Perinatal Adaptation

Question 1

what is the 3 shunts of the fetal circulation

Answer 1

Ductus venosus
Foramen ovale
Ductus arteriosus

Question 2

what is accumulated during 3rd trimester to prepare for birth

Answer 2

glycogen
brown fat
subcutaneous fat

Question 3

what else happens during the 3rd trimester to prepare for birth

Answer 3

surfactant production

swallowing amniotic fluid

Question 4

what happens to the circulatory system soon after the baby is born

Answer 4

Pulmonary vascular resistance drops

Systemic vascular resistance rises

Oxygen tension rises

Circulating prostaglandins drop

Duct constricts

Foramen ovale closes

Question 5

what happens to the fetal shunts after birth

Answer 5

Foramen ovale
- Closes or persists as PFO (10%)

Ductus arteriosus

• Becomes ligamentum arteriosus
• PDA

Ductus venosus
- Becomes Ligamentum teres

Question 6

what problems can there be with the circulatory/resp system in the newborn

Answer 6

Persistent Pulmonary Hypertension of the Newborn

Question 7

Mx of PPHN

Answer 7

Ventilation
Oxygen
Nitric oxide
Sedation
ECLS

Question 8

what is important to remember about haemostasis in a newborn

Answer 8

all babies need help to maintain temperature

Question 9

what reflex helps a baby breast feed

Answer 9

rooting and suck reflex

Question 10

what happens to The oxygen–haemoglobin dissociation curve after birth of a newborn and what causes the change

Answer 10

curves shift to the right

- increase in 2.3 DPG

Question 11

what causes jaundice in a newborn

Answer 11

> > Breakdown of fetal haemoglobin
Conjugating pathways immature
Rise in circulating unconjugated bilirubin
Generally not harmful unless very high levels