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Maternal Conditions Impacting Neonates: Prematurity, Liquor Volume, and Birth Injuries

This seminar addresses critical maternal conditions that affect neonatal outcomes, focusing on significant issues such as prematurity (including cervical incompetence and preterm rupture of membranes), liquor volume abnormalities like oligohydramnios and polyhydramnios, and the implications of placental issues. Additionally, it highlights birth injuries resulting from operative vaginal delivery, including common complications like shoulder dystocia and intracerebral hemorrhages. Understanding these conditions is vital for improving neonatal management and reducing perinatal morbidity and mortality rates.

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Maternal Conditions Impacting Neonates: Prematurity, Liquor Volume, and Birth Injuries

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  1. Clinical Coding Seminar 28th October 2007

  2. Maternal conditions affecting the neonate • Issues of prematurity (<37weeks): • Cervical incompetence – difficulties with diagnosis management issues outcomes ↑PNMR midtrimester M/C preterm delivery Chorioamnionitis

  3. Maternal conditions affecting the neonate • Issues of prematurity (contd): • Preterm rupture membranes (PROM)

  4. Maternal conditions affecting the neonate • Issues of prematurity (contd): • Preterm rupture membranes (PROM) Definition Diagnosis Consequences ↑PNMR PTL Chorioamnionitis hypoplastic lungs limb deformities Perinatal morbidity

  5. Maternal conditions affecting the neonate • Issues of liquor volume • (physiology of liquor formation) • Oligohydramnios - association with fetal anomalies PROM (diag) placental dysfunction (IUGR) - outcomes ↑PNMR infection PTL IUFD Hypoplastic lungs limb problems

  6. Maternal conditions affecting the neonate • Issues of liquor volume (contd) • Polyhydramnios - association with fetal anomalies multiple pregnancies diabetes - outcomes ↑PNMR PTL cord presentation/prolapse unstable fetal lie compound presentations metabolic issues (DM)

  7. Maternal conditions affecting the neonate • Placental issues • Position - pl.previa → APH, IUGR, prematurity • Morphology - pl.accreta/increta/percreta → IUGR • Function - Insufficiency → IUGR Transfusion syndrome Separation • Cord issues • Cord (funic) presentation/ Cord prolapse polyhydramnios, unstable lie/high PP malpresentations • Vellamentousinsertion

  8. Haemolytic disease of the newborn • Definition - breakdown RBCs → anaemia → reduced O2 capacity • Causes: Rhesus incompatibility ABO incompatibility Other (anti Kell, Duffy etc) ie, isoimmunisation • Outcomes: in utero – hydrops fetalis ex utero - anaemia kernicterus

  9. Birth Injuries • Operative vaginal delivery • Large baby • Maternal exhaustion • poor application/technique/choice • Macrosomia → shoulder dystocia • May not be associated with excessive force • (demonstration)

  10. Birth Injuries • Head - intracerebral – extra/subdural haem scalp – lacerations, haematoma facial nerve • Neck/spine – brachial plexus (Erb’s Palsy) • Other skeletal - # clavicle # humerus # femur

  11. Thank you

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