Professional Documents
Culture Documents
Conception - Pregnancy - Delivery 1 Week (Early) Neonatal Period: Birth 1 Week Late Neonatal Period: Birth 4 Week
Conception - Pregnancy - Delivery 1 Week (Early) Neonatal Period: Birth 1 Week Late Neonatal Period: Birth 4 Week
1st week
+ neurologic examination
1. Primiparity
2. Small maternal stature
3. Maternal pelvic anomalies
4. Prolonged or extremely rapid labor
5. Deep transverses arrest
6. Oligohydramnion
7. Abnormal presentation
8. Use of mid forceps or vacuum extraction
9. Version and extraction
10. VLBW infant or extreme prematurity
11. Fetal macrosomia
12. Large fetal head
13. Fetal anomalies
1. Soft tissue injuries
2. Head surface
3. Neck and shoulder
4. Extremity
5. External genital
6. Intra abnominal injuries
7. Intra cranial injuries
A. Head and neck injury
C. Bone injuries
E. Soft-tissue injuries
Erythema
Petechiae
Paralysis/Parese Duchene-ERB
Paralysis/Parese Klumppke
Paralysis/Parese nerve phrenicees
Clavicula fracture
1. Associated with fetal monitoring
2. Extracranial hemorrhage
a) Classification :
1. Cephalhematoma
2. Subgaleal hematoma
3. Caput succedaneum
4. Vacuum caput
b) Management :
3. Intracranial hemorhage
1. Cranial nerve injury
facial nerve injury
Malpresentation
Soft tissues
Humerus fracture
Femur fracture
Coxsae dislocation
Radial articulation dislocation
Extremely rare
Liver
Spleen
Adrenal gland
Intracranial haemorrhage
Cause : * mechanical
* hypoxic
* combined
Hypoxic trauma more difficent
to be avoided
CNS immaturity
Cerebral circulation
autoregulation
Classification
1. Subdural
2. Primary subarachnord
3. Intracerebral
4. Periventricular - intraventricular
Hypoxic birth trauma :
HIE necrosis
cerebral cortex atrophy
periventricular leucomalacia
basal ganglia degeneration
Classification :
Major
Minor
Genetic
Non genetic
Chromosome aberration
Multifactorial inheritance
~ Numerical Trisomy
Tetrasomy
Monosomy
~ Structural Deletion
Inversion
Translocation
~ Autosome dominant
~ Autosome Recessive
~ X-linked inheritance
~ Thalassemia
~ Sickle cell anemia
~ Haemophilia
~ Cystic fibrosis
~ G6PD deficiency
1. Infection : TORCH
2. Environment : Mercury
3. Drug-poison : ~ Thalidomide
~ Warfarin
4. Habit : ~ Alcohol
~ Retinoic acid
Total 2.41%
Malformation
Deformation Disruption
Malformation Disruption
Deformation
(poor formation) (mechanical) (destructive)
Multiple Single
localized Localized
defect defec
Malformation
association
Figure 4. Most patient with multiple structural defect will fall into one
of there five categories. The prognosis management, and recurrence risk
counseling may vary considerably among these vategories.
SINGLE LOCALIZED ANOMALY
in early morphogenesis
SECONDARY ANOMALIES
Genetic type :
Optimal perinatal service
Rehabilitation
Operative surgery
Supportive treatment
Genetic councelling
Pra-conceptional councelling