Complications of Preterm
- 1. HMD (Hyaline membrane disease) = RDS Respiratory Distress syndrome (>30% of neonatal mortality)
- 2. Apnea ( >20sec , or Any period if associated with central cyanosis and bradycardia )
- 3. Chronic lung disease (= Bronchopulmonary dysplasia) - Oxygen dependence even after >4wks life - Therefore give Home O2 Therapy.
- 4. CNS Depression (Birth asphyxia) , IVH (Intraventricular haemorrhage) , PVL (Periventricular Leucomalacia)
IVH - because capillaries in germinal matrix are fragile
- Sudden death ,
- Sudden shock ,
- Bulging out Anterior fontanale (Therefore do Transfontanale USG)
(Note : Term babies IVH - because of breech presentation.)
In Preterm - PVL --> Commando Crawling (UL strong , LL weak) -- Spastic Diplegia --> Cerebral Palsy
In Term - Parasagital --> Prolonged asphyxia --> Diffuse neuronal loss --> Status Marmoratus --> When child grows -- Spastic Quadriplegia --> Cerebral palsy
Cerebral Palsy Complications :
- Global developmental delay
- Microcephaly & Mental Retardation
- Feeding difficulties
- 5. CVS - Hypotension , PDA ( because of prostaglandins due to asphyxia ) (Treatment of PDA here - NSAIDS - Brufen , Indomethacin )
- Brufen is preferred over Indomethacin because of less renal side effects , i.e both decrease GFR but its less with brufen.
In Term - PDA is usually due to Rubella - because of vessel wall defect (therefore here t/t - Surgery - Inserting coils in Ductus Arteriosus or Use Duct Occluders.)
- 6. Blood - Anaemia , Jaundice of Prematurity
- 7. Hypothermia , Hypoglycemia , Hypocalcemia
- 8. Gut - NEC
- 9. Infections (because of decreased immunity)
- 10. ROP (Retinopathy of prematurity = Retrolental fibroplasia - if 100% oxygen given) - Proliferated, dilated and tortuous vessels in Vitreous.