DEFINITIONS IN NEONATOLOGY
EMBRYO
LMP
FETUS
12 wks.
CONCEPTION
INTRAUTERINE PERIOD
NEONATE
40
wks.
INFANT
1 month
BIR TH
1 year
BIRTHDAY
NEONATAL
PERIOD
PERI NATAL
NEONATAL – PERINATAL RISK GROUPS
1.
2.
2.
2.
Defined by:
Gestational age:
Preterm infant
Full term infant
Post term infant
over)
- less then 259 days (37 wks.)
- 259 – 293 days (37–41 wks.)
- 294 days and over (42 wks. &
2.
3.
3.
3.
Birth weight in relation to gestational age:
AGA - appropriate for gestational age
SGA - small for gestational age (SFD)
LGA – large for gestational age (LFD)
3.
4.
4.
4.
4.
Birth weight:
High birth weight
Low birth weight (LBW)
Very low birth weight (VLBW)
Extremely low birth weight (ELBW) -
4000 gm & more
2500 gm & less
1500 gm & less
1000 gm & kess
DETERMINATION OF GESTATIONAL AGE
1.
Last menstrual period (LMP)
first day of the LMP to the day of birth using complete weeks.
2.
DUBOWITZ SCORE (1971) – difficult to perform and time consuming
3.
BALLARD SCORE
– physical and neuromuscular maturity
4.
HITTNER SCORE
– eye (lens) vascularity
DETERMINATION OF GESTATIONAL AGE
Usher’s criteria
I.
II.
Sole creases
 <32 wks.

32 wks.

34-36 wks.

37 wks.

40-41 wks.
 >42 wks.
-
smooth soles without creases
first crease (near toes)
second crease
third crease in the middle of sole
creases on the entire sole
creases on the heel, desquamation
Male genitalia
Testis position
28-30 wks. - in inguinal canal
31 wks.
- external inguinal ring
36 wks.
- upper scrotum
Scrotum
<28 wks.
28-36 wks.
36 wks.
40 wks.
40 wks.
- lower scrotum
- smooth
- few rugae
- rugae anterior
scrotum
- on entire sac
II.
Female genitalia
30 wks.
- small labia majora, widely separated, prominent clitoris
36 wks.
- labia majora longer, nearly cover the clitoris
40 wks.
- labia majora completely cover labia minora and the clitoris
III.
Breast
Nipples
<32 wks.
32-36 wks.
>38 wks.
Breast tissue
- barely visible
<34 wks.
- well defined, flat areola 34-36 wks.
diameter <7 mm
36-38 wks.
- raised areola,
>38 wks.
diameter >7 mm
- not palpable
- 1-2 mm
- 4 mm
- >7 mm
IV.
V.
Ear
Cartilage
<32 wks.
32-36 wks.
Form
- pinna soft, stays folded <33 wks.
- scant, returns slowly
33-34 wks.
36-38 wks.
- thin, springs back
36-37 wks.
>38
- firm, immediate recoil
39-40 wks.
Hair
20-22 wks.
23-28 wks.
28-36 wks.
37-41 wks.
-
- flat, shapeless
- helix incurved up to
Darwin tubercle
- incurving upper
2/3 pinnae
- incurving extended
to ear lobe
appear on head
eyebrows and lashes
fine, woolly, bunches out from hear
silky, simple strands, lays flat.
NEONATAL RISK GROUPS
R
H
I
T
H
Preterm
HMD
IVH
Sepsis
Hypothermia
Reticulocytes
vs
M
M
O
Numerous
2%
PDA, ARF, NEC
S.G.A
Aspiration
Pulmonary
TORCHES
Hypothermia
Polycythemia
Thrombocytopenia
Hypoglycemia
7 – 8%
Postasphyxial
Post term infants
1. Respirator
2. Hematologic
3. Metabolic
Risks
Aspiration syndromes
Polycythemia
Erythroblastosis
Hypoglycemia
Large for dates
Neonatal complication
Mechanical
Neonatal asphyxia
Metabolic
Hypoglycemia
Hematologic
Polycythemia
Cephalhematoma
Fractures
Palsies
Pneumothorax
Cerebral hemorrhage
Hyperbilirubinemia
GOOD NEONATAL MEDICINE
Anticipation of problems with appropriate prophylaxis or, at
least, early
recognition with expedient intervention.