COMMON NEONATAL

DISORDERS
AND ITS MANAGEMENT
 INTRODUCTION:

 The first 24 hours of life is a very significant and

a highly vulnerable time due to critical
transition from intrauterine to extra uterine life
 A wide variety of disorders affecting the
newborn may originate in utero, during birth or
in immediate post natal period. These disorders
may be due to prematurity, genetic,
chromosomal aberrations or acquired from
environment.
 CLASSIFICATION;
• A. Common neonatal
problems
• B. Minor disorders of
newborn
• C. Congenital
malformations
A common Neonatal problems:
1. Birth injuries
 Soft tissue injury
 Caput succedanum
 Cephalohematoma
 Nerve Injury
- Facial palsy
- Brachial palsy
- Phrenic nerve palsy
2. Problem related to physiological factors
 Hyperbilirubinemia
 Hypoglycemia
 Hypothermia
3. Problems of respiratory system:
 Respiratory distress syndrome
 Meconium aspiration pneumonia
4. Neonatal septicemia
5. Neonate seizure
B. Minor Disorders of Newborns:
1. Ophthalmia Neonatrum
2. Oral thrust
3. Paronychia
4. Omphalitis
5. Neonate mastitis
6. Nasopharyngitis
7. Rhinitis
8. Vomiting
9. Excessive cry
C. Congenital Malformation:
1. Skeletal Defect
2. Central nervous system defect
3. Gastrointestinal defect
4. Respiratory system defect
5. Cardiovascular defect.
1. Birth injuries
 Soft tissue injury:
 Erythema and abrasion

 Petechiae
 Echymosis

 Subconjunctival hemorrhages
 Head Injury
Cephalohematoma
 Nerve Injury
1
- Facial palsy

- Brachial palsy
- Phrenic nerve palsy
 Brachial palsy

• Brachial Plexus injuries affect the network that

provides feeling and muscles control in the
shoulder, arm, forearm, hand and fingers.
• In newborns, these injuries can happen if:
• The birth is complicated by breech( bottom-
first) delivery
• The mother has a very long labor
• The baby weighs 8 pounds or more
• The baby’s shoulders are too wide to fit through
the birth canal.
- Phrenic nerve palsy
Phrenic nerve palsy or paralysis is the
loss of the ability to move the diaphragm and to
feel the sensations of the chest and upper
abdomen. This may be due to inflammation,
injury, invasion, or compression to the phrenic
nerve.
 NURSING MANAGEMENT:
 Maintained proper body alignment of the
baby.
 Gentle handling
 Careful dressing
 Immobilization
 Proper demonstration of exercise to the
parents
 Protection of eye patches every 4 hourly
 2. Problem related to physiological
functions:
Hyperbilirubinemia:
Hyperbilirubinemia of the newborn is an
excess accumulation of unconjugated bilirubin in the blood
resulting yellowish discoloration of the skin & mucous
membrane of the neonate.
It is usually caused by a deficiency of an enzyme that results
from physiological immaturity or by increased hemolysis,
especially that produced by blood group incompatibility,
which, in severe cases, can lead to kernicterus.
Indirect bilirubin level of more than 5mg/dl
manifested as jaundice.
 VALUES
Serum bilirubin direct: < 0.20 mg/dl
Serum bilirubin indirect: 0.1-1.0mg/dl
Serum bilirubin total: 0.1-1.2mg/dl
Incidence:
Signs of Neonatal Jaundice are seen within the first three days
of birth in 80% of preterm babies and 60% of full-term infants.
Pathophysiology:
 Bilirubin is form from the breakdown of RBC.
 It is excreted from the body in the form of
urobilinogen( through Urine)and stercobilinogen( through
stool)
 Jaundice occurred when the liver cannot excrete sufficient
bilirubin from the plasma.
Classification:
1. Physiological jaundice
2. Pathological jaundice
3. Breast feeding jaundice
 1. Pathological jaundice:
Causes: Immature hepatic function plus
increased bilirubin load from hemolysis of red
blood cells.
Onset: After 24 hours( preterm infants)
Duration: 5-7 days
Therapy: Phototherapy if bilirubin level
increases
2. Breast feeding associated jaundice:
Decreased milk intake related to fewer calories
consumed by infant before mothers milk is well-
establised.
Onset : 2-4 day
Duration: 3-12 weeks or more
Therapy: Increase breast milk, no other supplementary
feeding
3.Pathological jaundice :
Hemolysis of large number of RBC,
Excrete excess bilirubin from hemolysis
Onset: During first 24 hour
Duration : Dependent on severity
Therapy : Phototherapy, severe cases transfuse
of RBC