Clinical Coding Seminar

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Clinical Coding Seminar 28th October 2007
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Maternal conditions affecting the neonate

• Issues of prematurity (lt37weeks)
• Cervical incompetence difficulties with
  diagnosis
• management issues
• outcomes ?PNMR
• midtrimester M/C
• preterm delivery
• Chorioamnionitis

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Maternal conditions affecting the neonate

• Issues of prematurity (contd)
• Preterm rupture membranes (PROM)

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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

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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

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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)

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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
• Vellamentous insertion

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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

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Birth Injuries

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

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Birth Injuries

• Head - intracerebral extra/subdural haem
• scalp lacerations, haematoma
• facial nerve
• Neck/spine brachial plexus (Erbs Palsy)
• Other skeletal - clavicle
• humerus
• femur

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Thank you