Maharashtra University of Health Sciences Courses

D.M. (Neonatology)

Course Content

Since the students are trained with the aim of practicing as independent specialists, this course content will be mainly a guideline. They have to manage all types of cases and situations and seek and provide consultation. The emphasis shall therefore be on the practical management of the problem of the individual cases and the community within the available resources.

A. Basic Sciences

• Basic genetics
• Fetal and neonatal immunology
• Applied anatomy and embryology
• Feto-placental physiology
• Fetal growth
• Neonatal adaptation
• Physiology and Development of Respiratory system
• Physiology and development of Cardiovascular system, developmental defects, physiology and hemodynamics of congenital heart disease.
• Physiology and Development Nervous system
• Physiology and Development of gastrointestinal system
• Physiology and Development of Renal system
• Physiology and Development of Hematopoietic system
• Physiology and Development of Endocrinal system
• Metabolic pathways pertaining to glucose, calcium and magnesium
• Biochemical basis of inborn errors of metabolism
• Electrolyte balance
• Development pharmacology
• Mechanism of disease

B. General Topics

• Research methodology
• Teaching methodology
• Biostatistics
• Epidemiology
• Health economics
• Health Information System
• Ethics in Perinatology / Neonatology
• Medical education
• Computer & Information technology

C. Perinatology

• Perinatal outreach services
• Perinatal and neonatal mortality, morbidity, epidemiology ( Perinatal Audit )
• High risk pregnancy & impact on the fetus
• Fetal monitoring
• Intrapartum monitoring and procedures
• Genetic counseling
• Diagnosis and management of fetal diseases
• Fetal intervention
• Fetal origin of adult disease

D. Neonatology

• Neonatal resuscitation
• Management of normal newborn
• Management of LBW, VLBW, ELBW infants
• Management of sick neonate
• Emergency neonatal care
• Thermoregulation
• Neonatal transport
• Fluid & electrolyte management
• Neonatal ventilation
• Blood gas and acid base disorders

Neonatal assessment

• Assessment of gestation, neonatal behavior, neonatal reflexes
• Developmental assessment, detection of neuromotor delay, stimulation techniques

Respiratory system

• Neonatal airways: physiology, pathology; management
• Pulmonary diseases: hyaline membrane disease, transient tachypnea, aspiration Pneumonia, pulmonary air leak syndromes, pulmonary hemorrhage, developmental defects

• Oxygen therapy and its monitoring
• Pulmonary infections
• Miscellaneous pulmonary disorders

Cardiovascular system

• Fetal circulation, transition from fetal to neonatal physiology
• Examination and interpretation of cardiovascular signs and symptoms
• Special tests and procedure ( Echocardiography, angiography)
• Diagnosis and management of congenital heart diseases
• Rhythm disturbances
• Hypertension in neonates
• Shock: pathophysiology, monitoring, management

Gastrointestinal system

• Disorders of liver and biliary system
• Bilirubin metabolism
• Neonatal jaundice, Prolonged hyperbilirubinemia, Kernicterus
• Congenital malformations
• Necrotising enterocolitis

Neurology

• Clinical neurological assessment
• EEG, ultrasonography, CT scan
• Neonatal seizures
• Intracranial hemorrhage
• Brain imaging
• Hypoxic ischemic encephalopathy
• Neuro-muscular disorder
• Degenerative diseases
• CNS malformation

Renal system

• Development disorders
• Renal functions
• Fluid and electrolyte management
• Acute renal failure (diagnosis, monitoring, management).

Endocrine and metabolism

• Glucose metabolism, hypoglycemia, hyperglycemia
• Calcium disorders
• Magnesium disorders
• Thyroid disorders
• Adernal disorders
• Ambiguous genitalia
• Inborn errors of metabolism

Hematology

• Physiology
• Anemia
• Polycythemia
• Bleeding and coagulation disorders
• Rh hemolytic disease
• Blood Component therapy

Nutrition

• Fetal nutrition
• Physiology of lactation
• Lactation management
• Parenteral nutrition
• Vitamins and micronutrients in newborn health
• Human Milk Banking

Surgery and orthopedics

• Diagnosis of neonatal surgical conditions
• Pre and post operative care
• Neonatal anesthesia
• Metabolic changes during anesthesia and surgery
• Orthopedic problems

Neonatal infections

• Intrauterine infections
• Superficial infections
• Diarrhea
• Septicemia
• Meningitis
• Osteomyelitis and arthritis
• Pneumonias
• Perinatal HIV
• Miscellaneous infective disorders & fungal infections

Neonaal ophthalmology

• Development aspects
• Retinopathy of prematurity
• Sequelae of perinatal infections

Neonatal Hearing assessment

Community neonatology

• Vital statistics
• Health system
• Neonatal care priorities
• Care at primary, secondary & tertiary level of care
• Role of different health functionaries
• National programmes
• National Neonatology Forum

Neonatal dermatology

Neonatal Imaging

Developmental assessment and follow up

Organization of neonatal care

Adoption

Recent Advances

Laboratory Medicine

Neonatal procedures

Therapeutic agents

Biomedical equipments, use & maintenance

E. List of Skills

Clinical

• Neonatal examination & anthropometry
• Developmental assessment
• Neonatal resuscitation
• Neonatal ventilation: CPAP, Mechanical ventilation
• Blood sampling: Capillary, venous, arterial
• Insertion of peripheral venous, umbilical venous and umbilical arterial catheters
• Monitoring: invasive, non-invasive
• Enteral feeding (katori-spoon, gavage, breastfeeding)
• Lactation management
• Parenteral nutrition
• Endotracheal Intubation
• Lumbar puncture and ventricular tap
• Placing of ‘chest tube’
• Exchange transfusion
• Bed side tests: shake test, sepsis screen, hematocrit, glucose estimation, urine examination, CSF examination, Kleihauer technique, Apt test etc.
• Neonatal drug therapy
• Nursery house keeping routines
• Infection control & Universal precautions
• Handling, effective utilization and trouble shooting of neonatal equipment.
• Decision making, clinical diagnosis, planning & interpretation of investigations
• Management of Neonatal problems

Communication

• Communication with parents, families and communities
• Interdepartmental communication
• Human behavior studies

Education / Training

• Teaching skills
• Learning skills
• Participatory and small group learning skills
• Preparing learning resource material

Self-Directed Learning

• Learning needs assessment, literature search, evaluating evidence

Research Method

• Framing of research question
• Designing and conducting study
• Analyzing and interpreting data
• Publication & writing a paper
• Review & presentation of research findings