NEONATOLOGY: MANAGEMENT, PROCEDURES, ON-CALL PROBLEMS, DISEASES, AND DRUGS - part 1 pdf

[...]... The L-S ratio compares levels of lecithin, which increase in late gestation, with levels of sphingomyelin, which remain constant The L-S ratio is usually 1: 1 by 3 1- 3 2 weeks' gestation and 2 :1 by 35 weeks' gestation The following are guidelines to L-S ratios • L-S ≥ 2 :1: Lungs are mature (98% accuracy) Only 2% of these infants will experience respiratory distress syndrome (RDS) • L-S = 1. 5 -1 .9 :1: 50%... upper lip) 3000 38 2.5 3.0 3.5 3. 5-4 .0 6-7 7-8 8-9 9 -1 0 Based on guidelines from Bloom RS, Cropley C: Textbook of Neonatal Resuscitation American Heart Association/American Academy of Pediatrics, 19 95 iv The procedures just described may be continued for up to 2 min after delivery, but then other resuscitative measures (particularly ventilation and oxygenation)... assessment for trisomies 18 and 21 In the first trimester, these serum markers are the free β-human chorionic gonadotropin (hCG) and pregnancy-associated plasma protein A (PAPP-A) It is an effective screening tool, with a detection rate of 8 7-9 2% for trisomy 21 and fewer falsepositive results than the traditional triple-screen test (alpha-fetoprotein [AFP], unconjugated estriol, and hCG) First-trimester screening... administration TABLE 2-3 EXPECTED BIRTH WEIGHT (50TH PERCENTILE) AT 2 4-3 8 WEEKS' GESTATION Gestational age (weeks) Birth weight (g) 24 26 28 30 32 34 36 38 700 900 11 00 13 50 16 50 210 0 2600 3000 Based on data published in Battaglia FC, Lubchenco LO: A practical classification of newborn infants by weight and gestational age J Pediatr 19 67; 71: 159 TABLE 2-4 GUIDELINES FOR ENDOTRACHEAL TUBE SIZE AND DEPTH OF INSERTION... resuscitation and may cause a profound vagal response in the infant (Cordero, 19 71) b Mechanical ventilation Most infants can be adequately ventilated with a bag and mask provided that the mask is the correct size with a close seal around the mouth and nose and there is appropriate flow of oxygen to the bag (Figure 2 -1 ) The stomach should be emptied during and after prolonged bag -and- mask ventilation... beat-to-beat variability, and long-term variability are measured A Baseline fetal heart rate The baseline fetal heart rate is the rate that is maintained apart from periodic variations The normal fetal heart rate is 11 0 -1 60 beats/min Fetal tachycardia is present at 16 0 beats/min or more Causes of fetal tachycardia include maternal or fetal infection, fetal hypoxia, thyrotoxicosis, and maternal use of drugs. .. several TABLE 2 -1 EQUIPMENT FOR NEONATAL RESUSCITATION STANDARD EQUIPMENT SETUP Radiant warmer Stethoscope Oxygen source with warmer and humidifier Suction source, suction catheter, and meconium "aspirators" Nasogastric tubes Apparatus for bag -and- mask ventilation Ventilation masks Laryngoscope (handles, blades, and batteries) Endotracheal tubes (2.5, 3.0, 3.5, and 4.0 mm) Intravenous fluids (10 % dextrose,... Am J Obstet Gynecol 19 81; 140:289 Porter TF et al: Vibroacoustic and scalp stimulation Obstet Gynecol Clin North Am 19 99;26:657 Russell JC et al: Multicenter evaluation of TDx test for assessing fetal lung maturity Clin Chem 19 89;35 :10 05 Wilson RD: Amniocentesis and chorionic villus sampling Curr Opin Obstet Gynecol 2000 ;12 : 81 CHAPTER 2 Delivery Room Management OBSTETRIC ANESTHESIA AND THE NEONATE During... anesthetic and analgesic drugs cross the placenta to some degree Flow-dependent passive diffusion is the usual mechanism Most anesthetic and analgesic drugs have a high degree of lipid solubility, a low molecular weight ( . McGraw-Hill Companies NEONATOLOGY: MANAGEMENT, PROCEDURES, ON-CALL PROBLEMS, DISEASES, AND DRUGS - 5th Ed. (2004) FRONT MATTER TITLE PAGE a LANGE clinical manual Neonatology: Management,. copyright  19 99, 19 94, 19 92, 19 88 by Appleton & Lange 34567890 DOC/DOC 0987654 ISBN: 0-0 7 -1 38 91 8-0 ISSN: 069 7-6 295 Notice Medicine is an ever-changing science. As new research and clinical. y0 w0 h0" alt="" NEONATOLOGY: MANAGEMENT, PROCEDURES, ON-CALL PROBLEMS, DISEASES, AND DRUGS 5th Edition. (2004) Tricia Lacy Gomella, MD Part- Time Assistant Professor