ABC First Year by Geoffrey Chamberlain, Margery Morgan

By Geoffrey Chamberlain, Margery Morgan

(BMJ e-book) textual content has been up to date all through and redesigned within the present ABC structure. Covers association of care, common antenatal administration, fetal well being, paintings in being pregnant, raised blood strain, preterm exertions, a number of being pregnant, audit of start, and extra. past version: c1993. Softcover.

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By Geoffrey Chamberlain, Margery Morgan

(BMJ e-book) textual content has been up to date all through and redesigned within the present ABC structure. Covers association of care, common antenatal administration, fetal well being, paintings in being pregnant, raised blood strain, preterm exertions, a number of being pregnant, audit of start, and extra. past version: c1993. Softcover.

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Extra info for ABC First Year

Example text

Jaundice in the newborn Pale stools and a plasma conjugated bilirubin level greater than 30 ␮mol/l suggest the possibility of hepatitis or atresia of the bile ducts, and the advice of a paediatrician is needed. If there is a suspicion that the jaundice is related to breastfeeding, the other conditions causing jaundice should be excluded and the mother advised to continue breastfeeding. If the plasma bilirubin concentration is rising rapidly and breastfeeding is stopped for 48 hours, the infant’s plasma bilirubin concentration will fall abruptly and will not usually rise on return to breastfeeding.

Although about 10% of mothers are colonised and about 25% of their infants acquire this organism, only one in 1000 infants has symptoms. About half of those with symptoms die. In the early onset type, which occurs in the first few days of life, there may be a persistently raised respiratory rate followed by the vague features of septicaemia and later peripheral cyanosis. The chest radiograph may show extensive areas of consolidation in both lungs or it may be normal. The same organism may cause a more insidious septicaemia and meningitis towards the end of the first week.

An unnecessarily pessimistic prognosis based on out of date information may alter a mother’s attitude towards her baby and impair her attachment to him or her. In discussing management the help and support that will be given by social workers or physiotherapists should be emphasised and the parents advised to tell their relations and friends the diagnosis rather than hide it. A doctor with only limited experience of a particular problem should tell the parents that he or she needs to seek further advice rather than guess at the answer.

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