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Category Archives: Antenatal
Tip 109b: Listeria 2
Listeria infection in neonates has a poor outcome: spontaneous abortion (10-20%), preterm delivery (50%) and intrauterine fetal death (11%). At birth 34% of infants affected had signs of fetal distress, with 75% having meconium at delivery – particularly those who … Continue reading
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Tip 109a: Listeria
Listeria infection is 18 times more common in pregnant women than non-pregnant women, (a reflection of the deficiency of cell medicated immunity in the third trimester) and is usually a mild, flu-like illness for the mother. Reference: Okike, I. O., Lamont, … Continue reading
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Tip 95: CTG – pathological
A pathological CTG is one in which ≥2 non-reassuring or ≥1 abnormal features are present. Abnormal features are: Baseline HR <100bpm, >180bpm, or a sinusoidal pattern Variability <5bpm for 50 mins or >25bpm for 25 mins Single prolonged deceleration 3 mins Variable decelerations in >50% of … Continue reading
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92: CTG – non-reassuring
A suspicious CTG is one in which one non-reassuring feature is present: Baseline HR 100 – 109bpm or 161 – 180bpm Variability <5bpm over 30 – 50 mins, or >25bpm over 15 – 25 mins Variable decelerations with specific time intervals and … Continue reading
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Tip 91b: congenital pulmonary adenomatous malformation (CPAM)
If hydrops is not present antenatally, spontaneous ‘resolution’ is common, with 50% of babies being asymptomatic at birth. Abnormal tissue may still be present, however, with later risk of malignant transformation. Hence these babies should have postnatal CT chest with … Continue reading
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Tip 91a: congenital pulmonary adenomatous malformation (CPAM)
Previously called congenital cystic adenomatous malformation (CCAM), it is usually detected antenatally with a peak size at 25/40. The main risk is hydrops fetalis, with high mortality if present. Reference: Sfakianaki, A. K., & Copel, J. A. (2012). Congenital cystic lesions … Continue reading
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Tip 87: cardiotocography (CTG) – reassuring
A reassuring CTG is one in which: the fetal heart rate is 110 – 160 the HR variability is ≥5 there are accelerations with contractions and no decelerations. Reference: NICE intrapartum care – National Institute for Health and Care Excellence (2014). Intrapartum care. CG190. … Continue reading
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Tip 84: VZIG 2
~50% neonates exposed to maternal chicken pox will become infected despite VZIG prophylaxis. In up to 2/3 of these, infections are mild or asymptomatic but rare fatal cases have been reported in the period four days before to two days after delivery. … Continue reading
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Tip 83: varicella zoster immunoglobulin (VZIG)
VZIG is recommended for infants whose mothers develop chickenpox (but not shingles) in the period seven days before to seven days after delivery. VZIG is also recommended for VZ antibody-negative infants exposed to chickenpox or shingles in the first seven days of … Continue reading
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Tip 253b: BAPM extreme prematurity framework
Survival statistics made easy for parents are as follows and based on babies who are born alive and receive active stabilisation (very few babies at 22 weeks). More details are in the Framework. 22 weeks – 30% survival 23 weeks … Continue reading
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Neonatal Tips 