economics. economies and dis-economies of scale, statistics homework help

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GhgbeCreel

Mathematics

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define labour. 3 paragraphs

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NEONATAL SEPSIS
Definition
 Systemic response to infection in the newborn.
 The term should be reserved for documented infection in a newborn who has systemic illness
for which non-infectious causes have been excluded.
Epidemiology
 Neonatal sepsis occurs in from 0.5 to 8.0/1000 live births
 Developing countries 6-23/1,000 live births
 The highest rates occur in low-birth-weight (LBW) newborns, those with depressed
respiratory function at birth, and those with maternal perinatal risk factors.
 The risk is greater in males (2:1) and in newborns with congenital malformations, particularly
of the GU tract.
Classification
1) Early onset sepsis
 Onset within 1st to 3 days
 Bacteria acquired before and during delivery (GBS + Gram –ve enteric bacteria esp E.
coli)
2) Late onset
 Onset after 3rd day of life
 Bacteria acquired after delivery (Nosocomial or community) (Staph aureus)
Predisposition
 Why are newborns so prone to infection?
 Inefficient immune mechanisms;
1) Cellular immunity is compromised Polymorph function is ↓vis adherance, chemotaxis,
phagocytosis
2) Humoral immunity is deficient
IgG crosses placental barrier in 3rd trimester…preterms have very little. IgG useful
defense against gram +ves

 IgM….Doesn’t cross placental barrier important defence against gram –ve hence
newborns prone to gram-ve sepsis.
 IgA…..Doesn’t cross placental barrier production starts at age 2-5 weeks present in breastmilk responsible for mucosal immunity
 Other immune factors e.g. compliment, fibronectin etc are also low.
 Physical barriers……SKIN thin and friable- easily breached. …….Mucous membranes
breached by many invasive procedures have no IgA.
Risk factors
a) Maternal perinatal
 Chorioamnionitis (esp. with fetal tachycardia)
 Prolonged/premature rupture of membranes (18 hours)
 Maternal bleeding (placenta previa, abruptio placentae)
 Toxemia
 Precipitous delivery
 Maternal infection (urinary tract or endometrium, most commonly manifested as
maternal fever shortly before or during parturition).
 Maternal GBS colonisation
 Intrapartum asphyxia
 > 6 digital vaginal exams during labor with PROM
 Poo...


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