Maternal/Fetal/Neonatal Interactions

1. Maternal/Fetal/Neonatal Interactions Kristine Falcon Chimento October 7, 2011

2. ABP Content Specs • Infants affected by maternal disorders • Infants affected by maternal medications • Infants affected by maternal substance use

3. You are measuring serum electrolytes at 12 hours of age in a 4,500g infant delivered by cesarean section at 36 weeks' gestation. The infant is generally well-appearing, although he exhibits mild hypotonia. The laboratory results are: • Sodium, 135 mEq/L • Potassium, 4 mEq/L • Chloride, 105 mEq/L • Carbon dioxide, 18 mEq/L • Calcium (total), 6.5 mg/dL • Phosphorus, 5.5 mg/dL • Magnesium, 1.6 mg/dL • Serum glucose, 30 mg/dL

5. What is causing this infant’s abnormalities? • Diabetic Mother • What are some other findings you would look for in an IDM?

6. Infants of Diabetic Mothers

7. LGA is a baby > 90th % for gestational age • Macrosomia is a baby born > 4kg (90th % for full term) • SGA is a baby < 10th % for gestational age (2.5kg at term) • IUGR is a baby with reduction in expected fetal growth pattern *All SGA is IUGR, not all IUGR is SGA

8. Which of these babies was born to a diabetic mother?

9. Both! • LGA • Fetal hyperinsulinemia • Increased maternal nutrients • IUGR • Maternal microvascular disease • Placental Insufficiency • Decreased fetal nutrients

11. Macrosomia leads to … • Birth Asphyxia • Birth Trauma

12. Brachial Plexus Injury

13. Clavicular Fracture

14. Facial Palsy

15. Cephalohematoma