Fetal Circulation

Question 1

List the factors Involved in the transition to extrauterine life

Answer 1

Intrauterine circulation diverts blood away from the fetal lungs via 2 right to left shunts.
The accumulation of fetal lung fluid within the feral airways is critical for fetul lung development.
The transition to extrauterine life is characterised by changes in circulatory pathways, initiation of ventilation and oxygenation via lungs

Question 2

In relation to the new borns first breath, what physiological occurrences are taking place

Answer 2

At birth the clamping of the umbilical cord signals the end of the flower of oxygenated blood from the placenta. To establish effective oxygenation, the neonate must clear the lungs of fluid and establish a regular pattern of breathing.
Much of the transition takes 4-6 hours after birth whilst cardiovascular changes may take up to 6 weeks.
After birth most of the fluid is reabsorbed, where then the neonate moves through changes in heart rate, respiration, gastrointestinal and body temp

Question 3

Explain 4 cardiovascular changes that occur

Answer 3

Loss of umbilical circulation from placenta
Closure of the ductus venosus
Increase in pulmonary circulation
Changes in skin blood flow

Question 4

Name 4 respiratory changes that occur

Answer 4

Loss of placental gas exchange
Initiation of ventilation
Commencement of pulmonary gas exchange
Establishment of FRC

Question 5

Describe the 4 days an infant may lose heat and discuss how the midwife should prevent it

Answer 5

Convection- loss of heat from the infants skin to surrounding air when exposed
Conduction- loss of heat when the infant lies on a cold surface
Evaporation- loss of heat from the infants wet skin to surrounding air
Radiation- loss of heat from infants skin to distant or cold objects

The midwife should ensure a warm delivery room, immediate drying, skin to skin, BF, bathing and weighing postponed, appropriate clothing and bedding, awareness