Newborn

Clerkship

Lecture materials and small group cases are posted here for University of Calgary Cumming School of Medicine students. Access to these materials are password protected.

Objectives

By the end of the Paediatric Clerkship, a medical student will be able to:

• Propose an investigation and management plan for a baby with each of the following: respiratory distress, cyanosis, hypoglycemia, hypothermia, sepsis, hypotonia.
• List the associated medical issues of a premature baby, a large for gestational age baby, and a small for gestational age baby.
• Describe the management of an abnormal newborn screen.
• Correctly perform a physical exam on a newborn.Recognize abnormal physical examination findings and list the significance of each abnormal finding.
• Recognize and identify dysmorphic features in a newborn.
• List the signs and symptoms that are suggestive of neonatal abstinence syndrome.
• Explain why vitamin K is given immediately after birth.
• Describe the risk factors for birth trauma and list the injuries a baby might sustain following a traumatic delivery.
• List the congenital infections that are routinely screened for during pregnancy.

Half Day Cases

• 1 day old baby boy was born at 36 weeks gestation to a 31 year old G3, P1 mother with premature rupture of membranes occurred 27 hour prior to delivery. The infant was pale and did not cry immediately. The infant has not nursed well for the last 12 hours, developed fever over the past 6 hours and noted to be lethargic.
• 1 Hour old term baby boy birth weight was 4100g 38 weeks IDM was born by Caesarean section due LGA. Normal Apgar score. Needed routine resuscitation. On examination the baby is tachypnic and grunting. No heart murmur.
• Newborn Preterm 31 week male (BW 1300g), Uncomplicated pregnancy. Required significant resuscitation including IPPV and Nasal CPAP+6 FiO2 30%. Placed on the warmer in the delivery baby started to have increased working of breathing with desaturation and bradycardia.
• Preterm 25 weeks baby boy (BW 750g) born by Caesarean section due uncontrolled gestational hypertension GBS unknown. Mother did not receive antenatal steroids.
• 8 hours baby girl term baby 39 weeks (birth weight 4100g) born by SVD to mother 35 years old G3P2 her pregnancy was complicated with gestational diabetes and was controlled with insulin, baby was not feeding well and noticed to be irritable and jittery.
• 2 days old baby girl term 39 weeks SGA BW 2400g was born by SVD to 21 years old mother. Uncomplicated pregnancy, Normal Apgar score. Needed routine resuscitation. Discharged physical exam was normal except for an abnormal red reflex.