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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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