BERAT BADAN LAHIR RENDAH (BBLR)

ALI USMAN
PERINATOLOGY SUBDIVISION CHILD HEALTH DEPARTEMENT PADJADJARAN UNIVERSITY

I. LATAR BELAKANG
TIMBULNYA LBWI DI (DALAM) NEGARA SEDANG BERKEMBANG ( INDONESIA) RATA-RATA MASALAH: EADAAN TIDAK SEHAT DAN ANGKA KEMATIAN

II. DEFINITION
1. 2. 3. 4. 5.

BIRTH WEIGHT LBWI VERY LOW BIRTH WIGHT INFANT VERY VERY LOW BIRTH WIGHT INFANT PRETERM INFANT (PTI)

6. 7. 8. 9.

IMMATURE INFANT POST TERM INFANT FULL TERM INFANT LBWI GROUPING : FTI, AGA FTI, SGA POST TI, SGA PRE TI, SGA PRE TI, LGA

III. ETIOLOGY
A. PRETEM INFANT IN MANY CASES: LBWI. MOST CASES UNKNOWN CAUSES B. LBWI, SGA : 1. MATERNAL FACTORS 2. PLASENTAL LESIONS 3. FETAL FACTORS

IV. INCIDENCE OF LBWI IN DEVELOPING COUNTRIES : 20% (IBRAHIM, 1987)

INDONESIA : 13% RURAL AREA : 10,5% RSHS (1998) : 20,23% JAKARTA (RSCM,RSHK,RSPAD) : 13,3%

INDEVELOPED COUNTRY : USA (PRE TERM INFANT) 9 %

 V. PROBLEM OF PREMATURITY OR LBW : WHICH ARE RELATED TO DIFFICULTY IN EXTRA UTERINE ADAPTATION DUE TO IMMATURITY OF ORGAN SYSTEM OR INTRA UTERINE GRWOTH RETARDATION.

A. LBW, PRE TERM :

PERINATAL ASPHYXIA NEUROLOGY RESPIRATORY TEMPERATURE REGULATION CARDIOVASCULAR GASTROINTESTINAL METABOLIC PROBLEMS HEMATOLOGIC IMMUNOLOGY RENAL OPHTALMOLOGIC

VI. DIAGNOSTIC LBW / PRETERM INFANT :

BASED ON: 1. ASSESMENT OF LMP 2. ASSESMENT OF DOBOWITZ / BALLARD / SIMPLIFIED DUBOWITZ 3. W.H.O (BIRTH TO LOW WEIGHT)

VII. MANAGEMENT OF LBW/ PTI:

A. ANTE PARTUM B. INTRA PARTUM C. POST PARTUM

A. ANTE PARTUM :
1. FAETAL DISTRESS:

- INTRAUTERINE RESUSITATION
- TOCOLYTIC DRUGS - ANTIBIOTIC (INTRAUTERINE INFECTIONS) 2. CORTICOSTEROID 3. COMMUNICATION OBSTETRIC-PEDIATRIC DEPARTEMENT

B. INTRA PARTUM :
1. RESUSITATION AND 2. STABILITATION

C. POST PARTUM NEONATAL MANAGEMENT:

1. THERMAL REGULATION 2. OXYGEN THERAPY AND ASSISTED VENTILATION 3. NUTRITION : - PARENTERAL (FLUID AND ELECTROLYTE THERAPI) - ENTERAL

4. TO PREVENT AND TRATMENT OF INFECTION 5. TREATMENT OF HYPERBILIRUBINEMIA 6. TREATMENT OF PDA 7. PSYCHOLOGIC REQUIREMENT 8. TO INVOLVE HER/HIS PARENT CARE 9. IMMUNIZATION