high risk newborns followup NEW.pptx

Neonatal

1. FOLLOW UP OF HIGH RISK NEWBORNS By Dr SANDRA MARY JOSE

2. Birth weight <1.5 kg Gestation < 32 weeks Infants with BW of 1. 5 kg or more OR gestation 32 weeks or more AND IUGR Meningitis Received mechanical ventilation for 48 hours or more HIE stage 2 or higher Major malformation IEM / chromosomal /genetic /Intrauterine infections Symptomatic hypoglycemia Symptomatic polycythemia Retropositive mother

3. Hyperbilirubinemia requiring exchange transfusion OR Rh isoimmunisation/cholestasis Abnormal neurologic examination at discharge / seizures Major morbidities such as chronic lung disease , IVH grade III or more ( Papiles classification) and periventricular leucomalacia

4. ROP SCREENING

5. BERA

6. In infants with no risk factors  OAE In infants with risk factors  AABR ; if fail repeat ;if repeat fail – Diagnostic BERA Infants born < 34 weeks  after they reach 34 weeks post menstrual age Readmissions in the first month in high risk infants  Repeat hearing screen before discharge Missing the screen return after 6 weeks

7. NEUROIMAGING

8. Preterm neonates < 32 weeks – Routine NSG at 7 – 14 days and between 36- 40 weeks Term infants with asphyxia  Prognosis – MRI from day 3- 14 Prediction of outcome at 1 year of age - MRI at day 8 – 30 Term neonates with bilirubin encephalopathy  MRI in the newborn period once infant is clinically stable

9. METABOLIC SCREENING

10. THANK YOU