Parturition (labour) Flashcards
What type of placentation?
Haemochorial
What is the placenta responsible for?
Hormone production
Nutriends and removal of toxins
Gas exchange
What does the placenta contain on its surface?
Villi
Why is there increased fetal oxygen content?
- higher haemoglobin conc
- higher affinity for 02
- Fetal curve is shifted to the left due to: Reduced binding of 2,3-DPG to fetal Hb, Increased pC02
Which cells produce surfactant?
Type II pneumocytes
What does surfactant do?
Decreases surface tension at air-liquid interface in the alveoli, enabling them to remain open at end-expiration
What is the synthesis of fetal lung surfactant stimulated by?
Fetal glucocorticoids and thyroid hormones
What does lack of surfactant lead to?
Neonatal respiratory distress
What is the myometrial preparation for labour?
- rise in resting membrane potential
- increased intercellular coupling (gap junctions)
What is needed for the diagnosis of labour?
- regular contractions
- dilatation of cervix
- descent of the presenting part
What is the endocrine activity leading up to labour?
Cytokines –> prostaglandins –> oxytocin –> labour
What is birth asphyxia?
Perinatal asphyxia, neonatal asphyxia or birth asphyxia is the medical condition resulting from deprivation of oxygen to a newborn infant that lasts long enough during the birth process to cause physical harm, usually to the brain.
Why does asphyxia occur?
Compression of myometrial arteries Cessation of flow to placental bed Lack of gas exchange Relative fetal hypoxia Anaerobic metabolism Lactic acidosis (reduced PH)
What are the consequences of birth asphyxia?
Lactic acidemia
Tissue acidosis
Hypoxic-ischemic encephalopathey
cerebral palsy
What is the management for birth asphyxia?
Fetal heart rate monitoring
Measurement of fetal scapl PH
C-section
ECG monitoring