Newborn and Neonatal Care Part 2

A set of vocabulary flashcards covering neonatal statistics, maternal and newborn history, peripartum care, physical findings, Ballard scoring, EINC, vaccines, screening, and related Philippine legislation.

Neonatal mortality rate

The rate of deaths within the first 28 days of life per 1,000 live births (Philippines example: 14/1000).

Leading causes of neonatal death

Prematurity, asphyxia, congenital anomalies, infection/sepsis, and pneumonia.

APGAR score

A quick assessment of a newborn's well-being at 1 and 5 minutes after birth based on five criteria.

APGAR components

Appearance, Pulse, Grimace, Activity, Respiration—the five components scored 0-2 each for a maximum of 10.

APGAR interpretation at 5 minutes

7-10: good to excellent; 4-6: some resuscitation or support needed; 0-3: requires immediate intervention.

Ballard Score

A method to estimate gestational age using neuromuscular and physical maturity assessments, performed soon after birth or within 12 hours.

Neuromuscular maturity (Ballard)

Assessments of the newborn's neuromuscular development, including muscle tone, posture, and reflexes.

Physical maturity (Ballard)

Assessments of external physical characteristics such as skin, lanugo, eyes/ears, genital development, and other maturity indicators.

Posture (Ballard)

One component of neuromuscular maturity; scores reflect the openness of the limbs and overall tone.

Square Window (Ballard)

Assessment of wrist flexibility; the angle between palm and forearm indicates maturity level.

Arm Recoil (Ballard)

Measurement of the latency and speed of elbow flexion recoil, reflecting passive tone.

Popliteal angle (Ballard)

Angle formed at the knee when the thigh is flexed and the lower leg extended to test leg flexor tone.

Scarf Sign (Ballard)

Assessment of posterior shoulder girdle flexor tone by moving the elbow across the chest.

Heel to Ear (Ballard)

Assessment of hip flexor tone by bringing the leg toward the ear and noting resistance.

Cephalhematoma

A collection of blood between the surface of a cranial bone and its periosteal membrane that does not cross suture lines.

Caput Succedaneum

Swelling under the scalp that crosses suture lines due to edema; contrasts with cephalhematoma.

Anterior fontanel

Diamond-shaped soft spot at the junction of the cranial sutures; typically closes by 9-18 months.

Posterior fontanel

Smaller soft spot at the back of the head; usually closes by 2-4 months.

Head circumference (NV for Filipino babies)

About 33-35 cm; measured around the head from glabella to occipital area.

Chest circumference measurement

Measured at the level of the nipples; taken midway between inspiration and expiration, not too tight.

Birthweight (NV)

Typically 3-3.5 kg at term.

Birth length (NV)

Typically 50 cm at term.

Umbilical cord anatomy

Normal cord contains 2 arteries and 1 vein.

Omphalitis

Infection of the umbilical stump presenting with redness, edema, foul odor, or discharge.

Clavicular fracture (birth injury)

Fracture presenting with lump, tenderness, crepitus, or decreased movement after birth.

Genitourinary findings (newborn)

Assess urine output in first 24 hours; examine testes and urethral opening; check for ambiguous genitalia.

Brachial palsies (birth injury)

Erb-Duchenne palsy (C5-C6) and Klumpke palsy (C7-C8, T1) causing arm weakness or claw hand.

Essential Intrapartum and Newborn Care (EINC)

Core evidence-based practices: immediate thorough drying, skin-to-skin contact, properly timed cord clamping, and non-separation for early breastfeeding.

Gonococcal ophthalmia neonatorum prophylaxis

Preventive eye treatment with erythromycin or tetracycline ointment at birth (1 cm ribbon in each conjunctival sac).

Vitamin K prophylaxis

Intramuscular injection of phytonadione (0.5-1 mg) given shortly after birth to prevent hemorrhagic disease.

Vaccines at delivery

Hepatitis B vaccine and BCG given at or shortly after birth as part of newborn care.

Newborn hearing screening

Screening test for hearing loss conducted shortly after birth; part of standard newborn screening.

Newborn screening

Laboratory tests performed to detect certain genetic, endocrinologic, and metabolic disorders early in life.

EO 51 (Milk Code)

Executive Order governing the marketing of breast milk substitutes in the Philippines.

RA 7600 (Rooming-In and Breastfeeding Act)

Philippine law promoting rooming-in and exclusive breastfeeding of infants.

RA 10028 (Expanded Breastfeeding Promotion Act IRR)

Regulation promoting and supporting breastfeeding through health services and community programs.

Administrative Order 2009-0025 (EINC Unang Yakap)

Policy implementing EINC protocols and immediate mother-infant bonding at birth.

RA 9288 (Newborn Screening Act)

Law mandating newborn screening and follow-up services for affected infants.

RA 9709 (Universal Newborn Hearing Screening)

Law mandating universal newborn hearing screening and intervention.

RA 11148 (First 1000 Days Act)

Legislation supporting nutrition and development from conception through the first 1000 days of life.

Large for Gestational Age (LGA)

Infant weight at or above the 90th percentile for gestational age; often related to maternal diabetes.

Small for Gestational Age (SGA)

Birth weight below the 10th percentile for gestational age; may be symmetric or asymmetric.

Symmetric SGA

SGA with proportional slowing of growth due to early gestational issues (e.g., smoking, infection); brain/body size reduced in concert.

Asymmetric SGA

SGA where head size is relatively preserved; often due to uteroplacental insufficiency and late fetal growth restriction.

Lubchenco/Fenton growth charts

Growth charts used to assess weight, length, and head circumference percentiles; Lubchenco for term, Fenton for preterm.