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1. Reproduction > Foetal Adaption at birth > Flashcards

Foetal Adaption at birth Flashcards

1
Q

What is the role of the placenta?

A 
foetal homeostasis
gas exchange
nutrient transport to foetus
whole product transport from foetus
acid base balance
hormone production
transport of IgG
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2
Q

What % of foetal circulation goes through the lungs?

A

7%

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3
Q

What are the 3 shunts that close after a baby is born?

A

ductus venosus
foramen ovale
ductus arteriosus

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4
Q

What does the ductus venosus become?

A

ligamentum teres

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5
Q

What does the foramen ovale become?

A

closes completely or persists as patent foramen ovale

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6
Q

What does the ductus arteriosus become?

A

ligamentum arteriosus

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7
Q

How does the pulmonary vascular resistance change at birth?

A

decreases

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8
Q

How does the systemic vascular resistance change at birth?

A

increases

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9
Q

How does oxygen tension change at birth?

A

increases

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10
Q

How do the levels of circulating prostaglandins change at birth?

A

decrease

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11
Q

What is persistant pulmonary hypertension of the newborn?

A

marked pulmonary hypertension that causes hyperaemia secondary to right->left shunting of blood at the foramen ovale and ductus arterious

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12
Q

What causes persistant pulmonary hypertension of the newborn?

A

failure of normal circulation transition due to patent foramen ovale - they have no mechanism to close it

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13
Q

How is persistant pulmonary hypertension managed?

A 
ventilation
nitric oxide
sedation
inotrops
ECCs
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14
Q

How does the babies body prepare for birth in the 3rd trimester?

A

surfacant production
accumulation of glycogen - liver, muscle, heart
accumulation of brown fat - between the scapulae and around internal organs
swallowing amniotic fluid

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15
Q

How does the babies body prepare for birth during labour?

A

increases catecholamines and cortisol
synthesis of lung fluid stops
vaginal delivery squeezes lungs

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16
Q

How do babies perform heat loss?

A

radiation
conduction
convection
evaporation

17
Q

How do babies gain heat?

A

non shivering thermogenesis

18
Q

What is non shivering thermogenesis?

A

heat is produced by the breakdown of stored brown adipose tissue in response to catecholamines

19
Q

When does non shivering thermogenesis start?

A

AFTER 12 HOURS OF LIFE

20
Q

Why does non shivering thermogenesis not happen in the first 12 hours of life?

A

low BMR
high surfacea area:body mass ratio
low brown adipose tissue

21
Q

What 3 “hypos” are linked?

A

hypthermia
hypoxia
hypoglycaemia

22
Q

Before the non shivering thermogenesis kicks in, how should you keep a baby warm?

A

keep them dry - they are born wet
give them a hat and a blanket
heated matress

23
Q

How does glucose homeostasis change at birth?

A

increase in glycogen - mobilisation of these stores for gluconeogenesis
drop in insulin

24
Q

What do babies use as brain fuel?

A

ketones

25
Q

What are the 3 ways a baby can develop hypoglycaemia?

A

unwell/hypothermic -> increased energy demands
small/premature -> low glycogen stores
maternal diabetes/hyperinsulism -> innappropriate insulin/glucagon ratio

26
Q

What does oxytocin cause in relation to breast feeding?

A

milk ejection

27
Q

What changes happen haematologically at birth?

A

2,3,BPG curve -> RIGHT

haematopoesis moves to the bone marrow

28
Q

How is physiological anaemia caused?

A

adult Hb is synthesised slower than foetal Hb is broken down

29
Q

When does physiological anaemia peak?

A

8-10 weeks

30
Q

What causes physiological jaundice?

A

breakdown of foetal haemoglobin but the conjugating pathway is immature which causes a rise in circulating unconjugated bilirubin

31
Q

When is jaundice pathological?

A

<24hours of age

32
Q

When does jaundice become prolonged?

A

if term = 2 weeks

pre term = 3 weeks

33
Q

What is the usual course of physiological jaundice?

A

starts day 2

peaks day 5

1. Reproduction (50 decks)

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