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Cardiovascular > Foetal Circulation and congenital CVD > Flashcards

Foetal Circulation and congenital CVD Flashcards

1
Q

What is the placenta’s function?

A 
Fetal homeostasis
Gas exchange
Acid base balance
Nutrient transport to fetus
Waste product transport from fetus
Hormone production
Transport of IgG
PGE2
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2
Q

What is Prostaglandin E2 important for?

A
  • mainitng the foetal circulation

- can be given to maintain patency after birth if required in certain congenital heart diseases

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3
Q

What are the lungs filled with in the feotus?

A
  • fluid filled and unexpanded
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4
Q

Are the lungs involved in foetal circulation?

A
  • small amounts of blood enters the lungs so they get the nutrients to grow
  • the placenta is what oxygenates the blood
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5
Q

Where does the placenta sit in foetal circulation

A
  • at the end of the umbillica cord

- umbalical arteriers branch off the descending aorta to the placenta

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6
Q

In the umbilical cord the arteries carry_______ blood

oxygenated or deoxygenated?

A
  • deoxygenated
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7
Q

In the umbilical cord the veins carry_______ blood

oxygenated or deoxygenated?

A
  • oxygenated
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8
Q

Name the 3 shunts of foetal circulation?

A
  • ductus venosus
  • foramen ovale
  • ductus arteriosus
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9
Q

What is the ductus venousus

A
  • Connects the umbilical vein to the inferior vena cava
  • doesnt get processed in the liver
  • vascular structure
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10
Q

What is the Foramen ovale

A
  • Opening in atrial septum connecting RA to LA

- allows oxygenated blood to enter the left ventrical and then to the foetal body and brain

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11
Q

What is the ductus arteriosus?

A
  • Connects pulmonary bifurcation to the descending aorta
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12
Q

Right ventricle contains _____ blood?

- oxygenate/deoxgenated/ partially oxygenated

A
  • partially oxygenated blood
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13
Q

Ductus arteriosus is the pathway with the _____ resistance?

A
  • least
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14
Q

Where is bood from the inferior vena cava in foetal circulation encouraged to go?

A
  • encourage to go through the foramen ovalve

- into the left atrium

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15
Q

What produces prostaglandin E2 in the fetus?

A
  • the placenta
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16
Q

What circulator changes will occur as soon as a baby is born, in terms of pulmonary and systemic vascular resistance?

A
  • PVR will decrease as the lungs physically expand

- SVR increases and the cord clamped and cut

17
Q

Once a baby is born and taken its 1st breath, what happens to the foramen ovale

A
  • pressure in the left side of the heart becomes higher than the right (opposite of when they were in womb)
  • blood no longer flows through foramen ovale cause of pressure
  • the flap of foramen ovale closes
18
Q

What causes the foramen ovale to close in terms of nutrients?

A
  • Increased pO2 – oxygen sensitive muscular layer

- Decreased circulating PGE2 due to increased lung metabolism and placenta being removed

19
Q

What are complications of the ductus arteriosus after birth?

A
  • the duct may fail to close

- may lead to respiratory and circulatory complications

20
Q

How would you treat a failed closure of ductus arteiosus?

A
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • may close natural over time
  • surgery
21
Q

What is the primary problem that causes Persistent Pulmonary Hypertension of the Newborn?

A
  • lung vascular resistance fails to fall
22
Q

Treatment of Presistent Pulmonary Hypertension of the Newborn?

A
  • ventilation
  • oxygenation
  • increasing systemic blood pressure
  • inhaled nitric oxide
  • ECLS (extra-corporeal life support)
  • sedation
23
Q

How would you increase systemic vascular resistance in a newborn? for PPHN

A
  • inotropes
24
Q

When are congenital heart disease diagnosed?

A
  • antenatal screening
  • soon after birth
  • day 1-2 check
  • and from there on
25
Q

Management of antenatally diagnosed CHD?

A
  • Depends on disease
  • may decide to deliver in cardiac surgical centre
  • prostaglandin infusion if duct dependent lesion
26
Q

Differential diagnosis of cyanosis in a newborn?

A
  • cardiac disease
  • respiratory disease
  • persistent pulmonary hypertension of the newborn (PPHN)
27
Q

What happens if the ductus arteriosus closes in a congenital heart defect?

A
  • often between 2-7 days
  • severe cyanosis
  • tachypnoea
  • rapid deterioration / death
  • poor/absent pulse
  • acidotic
28
Q

Treatments of congenital heart disease?

A
  • surgery
  • valves
  • transplant
  • emotional and social help

Cardiovascular (26 decks)

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