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NewbornBy

Mohamed Reda Bassiouny, M.D.

Professor of Pediatrics/Neonatology

Mansoura University

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The Newborn Definition:

Is a baby whose age is less than one month.

 

 

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ClassificationAccording to maturity into:Full term:gestational age is between 37-41w. Preterm:gestational age < 37w. Post-term: gestational age > 42w.

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Full term Baby

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Preterm Baby

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Classification According to birth weight:• Normal birth weight: 2.5kg or more.

• Low birth weight:< 2.5kg.

• Very low birth weight < 1.5kg.

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Classification

According to birth weight and maturity:• Appropriate for gestational age (AGA):Whose birth weight is between 10th and 90th centile for

gestational age.• Small for gestational age (SGA): whose birth weight is below the 10th centile for

gestational age. • Large for gestational age (LGA): Whose birth weight is above 90th centile for gestational

age.

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Large for Gestational Age

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Small for Gestational Age

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Examination of the Newborn

•Physical assessment•Neurological evaluation for reflexes & maturity•Estimation of Gestational age

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Examination of the NewbornPhysical Assessment

•Measurements

•Skin and mucous membranes

•Cardiovascular system

•Respiratory system

•Abdomin

• Congenital malformations and dysmorphic features

•Urine

•Meconium

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Examination of the NewbornPhysical Assessment

•Measurements– Weight

– Length

– Head circumference

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Examination of the NewbornPhysical Assessment

•Skin and mucous membranes – Mottling

– Mongolian spots

– Cyanosis

– Pallor

– Plethora

– Jaundice

– Edema

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Examination of the NewbornPhysical Assessment

•Cardiovascular system– Normal Heart rate: 120-160 beat/minute

– Cardiac murmur

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Examination of the NewbornPhysical Assessment

Respiratory system – Normal respiratory rate: 40/minute

– Signs of respiratory distress• Tachypnea

• Grunting

• Flaring of alae nasi

• Intercostal and subcostal retraction

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Examination of the NewbornPhysical Assessment

•Abdomen:– Distention

– Umblicus

– Liver

– Spleen

– Kidneys

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Examination of the NewbornPhysical Assessment

Congenital malformations and dysmorphic features:

Exomphalos

Absence of anal opening

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Examination of the NewbornPhysical Assessment

•Urine

•Meconium

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Examination of the NewbornNeonatal Reflexes

•Significance

•How to elicit the reflex

•When it appears

•When it disappears

•Significance of abnormal response

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Examination of the NewbornNeonatal Reflexes•Moro reflex •Suckling reflex •Rooting Reflex•Grasp reflex •Stepping reflex •Placing reflex •Tonic neck reflex

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Examination of the NewbornNeonatal Reflexes

Moro reflex

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Examination of the NewbornNeonatal Reflexes

Grasp reflex

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Examination of the NewbornNeonatal Reflexes

Suckling reflex

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Examination of the NewbornNeonatal Reflexes

Asymmetric Tonic neck reflex

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Examination of the NewbornNeonatal Reflexes

Stepping reflex

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Examination of the NewbornEstimation of Gestational Age

•Last Menstrual Period

•Fetal Ultrasonic Examination

•Physical and neuromuscular maturity using scoring system

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What Are the Physical Differences between Full term

and Preterm babies ?

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The Resting Position

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Skin

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Ear Pinna

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Nipple

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Sole Sole of the Foot

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Male Genitalia

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Female Genitalia

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  Full term  Preterm  Skinoedema

Pale, Pink

absent

Dark, Red

Variable degree

Lanugo hair

Small amounts over the shoulder

Abundant over the whole back

Ear pinna Well-defined, incurving, firm.

Flat with little or no incurving,

soft.

 Nipple  >0.75cm in diameter, stippled and raised

 <0.5cm or barely visible, smooth and flat

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  Full term  Preterm  Sole of foot Creases over the entire

soleFaint red marks over

anterior part

Genitaliamale

Scrotum well developed, multiple deep rugae,

both testes are down in scrotum

Scrotum small with few rugae. Testes are absent or high up in

scrotum.

 female Labia majora completely cover

labia minora.

Labia majora widely

separated, labia minora

protruded

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Test Slides

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Thank You