新生儿医学-简介(英文)PPT课件
合集下载
相关主题
- 1、下载文档前请自行甄别文档内容的完整性，平台不提供额外的编辑、内容补充、找答案等附加服务。
- 2、"仅部分预览"的文档,不可在线预览部分如存在完整性等问题,可反馈申请退款(可完整预览的文档不适用该条件!)。
- 3、如文档侵犯您的权益，请联系客服反馈,我们会尽快为您处理(人工客服工作时间：9:00-18:30)。
An infant who should be under close observation by experienced physicians and nurses.
~9% of all births require intensive care
Fetal or neonatal factors:
Le Tour d’abandon (Decertion Tower)
Century of Progress International Exposition Chicago World's Fair, Chicago, Illinois
Julius Hess
“quiet premature nursery”
10 ~ 90th percentile --- appropriate for gestational age (AGA) >the 90th percentile --- large for gestational age (LGA)
ponderal index = BW(g)X100/Length3 (cm3) (>2~2.2)
premature labor, postdates, fetal distrass, breech presentation, meconium-stained fluid, nuchal cord, Cesarean section, forceps low Apgar score, BW<2500 or >4000, SGA or LGA, congenital malformation, tachypnea, cyanosis, pallor, plethora, petechiae
pregnancy to the 7th day of life. Perinatology or Perinatal Medicine
Definitions of Terms
Term defines births that occur from 37th to less than 42 completed
Definitions of Terms
Birth Weight (BW)
BW <2500g --- Low Birth Weight (LBW); <1500g --- Very Low Birth Weight (VLBW); <1000g --- Extremely Low Birth Weight (ELBW); >4000g --- Fetal Macrosomia (Beckwith-Wiedemann syndrome Infant of Diabetic Mother, IDM)
gestation. (37weeks of gestation ≈birth weight of 3000g)
Post-term refers to births that occurs at 42 or more completed
weeks (294 days).
Definitions of Terms
Historical Perspectives
➢ Emergence of neonatal Intensive Care (1971~1989)
- 1971, continuous positive airway pressure (CPAP) --Gregory - neonatal intensive care unit (NICU) - designated by level according to the intensity of service
Stillbirth and Fetal Death.
Early fetal death occurs at < 20 completed weeks of gestation, intermediate fetal death occurs >20 and < 28 completed weeks, late fetal death occurs after 28weeks, or termed as stillbirth.
新生儿医学-简介（英文）
Historical Perspectives
➢ Early History of Care of Infants
(1900~
- small infants were not expected to live
- temperature: hot-water bottles, heated cribs
10~20% of pregnant patient can be identified as high risk
~50% of all perinatal mortality and morbidity is associated with high risk pregnancy
High Risk Infant
I: normal birthing and NB care, II: common obstetric complications & intermediate NB care III: high risk maternal care and NICU - transferring of high risk infants or mothers - high risk and long term outcome - 1980s, extracorporeal membrane oxygenation (ECMO)
weeks, measured from the day of onset of the last normal menstrual period (259~293 days, with an average of 280 days).
Preterm is defined as less than 37 completed weeks’, or 259 days,
Historical Perspectives
➢ Expansion of Clinical Trials to Assess Therapy:
the Surfactant Era (1980~1996) - 1970s~1990s, glucocorticoids to accelerate lung maturation - 1980, first surfactant replacement therapy in humans - total parenteral nutrition (TPN) - high frequency oscillators - inhaled nitric oxide - prenatal diagnosis and genetic counseling - prospective, controlled clinical trials for intervention - “quiet premature nursery” to “a bustling space station”
Live Birth. WHO defines live birth as
The complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of pregnancy, which after such separation, breathes or any other evidence of life, such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached; each product of such a birth is considered liveborn.
Emelie, Cecile, Marie, Annette, Yvonne
The Dionne quintuplets
May 28, 1934, 13 pounds 6 ounces,
All together!
How small is too small? How much is too much?
Early Neonate refers to the first 7 completed days of life. Late Neonate refers to a period between 8 to 28 days of life. Perinatal period extends from the 28th completrolental fibroplasia
- 1945, 《The Physiology of the Newborn Infant》--C. Smith
Historical Perspectives
➢ Rapid Advances in Neonatal Care (1955~1970)
- 1959, surfactant deficiency, Avery ME, Mead J. Am J Dis Child - 1960, 《Disease of the Newborn》-Neonatology -A. Schaffer - culture, blood counts, urinalyses, radiographs, biopsies - milk formulas, breast milk bank - iv glucose & bicarbonate - blood gas analysis - improved incubators - early attempts of mechanical ventilation
Definitions of Terms
Birth Weight vs Gestational Age (GA)
BW <the 10th percentile --- small for gestational age (SGA) intrauterine growth restriction (IUGR)
High Risk Pregnancy
Pregnancies in which factors exist that increase the likelihood of maternal or fetal diseases
Economic, cultural-behavioral, biologic-genetic, reproductive and medical factors
- feeding: tube feeding, diluted cow milk
- separated facilities, isolation, washing hands
- hyaline membrane diseases---respiratory distress syndrome
- 1940s, modernized incubator, more oxygen
Life support: To continue or discontinue?
Definitions of Terms
Newborn or neonate refers to a infant period from birth to 28
days. Neonatology—health care, pathophysiology and management
Length/Head Circumference (HC)
(>1.36)
symmetric or unsymmetric SGA
Birthweight Curves
California male singleton Caucasian non-Hispanic birthweights by gestational age: 10th, 50th, and 90th percentiles.
~9% of all births require intensive care
Fetal or neonatal factors:
Le Tour d’abandon (Decertion Tower)
Century of Progress International Exposition Chicago World's Fair, Chicago, Illinois
Julius Hess
“quiet premature nursery”
10 ~ 90th percentile --- appropriate for gestational age (AGA) >the 90th percentile --- large for gestational age (LGA)
ponderal index = BW(g)X100/Length3 (cm3) (>2~2.2)
premature labor, postdates, fetal distrass, breech presentation, meconium-stained fluid, nuchal cord, Cesarean section, forceps low Apgar score, BW<2500 or >4000, SGA or LGA, congenital malformation, tachypnea, cyanosis, pallor, plethora, petechiae
pregnancy to the 7th day of life. Perinatology or Perinatal Medicine
Definitions of Terms
Term defines births that occur from 37th to less than 42 completed
Definitions of Terms
Birth Weight (BW)
BW <2500g --- Low Birth Weight (LBW); <1500g --- Very Low Birth Weight (VLBW); <1000g --- Extremely Low Birth Weight (ELBW); >4000g --- Fetal Macrosomia (Beckwith-Wiedemann syndrome Infant of Diabetic Mother, IDM)
gestation. (37weeks of gestation ≈birth weight of 3000g)
Post-term refers to births that occurs at 42 or more completed
weeks (294 days).
Definitions of Terms
Historical Perspectives
➢ Emergence of neonatal Intensive Care (1971~1989)
- 1971, continuous positive airway pressure (CPAP) --Gregory - neonatal intensive care unit (NICU) - designated by level according to the intensity of service
Stillbirth and Fetal Death.
Early fetal death occurs at < 20 completed weeks of gestation, intermediate fetal death occurs >20 and < 28 completed weeks, late fetal death occurs after 28weeks, or termed as stillbirth.
新生儿医学-简介（英文）
Historical Perspectives
➢ Early History of Care of Infants
(1900~
- small infants were not expected to live
- temperature: hot-water bottles, heated cribs
10~20% of pregnant patient can be identified as high risk
~50% of all perinatal mortality and morbidity is associated with high risk pregnancy
High Risk Infant
I: normal birthing and NB care, II: common obstetric complications & intermediate NB care III: high risk maternal care and NICU - transferring of high risk infants or mothers - high risk and long term outcome - 1980s, extracorporeal membrane oxygenation (ECMO)
weeks, measured from the day of onset of the last normal menstrual period (259~293 days, with an average of 280 days).
Preterm is defined as less than 37 completed weeks’, or 259 days,
Historical Perspectives
➢ Expansion of Clinical Trials to Assess Therapy:
the Surfactant Era (1980~1996) - 1970s~1990s, glucocorticoids to accelerate lung maturation - 1980, first surfactant replacement therapy in humans - total parenteral nutrition (TPN) - high frequency oscillators - inhaled nitric oxide - prenatal diagnosis and genetic counseling - prospective, controlled clinical trials for intervention - “quiet premature nursery” to “a bustling space station”
Live Birth. WHO defines live birth as
The complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of pregnancy, which after such separation, breathes or any other evidence of life, such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached; each product of such a birth is considered liveborn.
Emelie, Cecile, Marie, Annette, Yvonne
The Dionne quintuplets
May 28, 1934, 13 pounds 6 ounces,
All together!
How small is too small? How much is too much?
Early Neonate refers to the first 7 completed days of life. Late Neonate refers to a period between 8 to 28 days of life. Perinatal period extends from the 28th completrolental fibroplasia
- 1945, 《The Physiology of the Newborn Infant》--C. Smith
Historical Perspectives
➢ Rapid Advances in Neonatal Care (1955~1970)
- 1959, surfactant deficiency, Avery ME, Mead J. Am J Dis Child - 1960, 《Disease of the Newborn》-Neonatology -A. Schaffer - culture, blood counts, urinalyses, radiographs, biopsies - milk formulas, breast milk bank - iv glucose & bicarbonate - blood gas analysis - improved incubators - early attempts of mechanical ventilation
Definitions of Terms
Birth Weight vs Gestational Age (GA)
BW <the 10th percentile --- small for gestational age (SGA) intrauterine growth restriction (IUGR)
High Risk Pregnancy
Pregnancies in which factors exist that increase the likelihood of maternal or fetal diseases
Economic, cultural-behavioral, biologic-genetic, reproductive and medical factors
- feeding: tube feeding, diluted cow milk
- separated facilities, isolation, washing hands
- hyaline membrane diseases---respiratory distress syndrome
- 1940s, modernized incubator, more oxygen
Life support: To continue or discontinue?
Definitions of Terms
Newborn or neonate refers to a infant period from birth to 28
days. Neonatology—health care, pathophysiology and management
Length/Head Circumference (HC)
(>1.36)
symmetric or unsymmetric SGA
Birthweight Curves
California male singleton Caucasian non-Hispanic birthweights by gestational age: 10th, 50th, and 90th percentiles.