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Risk identification in the newborn

These newborns would need special care and should be referred to the FRU

1. Birth asphyxia:
– need referral to an FRU which is equipped to manage post-asphyxial problems such as convulsions, hypoxia, hypoglycaemia, hypocalcaemia, shock, renal failure etc.
• 2. Danger Signs:
– Convulsions
– Fast breathing (60 breaths per minute or more)
– Severe chest in drawing
– Nasal flaring
– Grunting
– Bulging fontanelle
– 10 or more skin pustules or a big boil
– If axillary temperature 37.5oC or above (or feels hot to touch) or temperature less than 35.5oC (or feels cold to touch)
– Lethargic or unconscious
– Less than normal movements
– Severe Jaundice
– Blood in the stools
– Not able to feed
– No attachment at all
– Not sucking at all
3. Major Malformations:
– Meningo-myelocoele, hydrocephalus,
– large omphalocoele are easily identified on inspection of the baby
– Diaphragmatic hernia may be suspected in a baby with respiratory distress and a scaphoid abdomen.
– Babies with excessive salivation and mucus discharge from the oral cavity may have esophageal atresia.
• There is an inability to pass a rubber catheter into the stomach.
• Most of these babies require immediate surgery for them to survive, and therefore should be referred to an FRU.
• The detailed information regarding sick newborn is not being mentioned here since it will be taken care of by IMNCI and Newborn Care lectures
Reference:
• Preventive Medicine in Obstetrics, Pediatrics and Geriatrics, Park’s Textbook of Preventive and Social Medicine: 23rd edition, 2015
• Maternal Health Division, Department of Family Welfare, Ministry of Health & Family Welfare, Government of India: August, 2005. Guidelines for Pregnancy Care and Management of Common Obstetric Complications by Medical Officers. Available on, http://jknrhm.com/Guideline/Normal_delivery_and_management_of_obstetric_... downloaded on 20th Dec 2016
• Maternal Health Division, Department of Family Welfare, Ministry of Health & Family Welfare, Government of India: August, 2009, TRAINEES' HANDBOOK for TRAINING of Medical Officers in Pregnancy Care and Management of Common Obstetric Complications. Available on, http://tripuranrhm.gov.in/Guidlines/Pregnancy_Care.pdf downloaded on 20th Dec 2016

Antenatal Care: http://www.ihatepsm.com/blog/antenatal-care
Components of Antenatal Care: http://www.ihatepsm.com/blog/components-antenatal-care
Prenatal Advice: http://www.ihatepsm.com/blog/prenatal-advice
Risk Approach in Antenatal Care: http://www.ihatepsm.com/blog/risk-approach-antenatal-care
Ensuring Complete Registration of Antenatal Women in the Jurisdiction: http://www.ihatepsm.com/blog/ensuring-complete-registration
Specific Health Protection during Antenatal Visits; http://www.ihatepsm.com/blog/specific-health-protection-during-antenatal...
Lecture on Antenatal Care: http://www.ihatepsm.com/resource/antenatal-care
http://www.ihatepsm.com/blog/essential-newborn-care