Isabella's Diagnosis

Here is some information I found that will explain Isabella's stay in the NICU.

Apnea
What is it?
Although it's perfectly normal for everyone to experience occasional pauses in breathing, newborns who don't take at least one breath in 20 seconds or more have a condition called apnea.

During an apnea spell:

the baby stops breathing
the heart rate may decrease
the skin may turn pale, purplish, or blue from lack of oxygen

What causes it?
Apnea is usually caused by immaturity in the area of the brain that controls the drive to breathe (the brain doesn't "remember" to take a breath), although illness can also be responsible. Almost all babies born at 30 weeks or less will experience apnea, but apnea spells become less frequent with age.

How is it diagnosed?
To accurately diagnose apnea, doctors monitor a baby's breathing rate in the NICU and may order a polysomnogram, which involves attaching the baby to several monitors and observing the infant for about 8 to 12 hours. The pneumogram provides information about the baby's heart rate, breathing, and oxygen saturation in the blood.

How is it treated?
In the NICU, all premature babies are monitored for apnea spells. The first line of treatment for apnea is simply stimulating the baby to help him or her remember to breathe. This can mean rubbing the infant's back or tapping the feet. However, when apnea occurs frequently, the infant may require medication (most commonly caffeine or theophylline) and/or a special nasal device that blows a steady stream of air into the airways to keep them open.

How long will my baby be in the NICU?
Babies remain in the unit until they've been apnea-free for 24 to 48 hours. Some may go home with an apnea monitor and on caffeine so parents can continue to watch for the condition. Many babies outgrow apnea by the time they're 10 weeks past their original due date. **Our Dr. says seven days**

Bradycardia
What is it?
This is an abnormal slowing of the heart rate.

What causes it?
Bradycardia often arises from other problems like low oxygen levels in the blood or apnea.

How is it diagnosed?
Taking the baby's pulse and monitoring in the NICU will confirm a diagnosis of bradycardia.

How is it treated?
Bradycardia is treated by dealing with the underlying cause, such as apnea. In some rare cases, a heart defect may be responsible for the slower heart rate. For the appropriate care, babies with a heart defect need to see a pediatric cardiologist (a doctor who specializes in treating heart problems in children).

How long will my baby be in the NICU?
Usually, the length of the stay is determined by the condition causing the bradycardia, not the bradycardia itself.

Jaundice
What is it?
Jaundice is a high level of bilirubin in the blood (bilirubin is a byproduct of the natural breakdown of blood cells, and the liver usually "recycles" it back into the body). Although mild jaundice is fairly common in full-term babies, it's much more common in premature babies.

What causes it?
Jaundice occurs when a baby has increased blood cell breakdown and the liver can't handle the extra bilirubin, which builds up, giving the skin and the whites of the eyes a yellowish color. Babies with jaundice are sometimes more sleepy than usual and, in severe cases, may be lethargic.

How is it diagnosed?
Although the yellow skin is a fairly good indicator, a diagnosis is made with a blood test to measure the bilirubin level.

How is it treated?
Extremely high levels of bilirubin can cause brain damage, so infants are monitored for jaundice and treated quickly, before bilirubin reaches dangerous levels. Standard treatment includes providing adequate fluids and light therapy, in which the baby spends time under a special blue-colored light. Some cases may also require a blood transfusion.

How long will my baby be in the NICU?
Babies with this condition stay in the NICU until their bilirubin level drops, usually in about 2 to 3 days.



Positive Coombs'

Indirect Coombs' (A.K.A. Antibody Screen)


ABO incompatibility occurs by the same general mechanism. Type O mothers are most commonly impacted, since they carry both anti-A and anti-B antibodies. If the infant is type A, type B, or type AB, risk for incompatibility exists. This is frequently referred to as a "set-up". If mixing of maternal and fetal blood occurs during pregnancy or the birth process, these antibodies can also attack the baby's rbcs and cause hemolysis. In general, this reaction is less serious than Rh incompatibility (which can be fatal if severe and untreated), and usually only results in jaundice and mild anemia.

An important thing to remember is that the presence of a positive coombs' test in the lab does not necessarily result in hyperbilirubinemia in the infant. The risk of needing phototherapy is certainly greater, but there are many factors impacting bilirubin levels, and assessment of all of these elements is critical to making an appropriate decision about treatment.


Kind of a lot of Medical information, hopefully it will explain things better than I can. :)