Abnormal intrauterine growth patterns not only increase the risk of morbidity and mortality in the early neonatal period, but long-term effect on the growth and development has changed, and CNS function changes and learning problems in childhood.
General management plan proposed an optimal control food for nurses with impaired intrauterine growth and accessibility to be used with the CPS: child two hours, two days in the world, and the premature infant, where apply. Growth disorders are classified as growth, intrauterine growth retardation / restriction (IUGR) and growth.
SGA / IUGR: birth weight each fall at or below the 10 percentile classification maps of local factors (eg ethnicity, height).
LGA / Macrosomic: All birth weight at or above 90 percentile value of the cards to local residents during the week of pregnancy (with special emphasis on the provision of appropriate gestational age) or who were born weighing more than 4,000 grams ( 8lb 13 g).
Neonatal EVALUATION DATABASE
Infant Growth
Activity/Rest
Events to a high level, with strong crying / hungry intake due to chronic intrauterine hypoxia.
Mother FACTORS
More / heavy training
Circulation
Maternal factors
Current date
Heart / lung, bleeding, severe anemia or sickle cell anemia, chronic hypertension or PIH
Elimination
Scaphoid abdomen may appear or hollow.
Maternal factors
Pyelonephritis, chronic renal failure
Food / Fluid
All parts of the body can be in the expected size of the gestational age, but relative to each other and symmetrical (with a chronic or long-term problem during pregnancy).
Weight compared with the length and head circumference (it looks long and thin with a normal head) suggests that episodic vascular insufficiency in the third trimester.
Sunken abdomen, lack of subcutaneous tissue.
Reduced muscle mass, especially in the cheeks, buttocks and thighs.
Demonstrate metabolic instability associated with hypoglycemia / hypocalcemia.
Maternal factors
Dwarfism
Malnutrition / poor food intake (chronic or during the third trimester), history of eating disorders
Advanced diabetes mellitus (class D or higher), PKU
Sensorineural
Cranial sutures and fontanelles blown wide fontanelles appear to be due to insufficient bone growth.
A small head with prominent forehead, nose bridge sank, turned a short nose, thin upper lip, receding chin (an indicator of fetal alcohol syndrome [FAS]).
Tight muscle tone can be displayed with flexion of the upper and lower limbs, small joint / limb abnormalities, and movement limitations (ie, FAS).
With a wide-eyed appearance (associated with chronic hypoxia in the uterus).
Chromosomal syndromes.
Breathing
Signs of respiratory distress may be present (especially in the presence of meconium aspiration syndrome [MAS], polycythemia, or infection).
Mucus may be colored green.
Maternal factors
Heavy smoker
Security
Dry, cracked and scaly skin, skin folds of the release, thin hair.
Meconium staining can be sure, with green spots on the nails in the feet of the cable.
Single umbilical artery may have and / or thin, light yellow, light, dry.
Congenital anomalies / defects or infection may be present.
Maternal factors
Treatment and use of drugs with teratogenic effects (eg, antimetabolites, anticonvulsants, trimethadione)
Collagen diseases, maternal infections such as rubella, syphilis, cytomegalovirus, toxoplasmosis, uterine tumors
Sexuality
Women tend to be smaller than males at birth.
Maternal factors
Junior or advanced maternal age (under 16 years or older than 40 years)
Primiparity, grand multiparity
Placenta previa / divorce, failure, heart attack, fibrosis, thrombosis, hemangiomas, abnormal cord insertion and single umbilical artery with vascular (double,)
Chromosomal abnormalities, chronic intrauterine infection, congenital malformations, multifetal pregnancy, congenital metabolic diseases
Social interaction
Maternal factors
Low socio-economic class
Another child (ren) at home with a history of FTT
Perhaps the previous or current participation in the Department of Social Services
Education and training
It may be premature (and / or multi-member child fetus)
Maternal factors
Poor / incomplete formal education
Alcoholism, drug addiction
Lack of prenatal care
Infant Growth
Activity
Problems maintaining a calm, awake state, slow start
Circulation
Skin color red (associated with polycythemia), jaundice (with bilirubienmetings)
Possible birth defects, such as the introduction of large ships, Beckwith syndrome, or n-erythroblastosis fetalis
Food / Fluid
Macrosomia, abnormal fat deposits and red skin, increased body size relative (excluding children of diabetic mothers [IDM], the weight ratio similar length)
Demonstrate metabolic instability associated with hypoglycemia / hypocalcemia, feeding difficulties
Weight is 4000 grams (8 oz 13 lbs) or more (depending on gestational age) is
Maternal factors
Inappropriate / about nutrition, excessive pregravid weight and / or weight gain> 35 lbs
Large Growth
Diabetes mellitus (class A, B or C)
Sensorineural
A large number of its
It can mean, hypotension / hypertension, impaired reflexes function
Breathing
Signs of respiratory distress may be present as the stress of childbirth, which meconium aspiration / choking, if delivered by a Caesarean, or if the infection.
Security
Birth injury (s) are placed, such as bruising, ulnar replacement cephalhematomas person diaphragmatic nerve palsy, brachial palsy, fracture of the clavicle, ICH / depressed skull fracture (a) Bulging fontanelle sign neurological problems, suggesting depressed fontanelle dehydration.
Intrapartum / renewal events can be detected fetal distress, meconium-stained amniotic fluid, Oligohidramnios, late / variable speed levels7.20 pH of the skin, resuscitation measures.
Proof congenital heart disease can, CNS, kidneys, lungs, digestive tract.
Long, hard nails, the toes and hands.
Absence of vernix caseosa / lanugo, peeling of the epidermis.
Sexuality
Higher prevalence in men
Maternal factors
Birth on the previous growth
Caesarean section due to cephalopelvic disproportion or oxytocin-induced labor related to diabetes / fetal distress / prolonged pregnancy
Multiparous
Social interaction
Slowly the face of a parent or voice (generally improve within 48 hours)
Education and training
It may be early / post-process
This may be a period (42 weeks or more) due to postconceptional bleeding, leading to miscalculation of the date / post term pregnancy associated with the menstrual cycle is longer than 28 days.
Diagnostic tests
Glucose Dextrostix Rating: Less than 40 mg / dL rise in food prices and 25 mg / dL increase in breastfeeding during the first three days indicate hypoglycemia.
Dextrostix serum glucose value <40>
Nurses PRIORITIES
1st Maintenance of physiological homeostasis.
2nd Prevention and treatment of complications.
3rd Identify / reduce the impact of birth trauma.
4th Providing families with the necessary information / strategies in the short term needs associated with growth failure to comply.
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