Reflection on neonatal examination

The lytic process may be the basis for fetal fibronectin an adhesive glycoprotein at the maternal-fetal interface detection by testing to separate false from true labor. The normal term placenta maternal surface, upon careful gross exam, has a faintly shiny "icing" or glaze over the cotelydon surfaces that is the remaining cotyledon-side, interface decidua basalis component still attached to the chorion. When there are dull patches are patches or zones remindful of the texture of suede or even disrupted or focal absence of the cotyledon surface, such distortions reflect the stripping that happens with the stubborn, sometimes desperate, clinical attempts to remove the adherent placenta at time of delivery.

Reflection on neonatal examination

The initial post-delivery assessment aims to exclude obvious abnormalities and includes: Assessment of colour to exclude pallor or cyanosis Muscle tone, posture and responsiveness Heart and respiratory rate Normality of facial features including eyes and mouth Normal alignment spine and exclusion of Reflection on neonatal examination bifida Genitalia to exclude ambiguity Trunk and limbs to exclude obvious abnormality Check anus for patency Evidence of birth trauma such as bruises or scalpel marks Birthweight, head circumference, temperature and Reflection on neonatal examination number of cord vessels are also recorded at this stage, and any concerns or abnormalities are reported to the paediatrician.

The aim of this more thorough examination is to: Screen for abnormalities Make referrals for further tests or treatment if needed Provide reassurance to the parents.

Nottingham Neonatal Service, This examination is more thorough than the initial assessment at birth and includes the key components of the NIPE screening test. These are the examination of the heart, eyes, hips, and in male infants, examination of the testes Royal Cornwall Hospitals NHS Trust Gathering relevant information prior to examination Anticipated problems based on the maternal and family history Factors affecting wellbeing during pregnancy and birth such as poor foetal growth Date, time, type of delivery and birth weight Whether the baby has passed urine and meconium Prior to examination, maternal consent should be obtained, the procedure explained and where possible the examination should take place at the bedside with the mother present.

Who should conduct the examination? However, regional variations may occur depending on the availability and qualifications of the staff available. Examination prior to discharge may also be performed by a Paediatrician or General Practitioner. Wolke notes that mothers were more likely to be satisfied when the newborn examination was conducted by a midwife rather than a doctor.

This was because midwives were more likely to discuss healthcare issues during the examination and were able to provide continuity of care. Note facial symmetry, the size of the fontanelles and the presence of any remaining caput, cephalhaematoma or trauma.

Note the position and placement of the ears.


Note any appearance of squint, conjunctivitis, discharge, or haemorrhage. The prime purpose of screening at this stage is to identify congenital cataracts as approximately 2 or 3 in 10, newborn babies have problems with their eyes that require treatment Public Health England The palate should be inspected for craniofacial abnormalities such as a cleft lip or palate.

These are among the most common of all birth defects, affecting over 1, babies in the UK each year Nursing Times Palpate the neck and clavicles. Check limbs, hands, feet and digits, assessing proportions and symmetry. Examine feet to exclude any postural abnormalities such as talipes.

Yet, differentiating between innocent and pathologic murmurs during auscultation is very hard and usually unfeasible. According to Public Health Englandthe overall incidence of congenital heart defects is per live births ranging from non-significant to major and critical lesions.

However, Niccolls suggests that the presence of a murmur does not always signify the presence of heart disease, nor does the absence of a murmur provide reassurance of normality. Observe the rate and pattern of chest movement.

Listen to the air entry to check for crackles and stridor. Note the presence of any respiratory problems such as tachypnoea at rest, retraction, grunting, or nasal flaring. Gently palpate to identify any organomegaly, masses or a hernia.

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Confirm the presence of bowel sounds. The condition of the umbilical cord should also be noted.

Reflection on neonatal examination

Palpate testes in male infants for presence or undescended position. Bilateral undescended testes may also be associated with ambiguous genitalia or an underlying endocrine disorder.

According to Public Health Englandearly diagnosis and intervention improves fertility, reduces the risk of torsion and may aid earlier identification of testicular cancer.

Examination of the back. Note the presence of dimples, hair tufts, naevus, or abnormal skin patches.

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Note the colour and texture of the skin as well as the presence of any birthmarks, rashes or abrasions. Reflexes and central nervous system. Observe tone, behaviour, movements and posture. The grasp, rooting and sucking reflexes are assessed.

The Moro reflex may also be included, though many experts choose to exclude it on the basis that it is cruel to deliberately startle the baby Ferrari et.

Reflection on neonatal examination

Check hips, symmetry of the limbs and skin folds. According to statistics from Public Health Englandapproximately 1 or 2 in 1, babies have hip problems that require treatment.

Six-week follow up Finally following the newborn examination, the parents should be informed that the examination will be repeated at weeks of age as some conditions can develop or become apparent later Public Health England Our group has been closely involved in community hospital placental pathology since Dr.

Shaw attended Dr. Doug Shanklin's groundbreaking CME course in Gatlinburg, Tenn. in We have given focused attention to placental pathology since then and consider that we have an actual "placenta program" concerning placenta evaluation for our patients (). Web resources: Bronchoscopy and Lung Tumors; gastrointestinal endoscopy; peroral endoscopy: examination of organs accessible to observation through an endoscope passed through the mouth; esophagoscopy: endoscopic examination of the esophagus by means of an esophagoscope (a flexible or rigid instrument for inspecting the lumen of the esophagus and carrying out diagnostic and .

The aim of both the initial examination at birth and the full neonatal examination within the first 72 hours of life is to confirm normality, identify any congenital abnormalities and exclude medical concerns.

It also gives the Midwife a precious opportunity for further health education and parental reassurance (RCM ). NNF Teaching Aids:Newborn Care 1 Examination of a newborn baby Slide EN- l,2 Examination at birth Examination of a baby allows us to assess and monitor the.

Introduction. This chapter discusses pregnancy in both pre-existing diabetes (type 1 and type 2 diabetes diagnosed prior to pregnancy), overt diabetes diagnosed early in pregnancy and gestational diabetes (GDM or glucose intolerance first recognized in pregnancy).

The health sector can sometimes use jargon. We have developed this glossary to explain these terms in more detail. You'll also find the glossary items throughout the site where they have been used.

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