Complications of Preterm

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Complications of Preterm

• 1. HMD (Hyaline membrane disease) = RDS Respiratory Distress syndrome (>30% of neonatal mortality) 

• 2. Apnea ( >20sec , or Any period if associated with central cyanosis and bradycardia )

• 3. Chronic lung disease (= Bronchopulmonary dysplasia) - Oxygen dependence even after >4wks life - Therefore give Home O2 Therapy.

• 4. CNS Depression (Birth asphyxia) , IVH (Intraventricular haemorrhage) , PVL (Periventricular Leucomalacia) 

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IVH - because capillaries in germinal matrix are fragile

1. Sudden death , 
2. Sudden shock , 
3. Bulging out Anterior fontanale (Therefore do Transfontanale USG)
4. Seizure

(Note : Term babies IVH - because of breech presentation.)

Birth Asphyxia

In Preterm - PVL --> Commando Crawling (UL strong , LL weak) -- Spastic Diplegia --> Cerebral Palsy

In Term - Parasagital --> Prolonged asphyxia --> Diffuse neuronal loss --> Status Marmoratus --> When child grows -- Spastic Quadriplegia --> Cerebral palsy

Cerebral Palsy Complications :

1. Global developmental delay
2. Microcephaly & Mental Retardation
3. Seizures
4. Feeding difficulties

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• 5. CVS - Hypotension , PDA ( because of prostaglandins due to asphyxia ) (Treatment of PDA here - NSAIDS -  Brufen , Indomethacin )


Brufen is preferred over Indomethacin because of less renal side effects , i.e both decrease GFR but its less with brufen.

In Term - PDA is usually due to Rubella - because of vessel wall defect (therefore here t/t - Surgery - Inserting coils in Ductus Arteriosus or Use Duct Occluders.)

• 6. Blood - Anaemia , Jaundice of Prematurity

• 7. Hypothermia , Hypoglycemia , Hypocalcemia

• 8. Gut - NEC

• 9. Infections (because of decreased immunity)

• 10. ROP (Retinopathy of prematurity = Retrolental fibroplasia - if 100% oxygen given) - Proliferated, dilated and tortuous vessels in Vitreous.

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