1. Neonatal Jaundice
Definition:
- Yellowish discoloration of the skin and sclera due to elevated bilirubin levels (>5 mg/dL) in neonates.
Types:
1. Physiological Jaundice (Benign, Common)
- Appears after 24 hours, Peaks at 3–5 days, Resolves by 10–14 days.
- Due to immature liver enzyme (UDP-glucuronosyltransferase).
2. Pathological Jaundice (Serious, Needs Treatment)
- Appears within 24 hours or lasts >2 weeks.
- Causes: Hemolysis (ABO/Rh incompatibility), Sepsis, Biliary atresia.
- May cause Kernicterus (Bilirubin encephalopathy).
Management:
- Phototherapy (For bilirubin >15 mg/dL).
- Exchange Transfusion (If bilirubin >25 mg/dL or signs of kernicterus).
2. Neonatal Sepsis
Definition:
Systemic infection in a newborn within the first 28 days of life.
Types:
- Early-Onset Sepsis (EOS): Within first 72 hours (From maternal infections).
- Late-Onset Sepsis (LOS): After 72 hours (From environment, hospital-acquired).
Common Pathogens:
- Group B Streptococcus (GBS) – Most common cause.
- E. coli, Listeria monocytogenes, Klebsiella, Staphylococcus aureus.
Clinical Features:
- Poor feeding, Hypothermia or Fever.
- Lethargy, Respiratory distress.
- Hypotonia, Jaundice, Vomiting.
Management:
- Empirical IV Antibiotics:
- Ampicillin + Gentamicin (First-line).
- Cefotaxime (If meningitis suspected).
3. Respiratory Distress Syndrome (RDS)
Definition:
- Surfactant deficiency leading to alveolar collapse and respiratory distress in preterm infants (<34 weeks).
Risk Factors:
- Prematurity (<34 weeks).
- Maternal diabetes.
- Cesarean delivery (without labor).
Clinical Features:
- Tachypnea (>60 breaths/min), Grunting, Nasal flaring, Intercostal retractions.
- Cyanosis, Low oxygen saturation.
Diagnosis:
- Chest X-ray: Ground-glass appearance, Air bronchograms.
Management:
- Antenatal steroids (Betamethasone) at <34 weeks to promote lung maturity.
- Surfactant therapy (Exogenous surfactant via endotracheal tube).
- Oxygen & CPAP (Continuous Positive Airway Pressure).
4. Meconium Aspiration Syndrome (MAS)
Definition:
Respiratory distress due to aspiration of meconium-stained amniotic fluid into the lungs.
Risk Factors:
- Post-term birth (>42 weeks).
- Fetal distress (Hypoxia, Cord compression).
Clinical Features:
- Respiratory distress at birth.
- Meconium-stained amniotic fluid.
- Coarse lung crackles on auscultation.
Management:
- Immediate suctioning at birth (If non-vigorous baby).
- Oxygen therapy & Mechanical ventilation (If severe).
- Surfactant & Antibiotics (If infection suspected).
5. Hypoxic-Ischemic Encephalopathy (HIE)
Definition:
Brain injury caused by perinatal asphyxia due to oxygen deprivation.
Causes:
- Prolonged labor, Cord prolapse, Uterine rupture, Placental abruption.
Clinical Features:
- Poor reflexes, Hypotonia.
- Weak or absent cry.
- Seizures (in severe cases).
Management:
- Therapeutic hypothermia (Cooling therapy to reduce brain damage).
- Seizure control (Phenobarbital).
- Supportive care (Ventilation, Fluids, Oxygen).
6. Neonatal Hypoglycemia
Definition:
Low blood glucose (<40 mg/dL) in a newborn.
Causes:
- Maternal diabetes (Hyperinsulinemia in baby).
- Prematurity, IUGR.
- Birth asphyxia, Sepsis.
Symptoms:
- Jitteriness, Lethargy.
- Poor feeding, Apnea, Cyanosis.
Management:
- Immediate feeding (Breastfeeding or formula).
- IV Dextrose (D10W) for severe cases.
Summary Table: Common Neonatal Diseases
|
Condition |
Cause |
Key Features |
Management |
|
Neonatal Jaundice |
Immature liver, Hemolysis |
Yellow skin, High bilirubin |
Phototherapy, Exchange transfusion |
|
Neonatal Sepsis |
Bacteria (GBS, E. coli) |
Fever, Poor feeding, Lethargy |
IV Antibiotics |
|
RDS |
Surfactant deficiency |
Tachypnea, Grunting, Cyanosis |
Surfactant, Oxygen, CPAP |
|
MAS |
Meconium aspiration |
Respiratory distress, Crackles |
Suction, Oxygen, Ventilation |
|
HIE |
Birth asphyxia |
Hypotonia, Seizures |
Cooling therapy, Oxygen |
|
Hypoglycemia |
Maternal diabetes, Prematurity |
Jitteriness, Cyanosis |
Breastfeeding, IV Dextrose |
Key Takeaways
- Neonatal jaundice is normal but severe cases need phototherapy.
- Sepsis requires immediate IV antibiotics.
- RDS occurs in preterm babies and needs surfactant therapy.
- HIE can cause long-term brain damage if not treated early.
- Neonatal hypoglycemia must be treated immediately to prevent brain damage.
