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Paediatric

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Neonatology

Question
20 out of 105
 

Which of the following is not true about newborn assessment - (AIIMS Nov 2013)



A APGARat 7 min indicates neonatal mortality depression

B APGAR at I min, indicators for neonatal resuscitation

C Fetus can tapidly washout CO, through placenta

D Anaeroblc metabolism causes academia

Ans. A

APGAR at 7 min indicates neonatal mortality depression

a. Later times APGAR score (after 5 minutes) indicates about long term neurological rlamagJ (not neonatal mortality) Interpretation of APGAR Score

b. The test is generally done at one and live minutes after birth, and may be repeated later if the score is and remains low. Scores 3 and below are generally regarded as critically low, 4 to 6 fairly low, and 7 to I 0 generally normal.

c. A low score on the one-minute test mat, show that the neonate requires ntedicsl attention (ig, resascintion) but is not necessarily an indication that there will be long-term problems; particularly if there is an lmprovement by the stage of the five-minute test. If the Apgar score remains below i at lotet times such as 10, 15 or j0 mintues, I here is a risk that the child will suffer longer-term neurological damage there is also a small but significant increase of the risk of cerebral palsy. However, the purpose of the Apgar test is to determine quickly whether a newborn needs immediate medical care; it was aol designed to make long-term predications on a child health.

CO2 trensport across placenta

a. CO2 is cleared by placenta by simple diffusion. CO2 is produced abundantly in the fetus, and the PCO2 of fetal blood is higher than matemal blood. CO2 therefore diffuses from fetal blood, trough the placenta, into the matemal circulation, and is disposed by expiration from mother’s lung.

Anaerobic metabolism causes acidemia due to lactate (lactic acid) production

a. Anoxic perfusion causes an increase in glucose consumption which is more than two fold higher than that seen in the oxygenated perfusion, resulting finally in placental uptake of glucose not only from the matemal but also from the fetal circulation.

b. Lactate production is increased during the anoxic perfusion, while the final tissue energy r value lies between the values observed for fresh tissue and for the oxygenated perfusion. The shift to anerobic metabolism shown by placental tissue in anoxic conditions enables continued functioning of the tissue over the 1-h pertusion period but it appear that under anoxic conditions the tissue may incur an energy debt not observed in oxygenated perfusions.

Neonatology Flashcard List

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