Assessment of a newborn baby in the first place reflects its vitality and adaptability to the external environment during the first 5 days of life. It depends on the degree of maturity, neurological status, the nature and severity of the pathological process and by the sum of these indicators can be represented as:
- very heavy,
- extremely heavy,
The main criteria that assess the state of the newborn include:
- the survival rate at the moment or the next few days,
- the need for intensive therapy, with the inclusion or absence of resuscitation,
- acute symptoms of systemic infection,
the possibility of severe complications:
- intestinal perforation (ANPC),
- pneumothorax (hard parameters of mechanical ventilation),
- the gestational age of the newborn: the following 25-27 weeks.
The determination of the terminal condition of the newborn does not require any comments, as there and so everything is clear.
Evaluation of critical condition is applied in cases, when the question of the survival of the child requires further observation or a child needs a comprehensive resuscitation biscuits.
Assessment of the newborn as heavy or very heavy in addition to need intensive treatment, including mechanical ventilation, reflects the acute phase of diseases such as purulent meningitis, osteomyelitis, combined with arthritis, ulcerative-necrotic lesions of the intestines, presence of infectious toxicosis, the inability enteral nutrition, acute manifestations of congenital adrenal insufficiency, seizure and hemorrhagic syndrome.
Naturally, the first 3-5 days of life indications for determining the state of the newborn as heavy diverging and, in particular, include lower gestational age 25-27 weeks. However, it should be noted that differentiation of status between heavy and medium-heavy is quite subjective, and in most cases, subjectivity extends in the direction of overstating the severity of the condition. This is true not only for individual neonatologists but also for a number of departments as a whole.
Such tactics, unfortunately, leads to unnecessarily prolonged antibiotic treatment where she was not shown.
Assessment of newborns with a birth weight of 900-1250 g and a gestational age of 28-30 weeks in the first 3-5 days of life is no exception. Everything is decided by the dynamics of the clinical picture and the duration of intensive care, including ventilation if necessary.
Statement of condition as of medium gravity, children of this weight and age is perfectly acceptable if they are on independent breath, not in need of oxygen support, no apnea events, able to receive enteral nutrition in the age and neurological status is not significantly different from the characteristic of their gestation.
But it is possible that the child from group of risk layering of various pathological processes in the dynamics may worsen their condition, but it does not give grounds to regard it as heavy as it currently is not.
Another thing is that in conversation with parents, you must warn them in an accessible form that their child is very small, immature and at any moment can worsen your condition, but at the moment it is quite stable.
In conclusion, we will focus on the assessment of the status of children in the first month of life with severe brain lesions and hopeless in its further psychomotor development, but quite decent in its somatike. Their condition can be regarded as moderate or as severe, but with the obligatory caveat — heavy nature of the disease.