Neonatal Hypoglycaemia

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Referance. Clinical chemistry and metabolic medicine, Martin A.Crook, seventh edition 1996,p.361-362. Behavioral objectives. DefinitionsCauses of neonatal hypoglycaemiaPathogenesis (mechanism) of neonatal hypoglycaemiaClinical features of neonatal hypoglycaemiaTreatment of neonatal hypoglyceami

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Neonatal Hypoglycaemia

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3. Neonatal Hypoglycaemia ?.????? ??? ?????? ???? ??????? ???? ?????? ?????? ???? ???? / ????? ??????

4. Referance Clinical chemistry and metabolic medicine, Martin A.Crook, seventh edition 1996,p.361-362

5. Behavioral objectives Definitions Causes of neonatal hypoglycaemia Pathogenesis (mechanism) of neonatal hypoglycaemia Clinical features of neonatal hypoglycaemia Treatment of neonatal hypoglyceamia Some examples of neonatal hypoglycaemia

6. Preliminary definitions Neonate: is alive baby within one month of birth Premature or preterm baby : baby born before 37 completed weeks of gestation Hypoglycaemia :defined as a plasma glucose concentration less than 2.5mmol/L in aspecimen collected into a tube containing an inhibitor of glycolysis.

7. Causes of neonatal hypoglycaemia 1.Reduced production of glucose Prematurity Birth asphyxia Sepsis Poor nutrition Congenital heart disease 2.Inborn error of metabolism Glycogen storage disease Galactosaemia and hereditary fructose intolerance Amino acid disorders e.g. tyrosinaemia Ketotic hypoglycaemia of infancy

8. 3.Hyperinsulinaemia Maternal diabetes Nesidioblastosis Beckwith-Wiedemann syndrome Insulinoma Erythroblastosis fetalis 4.Hormone deficiencies Hypothyroidism Hypopituitarism Adrenal insufficiency Congenital adrenal hyperplasia

9. Mechanism of the disease Hepatic glycogen store increase about threefold and adipose tissue (another sourece of energy ) is laid down during the last 10 weeks of pregnancy . Very premature infants therefore have little liver glycogen and adipose tissue and are especially prone to hypoglycemia. Full term infants may become hypoglycemic if initially adequately store are drown on more rapidly than normal, for example during perinatal asphyxia.

10. Infants at greater risk of hypoglycemia are those with: Infection Asphyxia Rhesus hemolytic disease Exchange transfusion Infant of diabetic mother.

13. Examples of neonatal hypoglycamia Nesidioblastosis is due to overgrowth of insulin-producing beta cells in the pancreas and present with severe hypoglycemia and hyperinsulinaemia. Beckwith-Wiedemann syndrome is due to deletion of short arm of chromosome 11 and is associated with hypoglyceamia , visceromegaly , exomphalos and mental retardation. The babies of diabetic mothers tend to be large , jaundiced, and hypocalcaemic and have lung immaturity and congenital defects. Neonatal hypoglycemia is related to the degree of maternal glycaemic control.

14. Thank you

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