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Newborn/Pediatric Cliff notes > Fetal development/Post natal compcliations > Flashcards

Fetal development/Post natal compcliations Flashcards

1
Q

What problems would you expect in a premature infant 24 weeks of gestation?

A
  1. RDS or BPD; lack surfactant to keep alveoli open for gas exchange and potential for lung damage
  2. Hypotension: PDA may stay open = abnormal blood flow between aorta and pulmonary artery
  3. Intraventricular hemorrhage: brain is literally fragile
  4. Apnea of prematurity (hypoxia caused by immature resp control center)
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2
Q

What are factors that could affect fetal development?

A
  1. Fetal lung fluid
  2. Teratogens
  3. Maternal-fetal gas exchange
  4. Amniotic fluid
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3
Q

Why is fetal lung fluid important to fetal development?

A

Promotes growth, maturation, and functional development of lung structures.

  • Fetus breathe liquid than transition to air
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4
Q

What happens if babes fail to transition to air or fetal fluid remains in the airway?

A
  1. Failure to transition to air could mean and lack of fetal fluid during development which could cause pulmonary hypoplasia
  2. Failure to clear liquid during transition leads to TTNB
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5
Q

What develops at each stage of fetal development?

A
  1. Embryonic: trachea + major bronchi
  2. Pseudo glandular: Conducting airways/tracheobronchial tree
  3. Canalicular: Vascular bed + framework of acinus
  4. Saccular: Terminal airways/saccule framework and maturation of surfactant
  5. Alveolar: Alveoli are developed
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6
Q

What weeks do each of the phases of development occur?

A
  1. Embryonic: 0-6
  2. Pseudo glandular: 6-16
  3. Canalicular: 17-26
  4. Saccular: 26-36
  5. Alveolar: 36-40
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7
Q

What week are fetus viable?

A

24-26 bc enough proliferation of immature surfactant is created

  • aka gas exchange can occur (not great)
  • surfactant appears at 20 weeks
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8
Q

Factors that affect fetal development

A
  1. Teratogens
  2. Fetal lung fluid
  3. Maternal fetal gas exchange
  4. Amniotic fluid
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9
Q

What could happen if fetal development is halted during the embryonic phase

A
  1. Choanal atresia
  2. Pulmonary hypoplasia
  3. Congenital diaphragmatic hernia
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10
Q

What happens if cilia dysfunction/impairment occurs during development

A

Impairs mucous transport increasing risk of infection

  • Cilia development begins in week 13
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11
Q

Maternal-fetal gas exchange route/develpment?

A
  1. Placenta (poor)
  2. Chorionic villi
  3. Umbilical cord
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12
Q

What is the limiting factor in maternal-fetal gas exchange that leads to fetal hypoxia?

A

Any factor that decreases uterine or fetal blood flow

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13
Q

3 sections of umbilical cord?

A
  1. 2 umbilical arteries
  2. 1 umbilical vein
  3. Wharton jelly (cushion)
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14
Q

Umbilical cord vs Umbilical vein blood flow/content?

A

Opposite of adults

  1. 2 Umbilical arteries carry deoxygenated blood to the placenta for reoxygenation
  2. 1 umbilical vein carries oxygenated blood to the fetus
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15
Q

Why is persistent fetal circulation (PRF) problematic?

A

Failure to transition after birth has the risk of hypoxia and worsening oxygen deprivation.

  • Alveoli and blood vessels are underdeveloped meaning they cannot oxygenate or ventilate
  • Can lead to pulmonary hypertension
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16
Q

Why is pulmonary hypertension a problem?

A

Increased PVR can strain the heart (RV) reducing overall oxygenation meaning hypoxia

17
Q

When does brown fat develop?

A

Week 26; and continues until 3-5 weeks after birth

18
Q

What is the physiological response for heat preservation by babes if they cannot support themselves mechanically (shivering) or chemically (brown fat)?

A

Peripheral Vasoconstriction to prevent blood from reaching the skin where heat loss occurs

19
Q

What are signs of hypothermia/cold stress?

A
  • Peripheral vasoconstriction
  • tachypnea
  • mottled skin
20
Q

What is the L/S ratio indicative of?

A

Lung maturation

  • Acquired via amniotic fluid via amniocentesis
21
Q

In a fetus, are right or left sided heart pressures higher?

  • why?
A

Right bc of hypoxic pulmonary vasoconstriction secondary to low PO2 values with nonaerated lungs

22
Q

In a fetus, are right or left sided heart pressures lower?

  • why?
A

Left in fetus bc of low resistance from the placenta

23
Q

Transition to neonatal circulation occurs because of what 3 factors?

A
  1. Clamping of the umbilical cord
  2. Initiation of the first breath
  3. Closure of fetal shunts
24
Q

Pulmonary vasodilators for neos?

A

iNO and oxygen are the big ones.

  • Sildenafil is also used for ppHn/high PVR
25
Q
A

Newborn/Pediatric Cliff notes (9 decks)

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