Adaptation at Birth Flashcards
name the 3 shunts of the fetal circulation
ductus venosus
foramen ovale
ductus arteriosus
where is brown fat located in the fetus?
between scapulae
around internal organs
where does glycogen accumulate in a fetus preparing for birth?
liver
muscle
heart
what colour is baby when they are born?
blue
____ vascular resistance is higher than ___ vascular resistance in a fetus
pulmonary
systemic
what happens to the ductus arteriosus and foramen ovale in a fetus?
duct constricts
foramen ovale closes
what makes the ductus arteriosus constrict?
increased pO2
decreased flow
decreased prostaglandins
the ductus arteriosus becomes what after birth?
ligamentum arteriosus
the ductus venosus becomes what after birth?
ligamentum teres
the foramen ovale is located between what 2 chambers?
right and left atria
persistant pulmonary hypertension of then newborn is caused by? what is the consequence
patent ductus arteriosus and foramen ovale
causes hypoxemia secondary to right-to-left shunting of blood at the foramen ovale and ductus arteriosus.
Tx PPHN
ventilation oxygen nitric oxide sedation inotropes ECLS
how does the baby lose heat after birth
convection
evaporation
conduction
radiation
main source of heat production in a newborn?
non-shivering thermogenesis
how is heat produced in non-shivering thermogenesis
breakdown of stored brown adipose tissue in response to catecholamines
what happens to blood vessels in non-shivering thermogenesis?
peripheral vasoconstriction
why are preterm babies at particular risk of hypothermia?
low stores of brown and SC fat
larger surface area to volume
how is hypothermia managed in babies?
keep dry hat skin to skin blanket/clothes heated mattress incubator
there is a/an __ in insulin and a/an ____ in glucose at birth
drop
increase
why do small/premature babies get hypoglycaemia?
have low glycogen stores
why might a term baby be hypoglycaemic?
increased energy demands eg if unwell/hypothermic
inappropriate insulin/glucagon ratio eg maternal diabetes
management of hypoglycaemia at birth?
identify at-risk babies
feed effectively
keep warm
monitor
the hypothalamus acts on the __ pituitary to produce ___ which causes milk ejection
posterior
oxytocin
the hypothalamus acts on the ___ pituitary to produce ___ which causes milk production
anterior
prolactin
increase in 2.3 DPG shifts the O2Hb curve to the ___
right
why do babies become slightly anaemic at birth?
fetal Hb breaks down rapidly but adult Hb is slow to make so cant keep up
why do babies get jaundice at birth? is this normal?
breakdown of fetal Hb but liver enzyme pathways are still quite immature so there is a rise in circulating bilirubin as they arent that effective yet;
NORMAL but in high quantities abnormal
who is at risk of adaptation problems?
hypoxia/asphyxia during delivery
what is neonatal absence syndrome?
a condition in babies who have been exposed to drugs
what happens to a hypoglycaemic baby’s pancreas
baby’s pancreas gets hypoplastic because its trying to control its mothers blood glucose
risk factors for neonatal infection?
if mum got IV antibiotics for a confirmed bacterial infection during labour or in the 24hrs after
rupture of membranes >24hrs in term infant
preterm baby
mum has infection signs
causes of unconjugated jaundice in newborns?
Physiological Breast Milk Haemolysis Infection Inherited causes Intestinal obstruction
causes of conjugated jaundice in newborns?
Biliary atresia TPN Hypothyroidism α1 Antitrypsin Galactosaemia Cystic Fibrosis Trisomy 21
Ix newborn jaundice?
serum bilirubin (SBR) FBC Coombs test (DAT)
