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Referance. Clinical chemistry and metabolic medicine, Martin A.Crook, seventh edition 1996,p.361-362. Behavioral objectives. DefinitionsCauses of neonatal hypoglycaemiaPathogenesis (mechanism) of neonatal hypoglycaemiaClinical features of neonatal hypoglycaemiaTreatment of neonatal hypoglyceami
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4. Referance Clinical chemistry and metabolic medicine, Martin A.Crook, seventh edition 1996,p.361-362
5. Behavioral objectives Definitions
Causes of neonatal hypoglycaemia
Pathogenesis (mechanism) of neonatal hypoglycaemia
Clinical features of neonatal hypoglycaemia
Treatment of neonatal hypoglyceamia
Some examples of neonatal hypoglycaemia
6. Preliminary definitions Neonate: is alive baby within one month of birth
Premature or preterm baby : baby born before 37 completed weeks of gestation
Hypoglycaemia :defined as a plasma glucose concentration less than 2.5mmol/L in aspecimen collected into a tube containing an inhibitor of glycolysis.
7. Causes of neonatal hypoglycaemia 1.Reduced production of glucose
Prematurity
Birth asphyxia
Sepsis
Poor nutrition
Congenital heart disease
2.Inborn error of metabolism
Glycogen storage disease
Galactosaemia and hereditary fructose intolerance
Amino acid disorders e.g. tyrosinaemia
Ketotic hypoglycaemia of infancy
8. 3.Hyperinsulinaemia
Maternal diabetes
Nesidioblastosis
Beckwith-Wiedemann syndrome
Insulinoma
Erythroblastosis fetalis
4.Hormone deficiencies
Hypothyroidism
Hypopituitarism
Adrenal insufficiency
Congenital adrenal hyperplasia
9. Mechanism of the disease Hepatic glycogen store increase about threefold and adipose tissue (another sourece of energy ) is laid down during the last 10 weeks of pregnancy .
Very premature infants therefore have little liver glycogen and adipose tissue and are especially prone to hypoglycemia.
Full term infants may become hypoglycemic if initially adequately store are drown on more rapidly than normal, for example during perinatal asphyxia.
10. Infants at greater risk of hypoglycemia are those with: Infection
Asphyxia
Rhesus hemolytic disease
Exchange transfusion
Infant of diabetic mother.
13. Examples of neonatal hypoglycamia Nesidioblastosis is due to overgrowth of insulin-producing beta cells in the pancreas and present with severe hypoglycemia and hyperinsulinaemia.
Beckwith-Wiedemann syndrome is due to deletion of short arm of chromosome 11 and is associated with hypoglyceamia , visceromegaly , exomphalos and mental retardation.
The babies of diabetic mothers tend to be large , jaundiced, and hypocalcaemic and have lung immaturity and congenital defects. Neonatal hypoglycemia is related to the degree of maternal glycaemic control.
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