Here is the Prezi that I have made over sickle cell and other blood complications. I will be presenting this in anatomy class on monday!
This past week I have been a little dormant on my blog, sorry about that. Not to make any excuses but I have been sick the past week and have not had much energy to do anything but sleep. But here I, somewhat healthy again! So in our anatomy class we have been talking about the brain. So I thought it would be perfect to look at common complications that happen in children born premature, so that is going to be my next post. I am also working on a Prezi over sickle cell and other blood compilations.
There are many types of cardiac and heart problems that may arise if a child is born early. Some may be less complicated like controlling an irregular blood pressure or a small hole within the heart that will close over time. Other are much more serious and need attentions from specialized doctors. Many cardiac and heart problems start when the heart is developing within the womb. These are considered congenital heart defects. They develop within the chambers, valves, and vessels within the heart. In this post I will be talking about the most common heart defects and complications that occur within Pre-Mature children.
One of the most common congenital heart defects is a hole in the heart. A hole in the heart is caused by a weak or under developed septum (muscular wall) within the heart. There are several different classifications for a hole in the heart depending on size, location, and other factors. Having a hole in the heart allows for oxygenated blood to mix with non-oxygenated blood or vise versa while traveling through the heart. Many times a small hole can heal on its own with monitoring by medical personnel. Other times a hole in the heart needs more serious and extensive care, such a surgery to patch the hole.
A ventricular septal defect is when there is a hole between the left and right ventricle. This allows for oxygenated blood to mix or leak into the right ventricle, this causes the blood to improperly move to the right ventricle instead of the aorta. This causes an improper flow throughout the body without a strong source of oxygen. A ventricular septal defect can lead to high blood pressure, endocarditis (infection of the heart), arrhythmias (irregular heart beat), delayed growth, and even heart failure. If it just a small hole between the two ventricles there may be no symptoms and will heal on its own.
An atrial septal defect is when the muscular wall (septum) separating the two atriums of the heart has a hole or does not properly closes. Depending on the degree of the hole, minor or major, action for treatment changes. A minor hole may cause little to no symptoms and rarely needs medical treatment. On the other hand, a major hole may have many symptoms and require cardiac catheterization or surgery. If I haven’t stressed this enough in my last few post I will say it again, each case is special and unique and no two cases are exactly the same.
These are just a few complications that may happen to a premature baby. I could spend almost a whole extra semester just looking at the different kinds of heart defects that occur in premature babies.
Cerebral Palsy is defined as “
Cerebral Palsy or CP is a very broad medical term used to refer a disease that effect the control of movement, caused by an intracranial hemorrhage or injury to the brain while it is still developing, this can happen before or during birth. If damage or injury occurs to the brain while a child is still within the mother’s womb it is considered to be congenital cerebral palsy (congenital means it is present at birth). A child may also get Cerebral Palsy from damage to the brain either during the birth or short after.
The exact cause of congenital CP is unknown but doctors believe it may be caused by a several number of things including; infection during pregnancy, severe jaundice or lack of bilirubin within the blood, Rh incompatibility between mother and child (The mothers blood cells will attach the fetuses while in utero), trauma of birth (physical or metabolic), and severe lack of oxygen to the brain or damage to the brain during labor or after.
Up to ten percent of Cerebral Palsy cases are acquired or developed within the first few months after birth. Some risk that may lead to CP are: respiratory or vascular complications at birth, birth defects (such as spinal cord formation, hernias near or around the groin, or a small jaw bone), Breech births, low Apgar score, being a twin or multiple, low birth weight, seizers short after birth, infection of the brain, or other complications.
If you can’t tell there are a lot of different risk that can cause CP. That is because 10,000 infants are diagnoses with Cerebral Palsy each year and it is estimated that 1,500 pre-school age children are diagnosed each year.
Cerebral Palsy doesn’t fully develop or show full symptoms until a child is between two-three years of age. It is a non-progressive brain disorder, meaning that the damage done to the brain will not get any better or worse throughout the child’s life. Each case is different and the symptoms are just as different as the case. The symptoms due to the brain damage can change over time, either for better or worse, but a doctor can never truly predict how the symptoms will change and develop. CP is stated as being on of the leading causes of childhood disability.
The term Cerebral Palsy is a broad term in the sense that it can affect each person differently, and each case is special and unique in its own way. CP affects the development, movement, and function or muscles and nervous system. This can lead to involuntary movement, lack of movement, lack of muscle coordination when trying to perform a task, stiff or tight muscles, using one leg to walk or more dependent on one leg, and slow reactions. Like I said before, each case is special and unique. One child with CP may be completely dependent on parents and care takers for the rest of its life, while others just may need special aid for specific task. It is all relative to the child, case, and prognosis of CP. Depending on the case Doctors and care takers can help in easing some of the symptoms or side effects of CP. Many times children that are diagnosed with Cerebral Palsy will have occupational and physical therapist.
Hope this helped in understanding what Cerebral Palsy is!
Because we are studying the brain in Anatomy right now I thought it would be perfect to talk about brain bleeds and neurological complications in pre-mature babies.
The earlier a child is born, before 37 weeks, the higher the risk of having a brain bleed or neurological complication. The neurological system is not fully developed until 31 weeks, so if born before this point a child cannot regulate body temperature. If a child is born more than 10 weeks early the chance of having a intraventricular hemorrhage is much greater than if born less than 10 weeks early. This is because the vessel in the brain are week and fragile up until week 30, between weeks 30-40 the vessels in the brain strengthen limiting the chance of any bleeding.
Most intraventricular hemorrhaging is mild with little to no long term impacts on the child. A intraventricular hemorrhage (IVH) is not normally present at birth, but will occur within the first few days of life. This is why many times a child will be held in the NICU if they are at a higher risk for IVH to that it can be properly treated by a doctor. Normally a child will not get an intraventricular hemorrhage after the first month of life because the vessels within the brain are becoming stronger. There are four different types or levels of IVH which are called grades. Grades 1 and 2 are small bleeds that normally case no long term neurological damage or complications and in some cases can naturally be resolved on its own. Grades 3 and 4 are more serious bleeds that cause pressure on the brain or leakage into the tissue of the brain. If this occurs, blood clots may form and cause the flow of cerebrospinal fluid to be blocked. Another side effect can be the build up of fluid in the brain.
If a child has Respiratory Distress Syndrome, abnormal blood pressure, blood disorder, or other medical conditions present at birth there is a higher risk of IVH. At the time of birth doctors will asses the child and look for any indicator of a brain bleed or neurological complications. There are many different symptoms that a doctor will look for including: excessive sleeping or lethargy, decrease in muscle tone and reflexes, changes in blood pressure or heart rate, breathing problems such as apnea, a weak suck or a hard time feeding, and seizures or other abnormal body movements. If the child was born before 30 weeks doctors will do an ultrasound of the head to look for any indications of a brain bleed. The test is usually done one-two weeks after birth to see if there are clear indicators of a bleed. Many times a second and third test will be done if a child has symptoms. Doctors may also do an ultrasound at the expected due date to see if there is any remaining bleeding or other problems.
There is nothing that can be done to treat or prevent IVH from happening in a pre-mature baby. Doctors and nurses will constantly monitor the child, making sure all vitals are stable. They can also help manage any symptoms that go along with IVH. If the there is a large amount of swelling of the brain or build up of fluid doctors may preform a spinal tap to relive the pressure and fluid. A shunt may also be placed to help drain fluid as a long term solution. Depending on the case it is hard to determine the long term effects of a grade 3 or 4 IVH. Some of the most common long term effects of an ntraventricular hemorrhage are cerebral palsy and development of cognitive and motor skills.
If a child is born before 32 weeks there is a good chance that they will have some degree of breathing problems. At 32 week the lungs finish fully developing, so if a child is born before the 32 week mark doctors and nurses will be more observant and thorough when listening to the respiratory system and giving the child its first “check-up”.
Some problems are due to the fact that the child’s lungs are not properly functioning. If that is the case the child will be place on oxygen, either by oxygen mask or ventilation/intubation. In some cases a child just need a little extra help until the lungs are strong enough to pump oxygen throughout the body on its own. But in other cases there can be a much more significant problem.
One of the common causes for breathing/lung issues is the lack of surfactant in the lungs leading to respiratory distress syndrome. Surfactant is a natural substance the body produces that coats and lines the lungs to allow them to expand and contract properly. If a child lacks this substance within the lungs they may appear blue from the lack of oxygen that they are receiving. A doctor is able to diagnose this by blood oxygen levels and chest x-rays. Once diagnosed doctors can properly treat the child so that no damage is done to the child’s overall health. The child will be put on oxygen, most likely through a ventilator to properly oxygenate the body. Doctors may also be able to give a treatment in which surfactant is give thought the windpipe to provide the surfactants that is missing. If left untreated it can cause brain damage or even death.
Some pre-mature babies can also develop what is called an apnea. An apnea is when someone momentarily stops breathing. Apneas can be cause by underdevelopment of the CNS (central nervous system) which includes the brain and spinal cord. The brain and spinal cord are responsible for controlling breathing and lung function. If a child is born before the CNS has fully developed (which happens around week 25) and the CNS is communicating with all major organ, such as the lungs, breathing complications such as apneas may occur. If an infant or premature baby stops breathing for 15-25 seconds in their sleep several times. This shouldn’t be confused with periodic breathing in which a child stops breathing for a few (less than 10) second, followed by sudden and rapid breaths.
A pre-mature babies may also be born with or develop a breathing condition called bronchopulmonary dysplasia, more commonly known as chronic lung disease. Bronchopulmonary dysplasia (BPD) is the abnormal development of the lung tissue, and is characterizes by inflammation and scaring of the lungs. It is most common for pre-mature babies born before week 32 to develop chronic lung disease, this is because the lungs are not fully developed. Most children will recover fully from BPD, very few have life long effects. Bronchopulmonary dysplasia requires serious intensive medical care. There is no treatment that can be give to cure BPD, doctors will provide treatment to help with symptoms and assist the child in recovering. Children will naturally overcome BPD overtime as the lungs develop more. In most cases the child will be put on ventilation, either jet ventilation or intubation, and give medication such as albuterol or other bronchodilators and diuretics, they may also receive small doses of steroids to help strengthen the lungs.
These are some of the most common complications when it comes to breathing of a pre-mature child. But there are many more that may arise. If a child presents breathing problems at the time of birth or short after a team of doctors will diagnose and treat to give the child the best chance of life.
I was creating a post to follow the short and long term effect of pre-mature birth and realized that I hadn’t posted the original post! It was save in my drafts… of course. So below is my original post that is about a week late! Ooopppies!