slowly improves over
3 to 12 weeks.
PATHOPHYSIOLOGY OF JAUNDICE
1. During stage 1 ( production of bilirubinI)
i)preterm babies
ii)infection
iii)blood incompatibility
2. During stage 2 (transport of bilirubin I)
i) hypoalbuminemia
3. During stage 3 (conjugation of bilirubin I)
i) hypoglikemia
Smokes tobacco
Hypoxia
Placenta previa
Ketuban pecah dini
Preterm labour
Nicotine
Low birth
weight
Release of
catelcolamine
Decrease
fetal
development
Vasoconstricti
on
Less nutrition
and blood
supply
Produce
protease
Inflammator
y mediator
release
Collagen
degradatio
n
Irritant
from
cigarret
e
ruptured
membra
ne
Initiate
cervical
change
Hypoxia
Increase
placenta
area ( find
the area
with high
oxygen)
Close cervix
surface
(high
oxygen
area)
Preterm
labour
Diagnosis
Bilirubin measurement
Blood type & Rh determination
Peripheral blood smear
Complete blood & Reticulocytes count
Direct Coombs test (DCT)
Anamnesis tambahan
Treatment
Jaundice
Fototherapy
Transfusion therapy
Breastfeeding baby
Regulation of environmental
temperature in an incubator with
temperature set :
Preterm
Feeding and Fluid Management of Preterm Babies
Babies without major illness:
1,75
2,5 kg
1,749 kg
1,49 kg
COMPLICATION OF LBW
inability
Long-term complications:
1. Cerebral
palsy.disorder of movement,
muscle tone or posture that is caused by
injury to a preterm's developing brain.
2. Impaired
cognitive
skills.Learning
disability.
3. Vision problems.Preterm born before 30
weeks
may
develop
retinopathy
of
prematurity (ROP).
4. Chronic health issues. Such as infection.
5. Dental
problems.Increased
risk
of
developing dental problems, eg delayed
tooth eruption, tooth discoloration and
COMPLICATION OF JAUNDICE
PREVENTION OF JAUNDICE
1. Antenatal
2. Avoid
care
Sulfa furazole
Novobiocin
Oxytocin, etc
3. Prevent
4. R/
5. Good
Ilumination
6. Early
feeding
7. Prevent
infection.
THANK YOU!