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Reproduction and sexual health > Adaptation at birth > Flashcards

Adaptation at birth Flashcards

1
Q

What is the function of the placenta

A 
hormone production 
gas exchange
waste removal 
nutrition 
homeostasis
acid base balance 
transport of IgG
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2
Q

What is the function of the foetal liver

A

albumin production
Erythropoeisis - RBC
clotting factors

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3
Q

What is the function of the foetal kidneys

A

produce urine and contributes to amniotic fluid

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4
Q

In foetal circulation, which vessel does oxygenated blood travel through to the foetus from the mother

A

Umbilical vein

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5
Q

In foetal circulation, which vessel does deoxygenated blood return to the mother from the foetus

A

Umbilical arteries

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6
Q

In foetal circulation, what shunt exists in the liver

A

Ductus venosus

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7
Q

In foetal circulation, where can blood in the right atrium go

A
  1. through the foramen ovale into the left atrium

2. to the right ventricle and then the pulmonary arteries

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8
Q

In foetal circulation, what direction of blood flow do the shunts allow for

A

Right to left

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9
Q

In foetal circulation, where does blood in the pulmonary trunk go

A
  1. small volumes to the lungs

2. majority to the aorta via the ductus arteriosus

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10
Q

In which trimester does the baby prepare for birth

A

3rd trimester

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11
Q

What does the foetus do to prepare for labour and delivery in the 3rd trimester

A 
surfactant production 
glycogen stores 
brown fat stores 
SC fat stores 
swallow amniotic fluid
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12
Q

What happens in the transition of foetal to adult circulation

A

Decrease in pulmonary vascular resistance
Increase in systemic vascular resistance
Increase in O2 tension
Decrease in circulating prostaglandins which closes the ductus arteriosus and venosus
Foramen ovale closes

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13
Q

What do the following structures normally become after delivery
Ductus arteriosus
Foramen ovale
Ductus venosus

A

ligamentum arteriosus
closes to form fossa ovalis
ligamentum teres

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14
Q

What is persistent pulmonary hypertension of the newborn PPHN

A

failure of the pulmonary vascular resistance to fall

and the right to left shunt persists

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15
Q

What investigation/examination can be done for PPHN

What is the significance

A

pre (right hand) and post (foot) ductal O2 saturations

>3% difference is highly suspicious of PPHN

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16
Q

What is the management of PPHN

A 
Ventilation 
Oxygen 
Nitric oxide 
Sedation 
Inotropes 
ECLS = extra corporeal life support
17
Q

What is transient tachypnoea of the newborn TTN

A

Diagnosis of exclusion
Common
fluid in lungs hasn’t yet cleared eg big babies delivered by c-section

18
Q

How do babies thermoregulate

A

breakdown of brown fat

peripheral vasoconstriction - acrocyanosis

19
Q

Why do babies need help keeping warm

A

They have a larger head than body - lose heat faster
Born wet - need drying
Babies don’t shiver

20
Q

What can be used as an energy source for the brain by babies

A

Ketones

21
Q

List causes of neonatal hypoglycaemia

A

Increased demands: Hypothermia, Infection
Low glycogen stores: SGA, premature
Abnormal insulin levels: maternal DM, hyperinsulinaemia
Drugs: B blockers

22
Q

Which is preferred, breast milk or formula milk

A

Breast milk

23
Q

Loss of up to __% body weight is normal for babies

A

10%

24
Q

What chemical helps to shift HbF to HbA

A

2,3 BPG

25
Q

Where does haematopoeisis occur in the foetus and then the neonate

A

Foetus: liver
Neonate: bone marrow

26
Q

What types of jaundice exist

A

Physiological

Pathological

27
Q

what happens in jaundice

A

breakdown of HbF + immature conjugating pathways leads to increase in unconjugated bilirubin levels

28
Q

When is the onset of physiological jaundice

A

2 days to 2 weeks old

29
Q

When is the onset of pathological jaundice

A

Early <24 hours/at birth

Prolonged >14 days term / >21 days pre term

30
Q

What are causes of early pathological jaundice

A

sepsis

haemolysis from Ab mismatch

31
Q

What are causes of prolonged pathological jaundice

A

biliary atresia!

congenital hypothyroidism

32
Q

What is the management of jaundice

A

Phototherapy

Exchange transfusion

33
Q

Why is it important to treat jaundice

A

to prevent Kernicterus

34
Q

What is Kernicterus

A

accumulation of very high levels of unconjugated bilirubin which can cross the BBB and settle in the basal ganglia leading to significant neurological problems and a type of CP

35
Q

what is the ideal temperature for neonates

A

36.5-37.5

Reproduction and sexual health (46 decks)

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