Disease of foetus (slides share presentation by Akash sen )

Disease of foetus ( Ashpxia neonatorum, Jaundice in newborn, caput succidanum, cephalohaematoma, neonatal conjunctivitis with homoeopathy medicine )

1. NARAYN SHREE HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL. CLINICAL & RESEARCH CENTER (BHOPAL) TOPIC: DISEASE OF FOETUS GUIDED BY : DR. SHEFALI SHINDE [PROFESSOR & HOD] DR. PRERNA TIWARI [ASSOCIATE. PROF] DR. NIHARIKA PRAHLADI [ASSISTANT. PROF] SUBMITTED BY: AAKASH SEN B.H.M.S 3 rd year BATCH: 2021-22 DEPARTMENT OF OBSTETRICS AND GYNECOLOGY

2. Disease of foetus

3. asphyxia neonatorum

4. Definition Asphyxia neonatorum is a clinical condition in which a newborn baby is unable to breathe normally after delivery, resulting in hypoxemia (low oxygen), hypercapnia (high CO₂), and metabolic acidosis.

5. Causes of asphyxia - 1. Antenatal causes (before birth): Maternal hypertension, anemia, diabetes Placental insufficiency Intrauterine growth restriction (IUGR)

6. Intranatal causes (during birth): Prolonged or obstructed labor Premature separation of placenta (abruption) Cord accidents (cord prolapse, cord around neck) Meconium aspiration

7. 3. Postnatal causeqs (after birth ): Prematurity (immature lungs) Respiratory distress syndrome Congenital anomalies (e.g., diaphragmatic hernia)

8. Clinical Features

9. Failure to cry immediately after birth Absent or weak respiration Cyanosis (bluish skin) Bradycardia (slow heart rate) Hypotonia (floppy baby) Poor reflexes

10. Complications Hypoxic ischemic encephalopathy (HIE) Cerebral palsy Seizures Multi-organ dysfunction

11. Manegement 1. Clear airway 2. Provide warmth and dry the baby 3. Stimulation to breathe 4. Positive pressure ventilation if no breathing/HR <100/min 5. Chest compressions + drugs (if HR <60/min despite ventilation)

12. Apgar score

13. Apgar score - A quick test done on a newborn at 1 minute and 5 minutes after birth. It helps doctors check how well the baby is doing outside the womb and whether they need extra care. It check 5 things each given 0,1and 2 point

14. Pata metus of APGAR (A) -Appearance (Skin Color): Checks if the baby's skin (P)- Pulse (Heart Rate): Measures the baby's heart rate. ( G ) -Grimace (Reflexes): Tests the baby's response to stimulation. (A)- Activity (Muscle Tone): Evaluates how much the baby moves. (R)- Respiration (Breathing): Assesses the regularity and strength of the baby's breathing or crying.

15. Total score -10 Good health ( 7-10) Sever 0-3 Mild (4-6)

16. How the Score is Interpreted Each of the five categories receives a score from O to 2, leading to a total score out of 10. 7-10: Reassuring, indicating the baby is in good health. 4-6: Moderately abnormal, suggesting a need for closer monitoring or care. 0-3: Low, which is considered dangerously low and requires immediate emergency care or resuscitation.

17. Jaundice of newborn

18. Jaundice - yellow discoloration of skin, sclera, and mucous membranes due to increased bilirubin levels in the blood.

19. Etiology - 1) Physiological Jaundice (common, harmless) Appears after 24 hours, peaks on day 3–5, disappears by 7–10 days. Cause - increase RBS destruction Short life span of RBC Increase bilirubin

20. 2. Pathological Jaundice (serious, needs treatment) Appears within 24 hours of birth. Serum bilirubin rises rapidly (>5 mg/dL/day). Causes : Hemolytic disease (Rh or ABO incompatibility) Infections (sepsis) Liver disorders G6PD deficiency

21. Danger of High Bilirubin Kernicterus (bilirubin encephalopathy): bilirubin deposits in brain → seizures, brain damage, even death. Causes - haemolytic disease in newborn Hyper bilirubin Server neonatal hepatitis

22. Clinical features - Yellow discoloration of skin eyes , nail tongue Loss of appetite, vometing, nausea, fever with lethargy

23. Management Identify cause (physiological vs pathological). Phototherapy: blue light converts bilirubin into water-soluble form for excretion. Exchange transfusion: if bilirubin is dangerously high. Adequate feeding: to prevent dehydration and help bilirubin excretion.

24. Injuries of newborn

25. A collection of blood between the skull bone and its periosteum (membrane covering bone) in a newborn. Caused by rupture of blood vessels during delivery. Cephalohematoma 👶

26. Causes; Prolonged or difficult labor Rupture of emisssary veins Contract pelvics Use of forceps or vacuum extraction Obstructed delivery Pressure of maternal bones on baby’s skull

27. Treatment / Management 1. Usually no active treatment Most cases resolve spontaneously within 2–6 weeks. Just reassurance to parents is enough. 2. Do NOT aspirate or incise Aspiration ↑ risk of infection and abscess formation. 3. Monitor for complications Jaundice → treat with phototherapy if bilirubin rises. Anemia (rare, if hematoma is large) → may require correction. 4. Calcified Cephalohematoma (rare) If swelling hardens and causes skull deformity, surgical correction may be considered later.

28. Caput succedaneum

29. Caput succedaneum is a diffuse, soft, pitting swelling of the scalp (usually over the presenting part of the head), caused by pressure of the cervix or vaginal wall on the fetal head during labor. Defination -

30. Location : On the presenting part of the scalp (commonly vertex). Crosses suture lines : Yes (because it is above the periosteum in the subcutaneous tissue). Consistency : Soft, boggy, pits on pressure. Size : Diffuse, ill-defined margins. Cause : Prolonged pressure of the birth canal on the presenting part → impaired venous return → edema. Timing : Present at birth. Resolution : Disappears spontaneously within 24–72 hours.

31. Definition Ophthalmia neonatorum is an acute conjunctivitis occurring in a newborn within the first 28 days of life, usually acquired during passage through the birth canal infected with bacteria or viruses.

32. Causes Bacterial Neisseria gonorrhoeae (gonococcal conjunctivitis – most severe) Chlamydia trachomatis Staphylococcus aureus, Streptococcus pneumoniae, E. coli Viral Herpes simplex virus (HSV) Chemical Due to silver nitrate drops (rare nowadays) detergent bath , antibiotics drops

33. Clinical Features Onset: Usually within first few days after birth Gonococcal → 2–5 days Chlamydial → 5–14 days

34. Symptoms : Redness and swelling of eyelids Conjunctival congestion Profuse purulent or mucopurulent discharge Chemosis (swelling of conjunctiva) Severe cases (esp. gonococcal) → corneal ulcer, perforation, blindness

35. Treatment General: Clean eyes frequently with sterile saline. Gonococcal: IV/IM Ceftriaxone + topical antibiotic drops. Chlamydial: Oral Erythromycin/Azithromycin + topical therapy. Herpes: IV Acyclovir + topical antivirals.

36. Homoeopathy therapy

37. 1 . Lachesis – When the child is born apparently dead, bluish discoloration, suffocative tendency, requires stimulation to breathe. 2. Antimonium tartaricum – Difficult, rattling, obstructed respiration, weak vitality, gasping. 3. Camphora – Collapse, icy cold body, no reaction, nearly lifeless. 4. Carbo vegetabilis – “Corpse-like” appearance, bluish, cold, nearly lifeless but with desire for air, faint pulse. 5. Opium – Asphyxia from difficult labour or use of anaesthetics, baby is unconscious, does not respond 6. China (Cinchona ) – Collapse after loss of blood (maternal or cord-related), weak vitality. 7. Hydrocyanic acid – Severe cyanosis, spasmodic breathing, almost no respiratory effort. Asphyxia Neonatorum

38. Chelidonium majus Liver remedy; yellow skin and eyes, clay-colored stools, dark urine; baby may be drowsy; often useful in hepatic or obstructive jaundice. Chionanthus virginica Intense jaundice, enlarged liver, nausea, bitter taste; stools clay-colored, offensive; liver tenderness. Mercurius solubilis Jaundice with thirst, offensive breath, salivation, yellowish stools. Nux vomica Jaundice in babies of mothers who had liver issues during pregnancy or from maternal drug exposure. Irritable, sleepless baby. Podophyllum Jaundice with diarrhea, stools yellowish or green, watery, profuse. Neonatal Jaundice)

39. Arnica montana First remedy after any injury. Bruises, shock, soreness, baby cries when touched. Prevents bleeding and promotes healing of soft tissue. Calendula officinalis For open wounds or lacerations, helps in healthy healing and prevents infection. Can be used externally (mother tincture, diluted) and internally. Hypericum perforatum For nerve injury or pain, especially when the spine, head, or nerve-rich areas are affected (e.g., after forceps delivery). Ruta graveolens For bone or periosteum injury, sprains, or strains — useful in minor fractures or instrumental delivery trauma. Symphytum officinale Promotes bone healing, especially after fracture of clavicle or limb bone in newborn. Often used after Arnica. Bellis perennis Deep internal trauma, especially to soft tissues, abdomen, or pelvic region (used in mother too after difficult labor). Ledum palustre For puncture wounds or injury from needles (injections, IV lines). Helps prevent infection and soreness. Injury in Newborn