Neonatal adaptations

Question 1

What does the ductus arteriosus become?

Answer 1

Ligamentum arteriosum

Question 2

What does the foramen ovale become?

Answer 2

Fossa ovalis

Question 3

What is the ductus arteriosus?

Answer 3

A blood vessel in the developing foetus connecting the trunk of the pulmonary artery to the proximal descending aorta. It allows most of the blood from the right ventricle to bypass the foetus’s fluid-filled non-functioning lungs

Question 4

What is the foramen ovale?

Answer 4

A small hole located in the septum, which is the wall between the two atria.

Question 5

What is the ductus venosus?

Answer 5

A shunt that allows oxygenated blood in the umbilical vein to bypass the liver and is essential for normal foetal circulation.

Blood becomes oxygenated in the placenta and travels to the right atrium via umbilical veins through the ductus venosus, then to the inferior vena cava

Question 6

What does the ductus venosus become?

Answer 6

Ligamentum venosum

Question 7

What is the umbilical vein?

Answer 7

A vein present during foetal development that carries oxygenated blood from the placenta into the growing foetus

Question 8

What does the umbilical vein become?

Answer 8

Ligamentum teres / round ligament of liver

Question 9

What is the round ligament of the liver?

Answer 9

The remnant of the umbilical vein that exists in the free edge of the falciform ligament of the liver.

Question 10

What do the umbilical arteries become?

Answer 10

Medial umbilical ligaments

Question 11

What are baby’s lungs like at birth?

Answer 11

Fluid filled

Question 12

What happens to baby’s lungs during first breath (about 10 seconds after delivery)?

Answer 12

1. Fall in pulmonary vascular resistance.
2. Increase in surface area for gas exchange.

Oxygenated blood now reaches the left atrium and ventricle, and through the descending aorta reaches the umbilical arteries

Question 13

How is placental blood flow reduced after birth?

Answer 13

Oxygenated blood stimulates constriction of the umbilical arteries after birth

Resulting in a reduction in placental blood flow and normally ceases completely after about three minutes.

Question 14

How are the foramen ovale and ductus arteriosus closed?

Answer 14

Increase in pulmonary venous return

Question 15

What does HbF change to HbA?

Answer 15

The change to the adult β haemoglobin chain takes several weeks.

Question 16

Describe the immediate baby checks after delivery

Answer 16

1. Dry the baby, start the clock

2. Assess (tone), breathing and heart rate

Question 17

What happens if baby is gasping or not breathing?

Answer 17

Open to airway
Give 5 inflation breaths
Consider SpO2 monitoring

Question 18

What happens if chest still not moving?

Answer 18

Recheck head position
Consider 2 person airway control and other airway manoeuvres
Repeat inflation breaths
Look for response

Question 19

When should compressions be started?

Answer 19

If heart rate is not detectable or slow

3 compressions to each breath

Question 20

When should venous access and drugs be considered?

Answer 20

If heart rate still not detectable or is slow after all of this