Friday, March 5, 2010

43 - Features of Prematurity

*Premature babies are those babies who are born before 37 completed weeks.

*Physical criteria of prematurity :
- Skin texture : Shiny gelatinous, thin, plethoric skin.
- Lanugo : abundant.
- Plantar creases : Single deep crease over anterior 1/3rd of sole or no deep creases. Sole may be full of superficial creases.
- Genitals : Males : Both testes are at external inguinal ring or above. Empty scrotum with scanty rugosities.
- Genitals : Females : Labia majora are widely separated with labia minora fully exposed with hypertrophied clitoris.
- Breast nodules : Lesser than 5 mm and nipple is small or absent.
- Ear cartilage : Cartilage is deficient or absent with poor recoil.
- Hair : Brownish-black, fuzzy or woolly.

*Neurological criteria :
- Posture : Hypotonic, arms and legs extended.
- Arm recoil : No recoil or returns to incomplete flexion.
- Popliteal angle : Usually greater than 90 degrees. (120-180 degrees).
- Scarf sign : Elbow usually crosses the midline of chest. (video below)
- Square window : Degree of flexion at wrist limited.
- Head lag
- Various neonatal reflexes absent or incomplete.

*Video of SCARF sign:



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