Inhoudsopgave
Normaalwaarden:......................................................................................................................6
1. Screening................................................................................................................................7
1.1 Prenatale screening............................................................................................................7
1.2 Chromosoomafwijkingen..................................................................................................8
1.3 Wet op bevolkingsonderzoek (WBO)................................................................................8
1.4 Counseling.........................................................................................................................8
1.5 NIPT..................................................................................................................................8
1.6 Hartfilmpje.........................................................................................................................9
1.7 Bloedonderzoek.................................................................................................................9
2. Diagnostische test................................................................................................................10
2.1 Vruchtwaterpunctie..........................................................................................................10
2.2 Vlokkentest......................................................................................................................10
3. Structureel echoscopisch onderzoek...................................................................................10
3.1 Echo’s..............................................................................................................................10
1. Erfelijkheid...........................................................................................................................11
1.2 Mitose..............................................................................................................................12
1.3 Meiose..............................................................................................................................12
1.4 Numerieke chromosomale afwijkingen...........................................................................13
1.5 Structurele bouwfouten op de chromosomen..................................................................13
1.6 Non-disjunctie..................................................................................................................14
2. De wet van Mendel...............................................................................................................14
2.1 Autosomaal overerving....................................................................................................14
2.2 Autosomaal recessief.......................................................................................................15
2.3 Geslachtsgebonden aandoening, X-gebondenchromosoom............................................15
2.4 Multifactorieel overerving...............................................................................................15
2.5 Mitochondriën..................................................................................................................15
3. Geboorteafwijkingen............................................................................................................15
3.1 Syndroom.........................................................................................................................16
3.2 Sequentie..........................................................................................................................16
3.3 Associatie.........................................................................................................................16
1. Fysiologie van de zwangerschap.........................................................................................18
1
, 1.2 De cyclus van een vrouw.................................................................................................18
1.3 Menstruatiecyclus............................................................................................................18
1.4 Ontwikkeling embryo......................................................................................................19
2. De placenta...........................................................................................................................20
3. De vliezen.............................................................................................................................20
3.2 Vruchtwater.....................................................................................................................21
4. Navelstreng...........................................................................................................................21
5. Foetale groei en ontwikkeling.............................................................................................21
1. Anatomie van het hart.........................................................................................................23
1.2 Foetale circulatie..............................................................................................................23
1.3 Tachycardie......................................................................................................................24
1.4 Bradycardie......................................................................................................................25
1.5 Kleurverandering van de huid..........................................................................................25
2. Anatomische en fysiologische veranderen na de geboorte.................................................25
2.1 Respiratoire veranderingen..............................................................................................25
2.2 Nierfunctie.......................................................................................................................26
3. Directe zorg post partum......................................................................................................27
3.1 Transitieperiode...............................................................................................................27
3.2 Thermoregulatie...............................................................................................................27
3.3 Soorten thermoregulaties.................................................................................................27
3.4 Soorten warmteverlies.....................................................................................................28
3.5 Observatie........................................................................................................................28
3.6 De Apgar-score................................................................................................................28
3.7 Capillaire refill.................................................................................................................28
3.8 Geboortetrauma...............................................................................................................28
4. Reflexen................................................................................................................................29
5. Algehele lichamelijke controle en observatie bij prematuren............................................29
5.1 Large of gestational age (LGA).......................................................................................29
5.2 Small for gestational age (SGA)......................................................................................29
1. Psychische problematiek in de zwangerschap....................................................................32
2. Psychofarmaca....................................................................................................................32
2.1 Indeling van de psychofarmaca.......................................................................................32
2
,3. Verslaving.............................................................................................................................33
3.1 Verslavingssyndroom......................................................................................................33
3.2 Gevolgen..........................................................................................................................34
3.3 Gevolgen verschillende drugs..........................................................................................34
4. Finnegan score....................................................................................................................35
5. NAS.......................................................................................................................................36
4.1 Symptomen......................................................................................................................36
4.2 Aanvullend onderzoek.....................................................................................................37
4.3 Verpleegkundige interventies..........................................................................................37
4.4 Klinisch verloop...............................................................................................................38
4.5 Nabeschouwing................................................................................................................38
6. FAS.......................................................................................................................................38
6.1 Klinisch beeld FAS..........................................................................................................38
6.2 Aanvullende onderzoek...................................................................................................39
6.3 Klinisch beleid.................................................................................................................39
6.4 Finnegan score lijst..........................................................................................................39
1. Transitiefase.........................................................................................................................42
1.1 Wet-long..........................................................................................................................42
1.2 Postnatale ontwikkeling...................................................................................................42
1.3 Postnatale onrijpheid.......................................................................................................43
2. Neonatale definities.............................................................................................................43
2.1 Verwachten problemen....................................................................................................44
3. Infecties................................................................................................................................44
3.1 Perinatale infecties...........................................................................................................45
3.2 Congenitale infecties........................................................................................................45
3.3 Uteriene infecties.............................................................................................................45
3.4 Besmetting na de geboorte...............................................................................................45
3.5 Symptomen sepsis...........................................................................................................45
4. Schedel neonaat...................................................................................................................46
4.1 Complicaties postpartum.................................................................................................46
4.2 Alarmsymptomen schedelomtrek....................................................................................46
5. Bilirubine.............................................................................................................................46
5.1 Hyperbilirubinemie..........................................................................................................46
3
, 5.2 Bilirubineproductie..........................................................................................................47
5.3 Bilirubine-uitscheiding....................................................................................................47
5.4 Fysiologische en pathologische icterus............................................................................47
5.5 Behandeling.....................................................................................................................47
5.6 Hyperbilirubinemie en borstvoeding...............................................................................47
5.7 Risico’s............................................................................................................................47
5.8 Rhesus antagonisme.........................................................................................................48
6. Onregelmatige ademhaling.................................................................................................48
7. Hypoglykemie.......................................................................................................................48
7.1 Oorzaken..........................................................................................................................49
7.2 Symptomen......................................................................................................................50
7.3 Risico’s en therapie..........................................................................................................50
1. Ziekenhuisindicatie voor pasgeborene................................................................................52
1.2 Observaties tijdens opnamen...........................................................................................52
1.3 zuurstof toediening..........................................................................................................52
2. Premature pasgeborene.......................................................................................................52
2.1 Lichaam..........................................................................................................................52
2.2 Problemen........................................................................................................................53
3. Dysmature pasgeborene.......................................................................................................53
3.1 Lichaam...........................................................................................................................53
3.2 Groeiachterstand..............................................................................................................54
3.3 Problemen........................................................................................................................54
4. Serotiene pasgeborene.........................................................................................................54
4.1 Lichaam..........................................................................................................................54
5. Macrosomie..........................................................................................................................54
1.1 Oorzaken..........................................................................................................................54
1.2 Complicaties....................................................................................................................55
6. Ademhalingsproblemen.......................................................................................................55
6.1 Respiratoire distress.........................................................................................................55
7. Wet lung...............................................................................................................................56
3.1 Risicofactoren..................................................................................................................56
3.4 Symptomen......................................................................................................................56
4
Normaalwaarden:......................................................................................................................6
1. Screening................................................................................................................................7
1.1 Prenatale screening............................................................................................................7
1.2 Chromosoomafwijkingen..................................................................................................8
1.3 Wet op bevolkingsonderzoek (WBO)................................................................................8
1.4 Counseling.........................................................................................................................8
1.5 NIPT..................................................................................................................................8
1.6 Hartfilmpje.........................................................................................................................9
1.7 Bloedonderzoek.................................................................................................................9
2. Diagnostische test................................................................................................................10
2.1 Vruchtwaterpunctie..........................................................................................................10
2.2 Vlokkentest......................................................................................................................10
3. Structureel echoscopisch onderzoek...................................................................................10
3.1 Echo’s..............................................................................................................................10
1. Erfelijkheid...........................................................................................................................11
1.2 Mitose..............................................................................................................................12
1.3 Meiose..............................................................................................................................12
1.4 Numerieke chromosomale afwijkingen...........................................................................13
1.5 Structurele bouwfouten op de chromosomen..................................................................13
1.6 Non-disjunctie..................................................................................................................14
2. De wet van Mendel...............................................................................................................14
2.1 Autosomaal overerving....................................................................................................14
2.2 Autosomaal recessief.......................................................................................................15
2.3 Geslachtsgebonden aandoening, X-gebondenchromosoom............................................15
2.4 Multifactorieel overerving...............................................................................................15
2.5 Mitochondriën..................................................................................................................15
3. Geboorteafwijkingen............................................................................................................15
3.1 Syndroom.........................................................................................................................16
3.2 Sequentie..........................................................................................................................16
3.3 Associatie.........................................................................................................................16
1. Fysiologie van de zwangerschap.........................................................................................18
1
, 1.2 De cyclus van een vrouw.................................................................................................18
1.3 Menstruatiecyclus............................................................................................................18
1.4 Ontwikkeling embryo......................................................................................................19
2. De placenta...........................................................................................................................20
3. De vliezen.............................................................................................................................20
3.2 Vruchtwater.....................................................................................................................21
4. Navelstreng...........................................................................................................................21
5. Foetale groei en ontwikkeling.............................................................................................21
1. Anatomie van het hart.........................................................................................................23
1.2 Foetale circulatie..............................................................................................................23
1.3 Tachycardie......................................................................................................................24
1.4 Bradycardie......................................................................................................................25
1.5 Kleurverandering van de huid..........................................................................................25
2. Anatomische en fysiologische veranderen na de geboorte.................................................25
2.1 Respiratoire veranderingen..............................................................................................25
2.2 Nierfunctie.......................................................................................................................26
3. Directe zorg post partum......................................................................................................27
3.1 Transitieperiode...............................................................................................................27
3.2 Thermoregulatie...............................................................................................................27
3.3 Soorten thermoregulaties.................................................................................................27
3.4 Soorten warmteverlies.....................................................................................................28
3.5 Observatie........................................................................................................................28
3.6 De Apgar-score................................................................................................................28
3.7 Capillaire refill.................................................................................................................28
3.8 Geboortetrauma...............................................................................................................28
4. Reflexen................................................................................................................................29
5. Algehele lichamelijke controle en observatie bij prematuren............................................29
5.1 Large of gestational age (LGA).......................................................................................29
5.2 Small for gestational age (SGA)......................................................................................29
1. Psychische problematiek in de zwangerschap....................................................................32
2. Psychofarmaca....................................................................................................................32
2.1 Indeling van de psychofarmaca.......................................................................................32
2
,3. Verslaving.............................................................................................................................33
3.1 Verslavingssyndroom......................................................................................................33
3.2 Gevolgen..........................................................................................................................34
3.3 Gevolgen verschillende drugs..........................................................................................34
4. Finnegan score....................................................................................................................35
5. NAS.......................................................................................................................................36
4.1 Symptomen......................................................................................................................36
4.2 Aanvullend onderzoek.....................................................................................................37
4.3 Verpleegkundige interventies..........................................................................................37
4.4 Klinisch verloop...............................................................................................................38
4.5 Nabeschouwing................................................................................................................38
6. FAS.......................................................................................................................................38
6.1 Klinisch beeld FAS..........................................................................................................38
6.2 Aanvullende onderzoek...................................................................................................39
6.3 Klinisch beleid.................................................................................................................39
6.4 Finnegan score lijst..........................................................................................................39
1. Transitiefase.........................................................................................................................42
1.1 Wet-long..........................................................................................................................42
1.2 Postnatale ontwikkeling...................................................................................................42
1.3 Postnatale onrijpheid.......................................................................................................43
2. Neonatale definities.............................................................................................................43
2.1 Verwachten problemen....................................................................................................44
3. Infecties................................................................................................................................44
3.1 Perinatale infecties...........................................................................................................45
3.2 Congenitale infecties........................................................................................................45
3.3 Uteriene infecties.............................................................................................................45
3.4 Besmetting na de geboorte...............................................................................................45
3.5 Symptomen sepsis...........................................................................................................45
4. Schedel neonaat...................................................................................................................46
4.1 Complicaties postpartum.................................................................................................46
4.2 Alarmsymptomen schedelomtrek....................................................................................46
5. Bilirubine.............................................................................................................................46
5.1 Hyperbilirubinemie..........................................................................................................46
3
, 5.2 Bilirubineproductie..........................................................................................................47
5.3 Bilirubine-uitscheiding....................................................................................................47
5.4 Fysiologische en pathologische icterus............................................................................47
5.5 Behandeling.....................................................................................................................47
5.6 Hyperbilirubinemie en borstvoeding...............................................................................47
5.7 Risico’s............................................................................................................................47
5.8 Rhesus antagonisme.........................................................................................................48
6. Onregelmatige ademhaling.................................................................................................48
7. Hypoglykemie.......................................................................................................................48
7.1 Oorzaken..........................................................................................................................49
7.2 Symptomen......................................................................................................................50
7.3 Risico’s en therapie..........................................................................................................50
1. Ziekenhuisindicatie voor pasgeborene................................................................................52
1.2 Observaties tijdens opnamen...........................................................................................52
1.3 zuurstof toediening..........................................................................................................52
2. Premature pasgeborene.......................................................................................................52
2.1 Lichaam..........................................................................................................................52
2.2 Problemen........................................................................................................................53
3. Dysmature pasgeborene.......................................................................................................53
3.1 Lichaam...........................................................................................................................53
3.2 Groeiachterstand..............................................................................................................54
3.3 Problemen........................................................................................................................54
4. Serotiene pasgeborene.........................................................................................................54
4.1 Lichaam..........................................................................................................................54
5. Macrosomie..........................................................................................................................54
1.1 Oorzaken..........................................................................................................................54
1.2 Complicaties....................................................................................................................55
6. Ademhalingsproblemen.......................................................................................................55
6.1 Respiratoire distress.........................................................................................................55
7. Wet lung...............................................................................................................................56
3.1 Risicofactoren..................................................................................................................56
3.4 Symptomen......................................................................................................................56
4
