Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- último período menstrual (UPM) materno
- distância do púbis superior materno ao fundo uterino
- índice de maturidade física do bebê
- índice de maturidade neuromuscular do bebê
- índice de maturidade física/neuromuscular combinada <10: idade gestacional <28 semanas
- índice de maturidade física/neuromuscular combinada 11 a 19: idade gestacional 29 a 31 semanas
- índice de maturidade física/neuromuscular combinada 20 a 24: idade gestacional 32 a 33 semanas
- índice de maturidade física/neuromuscular combinada 25 a 33: idade gestacional 34 a 36 semanas
Other diagnostic factors
- peso ao nascer do bebê (bebês adequados à idade gestacional)
Risk factors
- infecção intrauterina
- ruptura prematura das membranas fetais pré-termo (RPMpt)
- pré-eclâmpsia/hipertensão induzida pela gestação
- descolamento da placenta/ hemorragia anteparto
- volume anormal de líquido amniótico
- vaginose bacteriana grave
- gestação múltipla
- nascimento pré-termo prévio
- anormalidade fetal
- incompetência cervical/anormalidade uterina
- diabetes gestacional
- cirurgia materna durante a gestação
- doença materna crônica
- intervalo curto entre gestações
- uso de drogas (tabaco, cocaína, heroína)
- índice de massa corporal (IMC) materno na gestação <19 ou >35
- estresse/depressão
- extremidades etárias maternas
- raça não branca
Diagnostic investigations
1st investigations to order
- biometria fetal durante o período pré-natal
Treatment algorithm
idade gestacional <28 semanas
idade gestacional de 28 a 31 semanas
idade gestacional de 32 a 33 semanas
idade gestacional de 34 a 36 semanas
Contributors
Authors
Mohan Pammi, MD, PhD
Professor of Pediatrics
Section of Neonatology and Department of Pediatrics
Baylor College of Medicine
Houston
TX
Disclosures
MP declares that he has no competing interests.
Kushal Bhakta, MD
Associate Professor
Neonatal Intensive Care Unit
Children’s Hospital of Orange County
Orange County
CA
Disclosures
KB declares that he has no competing interests.
Acknowledgements
Dr Mohan Pammi and Dr Kushal Bhakta would like to gratefully acknowledge Dr Stephen Welty and Dr James L. Wynn, previous contributors to this topic.
Disclosures
SW and JLW declare that they have no competing interests.
Peer reviewers
Isaac Babarinsa, MSc, MRCOG
Consultant Obstetrician and Gynaecologist
Gloucestershire Royal Hospital
Gloucester
UK
Disclosures
IB declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
American Heart Association. AHA guidelines for CPR and emergency cardiovascular care. Part 5: neonatal resuscitation. 2020 [internet publication].Full text
Ballard JL, Khoury JC, Wedig K, et al. New Ballard Score, expanded to include extremely premature infants. J Pediatr. 1991 Sep;119(3):417-23. Abstract
Ng EH, Shah V. Guidelines for surfactant replacement therapy in neonates. Paediatr Child Health. 2021 Feb;26(1):35-49.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Pequeno para a idade gestacional (PIG)
- Restrição do crescimento intrauterino (RCIU)
More DifferentialsGuidelines
- Neonatal infection: antibiotics for prevention and treatment
- American Heart Association and American Academy of Pediatrics focused update on neonatal resuscitation
More GuidelinesPatient information
Parto prematuro
More Patient information
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