Common medical conditions

To newcomers, it may seem that all the staff in NICU speak a different language. This page gives a layman's description of some of the more common medical conditions we see on NICU. These are only short, non-medical summaries. To learn more about your baby's condition or treatment, it is very important that you speak to the medical staff caring for your baby. They will be very happy to help and answer any questions you have. Because each baby is different and there are usually a variety of treatments which can be given, we do not mention any treatments on this page.

There is a similar layman's description of the "...ologists" on our page about the specialists you may meet on NICU.

RDS - Respiratory Distress Syndrome
ROP - Retinopathy of Prematurity
CLD - Chronic Lung Disease
PDA - Patent Ductus Arteriosus
NEC - Necrotizing Enterocolitis (an infection)
Metabolic Bone Disease
Interventricular Haemorrhage
Hydrocephalous
Periventricular Leucomalacia
Hypoxic Ischemic Enchephalopathy
Jaundic
Hypoglycaemia
Coag Negative Staph Infection
Group B Strep

Exomphalos
Gastroschisis
Congenital Heart Disease

TOF - Tetralogy of Fallot

RDS - Respiratory Distress Syndrome
RDS means that the baby is finding it hard to breath. Babies in the womb do not need to use their lungs. Newborns with immature lungs, particularly premature babies, often have RDS because the lungs are not sufficiently developed to breath effectively. The lungs of a full-term infant produce a chemical known as surfactant that helps keep the lungs open and stops them sticking together like a wet balloon. Premature babies do not have enough surfactant in their lungs, which makes breathing difficult and hard work. Doctors suspect RDS in any premature baby or in full-term infants who are breathing particularly hard and fast, or require extra oxygen. A chest X-ray can confirm this diagnosis.

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ROP - Retinopathy of Prematurity
Premature babies sometimes have damage to the blood vessels in the eye's retina, a condition known as ROP. Although they are unsure of the exact cause, doctors suspect that the vessels may begin to grow in an abnormal pattern. Because many very premature babies suffer from some level of ROP, your baby will have an eye exam by a paediatric ophthalmologist if ROP is suspected.

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CLD Chronic Lung Disease
CLD is scarring of the lungs and sometimes happens if a baby has had problems breathing after birth. The combination of the premature baby's immature lungs and the treatments used to help with breathing (including machines and oxygen) can sometimes cause damage. Babies who still need oxygen at 4 weeks before their original due date are considered to have CLD. As the baby matures, more lung tissue grows, which can gradually improve breathing. A baby with CLD often needs help breathing eg. oxygen.

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PDA - Patent Ductus Arteriosus
When a baby is in the womb, it does not need to use its lungs, so the blood circulates around the heart in a different way. A special blood vessel called the Ductus Arterios (DA) allows blood to bypass the lungs. Usually it closes shortly after birth. But in some babies, most often premature, it remains open or reopens. Then blood flows through the DA and floods the vessels in the lungs, making it difficult for the baby to breath. These breathing problems are clues that a baby is suffering from PDA. A heart murmur may also lead physicians to suspect PDA, which is then confirmed with an ultrasound of the heart.

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NEC - Necrotizing Enterocolitis
Damage to the intestines from infection and poor blood flow is known as necrotizing enterocolitis. Although the exact cause is unknown, the more premature a baby is, the greater the risk for NEC, perhaps because the intestines are not developed enough to handle digestion. An X-ray of the abdomen sometimes confirms the diagnosis.

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Metabolic Bone Disease
Bones need essential minerals, particularly calcium and phosphate, in order to grow and mature properly. Babies who are premature, have been very ill, or who have particular genetic conditions sometime do not have high enough levels of minerals, which can result in bones not developing properly.

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Interventricular Haemorrhage
This is bleeding in the brain. This usually occurs in premature babies, because the vessels in their developing brains are especially fragile and can bleed easily. Severe cases of IVH may cause a drop in blood pressure or seizures, but there are a few other obvious symptoms. It is diagnosed with an ultrasound of the head, so doctors can look for collections of blood in the brain.

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Hydrocephalous
This is more commonly know as "water on the brain". It is caused by a build-up of the fluid that surrounds the brain and the spinal cord. It occurs when something blocks the flow of the fluid, often bleeding or an abnormality of the brain or skull. The build-up can create pressure that can damage the brain. Doctors suspect hydrocephalus if a baby has a particularly large head or if head size increases rapidly.

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Periventricular Leucomalacia
This is effectively a form of damage to the brain which can result in problems with development including walking and sometimes seeing properly. The brain of a premature baby is prone to damage from lack of blood and oxygen. This is because the normal blood supply has not yet spread to all parts of a premature baby’s brain.

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Hypoxic Ischemic Enchephalopathy
Hypoxic ischemic encephalopathy (often abbreviated HIE) is an acute problem with swelling and irritation of the brain caused by lack of oxygen to the brain. In mild cases the baby recovers completely but in more severe cases it can result in permanent brain damage.

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Jaundice
When blood cells are broken down, a by product called bilirubin is produced. Usually, the liver "recycles" it back into the body. If there is more than the liver can cope with, a high level of bilirubin builds up in the blood, giving the skin a yellowish colour. This is known as jaundice. Babies with this condition are sometimes more sleepy than usual and in severe cases may be lethargic. Although yellow skin colour is a fairly good indicator, the diagnosis is made with a blood test to measure the bilirubin level.

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Hypoglycaemia
This is commonly known as "low blood sugar". Babies need a constant supply of sugar to provide them with energy. If sugar levels fall too low, they may become tired, lethargic, refuse to feed and can have convulsions. Babies usually get sugar from colostum (early breast milk which is very high in sugar and other nutrients babies need) or make it from their own body fat. Premature babies are particularly at risk of hypoglycaemia as they do not have much body fat and can find it hard to feed.

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Coag Negative Staph Infection
Straphylococcus is the name of a group of bacteria (bugs) that can (and do) cause a multitude of diseases. Coag negative Staph is a very common skin bug which does not cause any illness in older children or adults but can make premature babies ill. It is the commonest bug in premature babies.

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Group B Strep
Group B Strep are another group of bacteria. These bacteria can normally live harmlessly in our bodies. In fact one third of men and women carry Group B Strep in their intestines with no symptoms. Group B strep can however become a problem in weak or newborn babies who are not strong or mature enough to stop the bacteria spreading to areas of the body, such as the bloodstream.

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Exomphalos
If a baby has exomphalos, some or all of the contents of the abdomen are outside the body, rather than being neatly tucked up inside as they are supposed to be. Exomphalos occurs when the abdomen fails to close around the base of the umbilical cord during the early development of the baby. The size of the Exomphalos depends on the number of organs exposed. This is usually the bowel but may include the liver and other organs. The sac containing the exposed organs is usually covered in a protective membrane. The abdominal cavity is sometimes smaller in Exomphalos children due to the organs growing externally. In about 30% of cases Exomphalos occurs in conjunction with other problems.

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Gastroschisis
This is similar to Exomphalos (above) but with Gastroschisis, there is an abnormality (defect or hole) in the abdominal wall that allows the abdominal contents to protrude outside the body. There is no protective membrane covering over the bowel or other contents. The defect is usually near the belly button/navel but is completely separate from the umbilical cord. The abnormality is usually very small, but the exposed contents can range from the stomach to the rectum.

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Congenital Heart Disease
This is a term which includes a number of different but common heart problems. Congenital Heart Disease affects about one baby in 120, so it is by no means rare.

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TOF - Tetralogy of Fallot
Tetralogy of Fallot is one of the most common forms of complex heart defects. TOF consists of three different heart defects.

  • The first defect is called a ventricular septal defect (VSD). This is a hole between the two bottom chambers (ventricles) of the heart.
  • The second defect is called pulmonary stenosis. This is a narrowing at or just below the pulmonary valve which controls blood flow to the lungs.
  • The third part of Tetralogy of Fallot involves the aorta being positioned in the wrong place.

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