This morning, a premature baby of 25+4 weeks gestation was brought in. The mother had spontaneously given birth to twins at home alone in the early hours of the morning. The umbilical cord of one twin ruptured and he died on the spot. The other twin could be resuscitated and is now in the NICU. His chances are not good either. Neonatology is sometimes very cruel...
Today I took part in the rounds in the NICU and was allowed to auscultate again. A mature newborn suffers from hypertension, which is much rarer in newborns than in adults and is of secondary origin. Possible causes include coarctation of the aortic arch (for which the blood pressure should be measured on the right hand and foot in comparison), kidney problems such as renal artery stenosis, or hyperthyroidism. To get to the bottom of the matter, a kidney ultrasound was ordered, which I was allowed to watch (*photo with parents' permission). The bladder and also the size of the kidneys are in order and both the arterial and venous blood flow could be shown by Doppler and flow measurement. After that I went straight to the minor students' class. The topics today were complications of prematurity affecting the brain, lungs and bowel. Afterwards there was a seminar on the follow-up of premature babies in the Netherlands. I particularly liked the example videos from the LUMC.
The transport incubator for transporting newborns. It is equipped with everything necessary for resuscitation.
The ultrasound of the kidneys with flow and Doppler measurements of the renal arteries and veins.
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