DISEASES OF THE
NEWBORN
Respiratory Distress
Syndrome
(Hyaline Membrane Disease)
RDS
Incidence
occurs
primarily in primarily in
premature infants
it occurs in 60-80% of infants < 28
week of gestational age
15-20% of those between 32 and 36
week
5% beyond 37 week
Predisposing Factors:
Premature
infant.
Asphyxia at birth.
Infant of diabetic mothers.
Cesarean Section delivery.
Previous history of hyaline
membrane disease (HMD) in sibling.
Multiple pregnancies.
Pathophysiology of HMD:
Surfactant
Clinical Manifestations:
Diagnostic Tests:
Chest x-ray shows congested lung
field with a ground- glass
appearance that represents alveolar
atelectasis, and dark streaks.
Therapeutic Management
*Maintain
*Oxygen
should
be
warmed
and
humidified
*Maintain
Therapeutic Management
Maintain
acid-base
balance by correct
respiratory
acidosis
through
assisted
ventilation and correct
metabolic acidosis by
IV administration of
sodium bicarbonate.
Maintain
Prevention of HMD
Administration
of corticosteroids to the
mother (24 hours to 7 days before
delivery).
Prophylactic
administration of artificial
surfactant into trachea of premature
neonate.
Prognosis
RDSisaselflimitingdiseaseifmild,
andfollowingaperiodof
deterioration(approximately48hrs)
andintheabsenceofcomplications,
affectedneonatesbegintoimproveby
72hours.
Prognosis
Prognosis
Clinical Manifestations
TTN vs RDS
Etiology
supportive
Observe for the development of respiratory
fatigue and signs of clinical deterioration that
may suggest some other diagnosis
NEONATAL PNEUMONIA
Introduction
Pneumonia
is an important cause of neonatal
infection
Accounts morbidity and mortality
aspecialy in developing country
Pathogenesis
Routes of acquisition: Varies in part
with
the time of onset of pneumonia
Infected individuals
Contaminated equipment
injury tracheal
bronchoia mucosa
bloodstream
In GBS pneumonia,
Pathology
(The patologic changes very with type of
organisms)
Bacteria :
Inflammation of pleura
infiltration / distruction of
brochopulmonary tissue
leukocyte and fibrious exudate within
alveoli and bronchi/ bronchioles
Bacteria are seen within interstitial
spaces, alveoli,bronci/bronchioles
Virus
Microbiology
Cause :
Bacterial
Viral
Spirochetal
Protozoan
Fungal pathogens
Bacterial infections
1.
2.
3.
4.
5.
6.
Escherichia coli
Group B streptococcus
Kleibsiella spp
Staphylococcus aureus
Streptococcus pneumonia
Mycobacterium tuberculosis
transplacentally
7.
Listeria monocytogenes
2.
Viral infections
1.
2.
3.
4.
5.
6.
3.
Fungal infections
1.
4.
Other patogens
1.
2.
Toxoplasma
Syphilis
Bacterial infections
1.
2.
3.
4.
5.
6.
7.
Staphylococcus
Kleibsiella
Escheichia coli
Enterobacter cloacae
Streptococcus pneumoniae
Pseuodomonas aeroginosa
Serratia marcescens
2.
Viral infections
1.
2.
3.
4.
5.
6.
3.
Adenovirus
Parainfluenza virus
Rhinovirus
Enteroviruses
Influenza
RSV
Fungal infections
1.
Candida sp
Risk factors
Assisted ventilation
Other factors
Clinical manifestation
Early- onset pneumonia
Lethagy
Apnea
Tachycardia
Poor perfusion
Septic
Shock
Other sign
Temperature instability
Metabolic acidosis
Abdominal distentions
Respiratory distress
Apnea
Tachypnea
Tachycardia
Poor feeding
Abdominal distention
Jaundice
Emesis
Circulatory collapse
Diagnosis
Treatment
+ gentamycin
Cephalosphorin
Vancomycin + aminoglycoside
viral infection
Acylovir