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Clinical Coding Seminar 28th October 2007

Clinical Coding Seminar 28th October 2007. Maternal conditions affecting the neonate. Issues of prematurity (<37weeks): Cervical incompetence – difficulties with diagnosis management issues outcomes ↑PNMR midtrimester M/C preterm delivery Chorioamnionitis.

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Clinical Coding Seminar 28th October 2007

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  1. Clinical Coding Seminar 28th October 2007

  2. Maternal conditions affecting the neonate • Issues of prematurity (<37weeks): • Cervical incompetence – difficulties with diagnosis management issues outcomes ↑PNMR midtrimester M/C preterm delivery Chorioamnionitis

  3. Maternal conditions affecting the neonate • Issues of prematurity (contd): • Preterm rupture membranes (PROM)

  4. Maternal conditions affecting the neonate • Issues of prematurity (contd): • Preterm rupture membranes (PROM) Definition Diagnosis Consequences ↑PNMR PTL Chorioamnionitis hypoplastic lungs limb deformities Perinatal morbidity

  5. Maternal conditions affecting the neonate • Issues of liquor volume • (physiology of liquor formation) • Oligohydramnios - association with fetal anomalies PROM (diag) placental dysfunction (IUGR) - outcomes ↑PNMR infection PTL IUFD Hypoplastic lungs limb problems

  6. Maternal conditions affecting the neonate • Issues of liquor volume (contd) • Polyhydramnios - association with fetal anomalies multiple pregnancies diabetes - outcomes ↑PNMR PTL cord presentation/prolapse unstable fetal lie compound presentations metabolic issues (DM)

  7. Maternal conditions affecting the neonate • Placental issues • Position - pl.previa → APH, IUGR, prematurity • Morphology - pl.accreta/increta/percreta → IUGR • Function - Insufficiency → IUGR Transfusion syndrome Separation • Cord issues • Cord (funic) presentation/ Cord prolapse polyhydramnios, unstable lie/high PP malpresentations • Vellamentousinsertion

  8. Haemolytic disease of the newborn • Definition - breakdown RBCs → anaemia → reduced O2 capacity • Causes: Rhesus incompatibility ABO incompatibility Other (anti Kell, Duffy etc) ie, isoimmunisation • Outcomes: in utero – hydrops fetalis ex utero - anaemia kernicterus

  9. Birth Injuries • Operative vaginal delivery • Large baby • Maternal exhaustion • poor application/technique/choice • Macrosomia → shoulder dystocia • May not be associated with excessive force • (demonstration)

  10. Birth Injuries • Head - intracerebral – extra/subdural haem scalp – lacerations, haematoma facial nerve • Neck/spine – brachial plexus (Erb’s Palsy) • Other skeletal - # clavicle # humerus # femur

  11. Thank you

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