Neonatal Hypoglycaemia, a Literature Review. Essay

1374 Words May 22nd, 2014 6 Pages
Neonatal Hypoglycaemia, a Literature Review.
The key words used when researching this review: Neonatal hypoglycaemia/hypoglycemia, New-born hypoglycaemia, Low plasma glucose level, New-born/Infant low blood sugar, Hypoglycaemia in preterm/high risk neonates, Hypoglycaemia/breastfeeding, gluconeogenesis/ketone bodies. The databases and search engines used: Google scholar, CINHAL and Medline.
Hypoglycaemia is common among neonates, therefore Healthcare professionals must be aware of the risk factors that predispose infants, allowing for early screening so that asymptomatic hypoglycaemia can be detected and treated early preventing more severe or symptomatic hypoglycaemia. This essay will examine the physiology behind neonatal hypoglycaemia
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The labour was induced at 35 weeks using 2mg of Prostin. After 12 hours she was given IV Benzilpennicillin and Syntocinon with an Epidural. Labour progressed for another 18 hours to fully and the baby was born by assisted forceps delivery and episiotomy, with cord around the neck at 14:45. Apgar was 9 at one minute and 10 at five minutes, baby weighed 2440g. On initial examination the he was in good condition. By 15:00 The Neonate was put on PROM OBS for 24hours with a plan for the first Pre-feed True Blood Glucose test (TBG), before the 2nd feed and to aim for two consecutive TBG’s of >2.5mmol/l and to commence skin to skin and to breastfeed as soon as possible.
At 16:00 skin to skin and breast feeding was attempted with a successful feed for 10 minutes with good attachment and sucking seen. By 17:20 mother and baby were taken to the post-natal ward, and baby was observed to be alert and active with good tone. At 18:00 The 1st Pre feed TBG was taken with consent at approximately 4 hours of age, using a heel prick test, collected in a yellow top paediatric tube and analysed by a YSI True Blood Glucose and Lactate Machine in NNU. The TBG result was 1.33mmol/l below the threshold of 2.5mmol/l, the on call paediatrician was informed immediately.
By 19:00 the baby was seen by the on call SHO, who noted that the baby was asymptomatic but unable to latch on to the breast successfully, as mum was very tired a plan was put into…