Download - Clinical Coding Seminar 28th October 2007
Maternal conditions affecting the neonate
Issues of prematurity (<37weeks):
– Cervical incompetence – difficulties with diagnosis
management issues
outcomes ↑PNMR
midtrimester M/C
preterm delivery
Chorioamnionitis
Maternal conditions affecting the neonate
Issues of prematurity (contd):
– Preterm rupture membranes (PROM)
Maternal conditions affecting the neonate
Issues of prematurity (contd):– Preterm rupture membranes (PROM)
DefinitionDiagnosisConsequences ↑PNMR
PTLChorioamnionitishypoplastic lungslimb deformitiesPerinatal morbidity
Maternal conditions affecting the neonate
Issues of liquor volume– (physiology of liquor formation)– Oligohydramnios - association with fetal anomalies
PROM (diag)placental dysfunction (IUGR)
- outcomes ↑PNMRinfectionPTLIUFDHypoplastic lungs
limb problems
Maternal conditions affecting the neonate
Issues of liquor volume (contd)– Polyhydramnios - association with fetal anomalies
multiple pregnancies
diabetes - outcomes ↑PNMR
PTLcord presentation/prolapseunstable fetal liecompound presentationsmetabolic issues (DM)
Maternal conditions affecting the neonate
Placental issues– Position - pl.previa → APH, IUGR, prematurity– Morphology - pl.accreta/increta/percreta → IUGR– Function - Insufficiency → IUGR
Transfusion syndromeSeparation
Cord issues– Cord (funic) presentation/ Cord prolapse
polyhydramnios, unstable lie/high PPmalpresentations
– Vellamentous insertion
Haemolytic disease of the newborn
Definition - breakdown RBCs → anaemia → reduced O2 capacity
Causes: Rhesus incompatibilityABO incompatibilityOther (anti Kell, Duffy etc)ie, isoimmunisation
Outcomes: in utero – hydrops fetalisex utero - anaemia
kernicterus
Birth Injuries
Operative vaginal delivery– Large baby– Maternal exhaustion– poor application/technique/choice
Macrosomia → shoulder dystocia– May not be associated with excessive force– (demonstration)
Birth Injuries
Head - intracerebral – extra/subdural haemscalp – lacerations, haematomafacial nerve
Neck/spine – brachial plexus (Erb’s Palsy)
Other skeletal - # clavicle# humerus# femur