SP28112018 2 day old 2kg male baby arrived in IPD with C/O jitteriness,poor activity,exessive peeling of skin,hold breath >20 sec with sPo2 falled up to 56%,BMG 38 mg/dl Vitals SpO2 89-96% PR 136bpm RR 66bpm,SCR++,CRT<3sec Didnt fed well after birth, M/H FT/SGA/ROM<18hr/delayed cry at birth/SVD/MSL Ddx birth asphyxia/HIE1/EONS/Hypoglycemia/Apnea? Inj pipzo,amika,mero,gardinal going on Kindly add your valuable opinion, I will add reports as soon as possible 30/11/2018 reports added,hyperbillirubinemia in todays report,phototherapy started,baby is stable,PR 163 bpm,SpO2 94%,curves are normal,CRT<3sec

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All the symptoms r arising due to perinatal asphyxia . Do cbc CRP blood c/s x-ray usg cranium vbg. Give high flow humidified oxygen . Give a bolus of 10% dextrose at 2 ml/kg . Then start dextrose infusion at a rate of 6 to 8 mg/kg/min . Monitor blood sugar . Add dobutamine to improve perfusion n iv calcium gluconate .apnea was due to asphyxia or hypoglycemia.

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Case of perinatal Asphyxia, More close monitoring required as to prevent Hypoxia/hyperoxia, avoid further metabolic stress, restrict fluids till urinary output is more than 1ml per kh per hour,, cerebral perfusion, GIT careby gastric aspiration and abdominal girth.

Premature baby, under weight, exclude Cong syphilus

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Birth asphyxia secondary to eos... Peeling is normal... Treat as sepsis with hypoglycemia

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??Perinatal Asphyxia , Rx as mentioned by Dr.Prasad& follow up

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EONS Treat as advised by Dr. Nitesh

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Likely EONS ...

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either use pipzo or mero,dont use simultaneously...skin peeling may be due to meconium (as umbilical cords looks like), with HIE 1 or 2 ,please add anticonvulsant....accordingly

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Perinatal asphyxia

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EONS

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