neonatalogy Flashcards
What vessel supplies oxygenated blood to the foetus
Umbilical vein through the ductus venosus
Describe the foetal circulation
- Some blood via the foramen ovale goes to the left atrium, left ventricle and then the aorta
- Some of the blood goes to the right ventricle and then the pulmonary artery but then travels through the ductus arteriosus to the aorta
What is the function of the ductus arteriosus
- It protects the lungs against circulatory overload during development
- Allows the right ventricle to strengthen
- Connects the pulmonary artery to the aorta
What is the ductus venosus and what does it carry
Foetal blood vessel connecting the umbilical vein to the IVC - carries mostly oxygenated blood
How are babies thermoregulated
- Newborn babies lack shivering thermogeneisis
- they have brown fat which in cold stress undergoes lipolysis which leads to heat production
Why are babies dried when they are born
If the fluid on them evaporates, it will cause heat loss
What is used to mantain the heat of a newborn
Resuscitare
What weight is considered born too small
<2.5kg
What are the common acute complications of babies being small for date
- Perinatal hypoxia
- Hypoglycaemia
- Hypothermia
- Polycythaemia
- Thrombocytopenia
- Hypoglycaemia
- GI problems
What are the chronic complications of babies being small for date
- Hypertension
- Reduced growth
- Obesity
- Ischaemic heart disease
What is given to prevent respiratory distress syndrome
Antenatal steroids
What is the early treatment of respiratory distress syndrome
- Surfactant
- Early extubation
- Non invasive CPAP
What is broncho-pulmonary dysplasia
- Complication of Respiratory distress syndrome
- Overstretch by volu-baro-trauma
- Causes atelectasis
- O2 toxicity
- Inflammatory changes and scarring
What is the treatment of broncho-pulmonary dysplasia
- Patience
- Nutrition and growth
- Steroids
What is the treatment of apneoa or irregular breathing in a newborn
Caffeine to stimulate the respiratory centre in the medulla
How is intraventricular haemorrhage prevented and treated
- Prevented with antenatal steroids
- Symptomatic treatment
When does the ductus arteriosus close
6-72 hours after birth
What is seen in patent ductus arteriosus and why
- Lung oedema due to overperfusion of the lungs from the blood coming from the left side to the right
- Systemic ischaemia because blood from the left goes to the right side of the heart so less blood being pumped to systemic circulation from the left ventricle
What is the presentation of necrotising entero-colitis
Highly distended, shiny and tender newborn
What is the treatment of necrotising entero-colitis
- Surgery often required
- Conservative management sometimes
- Antibiotics and parenteral nutrition
