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INFANTS OF DIABETIC MOTHER.pdf

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INFANTS OF DIABETIC MOTHER.pdf

  1. 1. SCHOOL OF NURSING AND PARAMEDICAL SCIENCES
  2. 2. INFANTS OF DIABETIC MOTHER -SRIKESHVAR KUMAR MAURYA -B.Sc Nursing (4th Year) O.I.N.S.R, DAMOH (M.P)
  3. 3. CONTENTS • INTRODUCTION • DEFINITION • TYPES • CLINICAL FEATURES • DIAGNOSTIC EVALUATION • COMPLICATIONS • MANAGEMENT • PREVENTION • NURSING MANAGEMENT
  4. 4. INTRODUCTION Diabetes is a chronic disorder of metabolism characterized by a partial or complete deficiency of the hormone insulin. It is the most common metabolic disease. Diabetes mellitus affect approximately 15.7 million persons in the United States. DM in children can occur at any age but has a peak incidence between ages 10 and 15 years, with 75% diagnosed before 18 years of age. The incidence in boys is slightly higher than in girls. Maternal diabetes mellitus leads various health problems in infants.
  5. 5. DEFINITION It is defined as a baby who is born to a mother with diabetes that causes baby at risk of problems.
  6. 6. TYPES 1. Gestational Diabetes Mellitus – Mother who are detected diabetes mellitus first time during the present pregnancy. 2. Pre-existing (pre-pregnant) Diabetes Mellitus – Mothers who have diabetes approximately mellitus before pregnancy or conceiving.
  7. 7. INCIDENCE It is estimated that childhood diabetes accounts for around 5% of total population of diabetes. In India there are about 4,00,000 infants and children with this disease.
  8. 8. CLINICAL FEATURES or EFFECTS OF DIABETES MELLITUS  The infant of a diabetic mother is larger and heavy (macrosomia).  Body of neonates covered with vernix caseosa.  Neonates may develop hypoglycemia if mother is having severe hypoglycemia, sometimes it is required to provide glucose by intravenously.  Birth injury can occur due to large size of baby during passage of fetus from birth canal.
  9. 9. DIAGNOSTIC EVALUATION 1. Before baby is born A. Ultrasound :- It is done to detect the size of baby. It would show Macrosomia. B. Lung maturity test :- In this take sample of amniotic fluid to detect lung surfactant ratio. 2. After Birth A. Check Baby’s blood sugar level :- It check within first hour or two hours after birth & rechecked regularly until it is consistently normal. This test would show hypoglycemia. B. Check bilirubin level :- This test would show increased bilirubin level (>5 mg/dl). Normal bilirubin level in infant is below 5mg/dl.
  10. 10. C. Check the baby for sign of trouble with heart & lungs D. Echocardiogram :- It is a imaging test done to check the size of baby’s heart. Contd…
  11. 11. COMPLICATIONS • Respiratory distress syndrome • Hypocalcemia & Hyperbilirubinemia • Congenital Malformation of brain, gastrointestinal, urinary system and spinal cord can occur. • Pulmonary hypertension & polycythemia can occur • Birth asphyxia may occur.
  12. 12. MANAGEMENT • Treatment of birth injury as early as possible. • Oxygen supply to neonates if respiratory distress occur. • Provide glucose to prevent hypoglycemia. • Continue monitoring of blood glucose level by a umbilical catheter or by a needle. • Start oral feeding as early as possible. • Continue close monitoring of baby and treat the possible symptoms.
  13. 13. PREVENTION • It is based on pre-natal care. • Regular checkup of pregnant mother. • Regular monitoring of blood glucose. • Provide the insulin therapy. • Provide education and counselling to mothers. • Conduction of delivery at well equipped hospital with all modern neonatal intensive care services. • Provision of adequate antenatal care. • Educate mother about breastfeeding and care of the baby. • Early detection and immediate treatment plan should follow.
  14. 14. NURSING MANAGEMENT • Monitor serum bilirubin level. • Maintain thermal environment. • Provide IV glucose according to need. • Monitor glucose level 3 to 4 hours level not above 40mg/dl. • Initiating and maintaining respiration.

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