Perinatal adaptation Flashcards
What changes happen in the baby in the 3rd trimester to prepare for birth?
Surfactant production
Accumulation of glycogen (liver, muscle, heart)
Accumulation of brown fat(between scapulae & around internal organs)
Accumulation of sub cut fat
Swallowing amniotic fluid
What change brings on the onset of labour?
Increased catecholamines/cortisol
What happens in the first few seconds of life?
PVR drops
Oxygen tension rises
Circulating prostaglandins drop
What are the 3 embryological remnant that change in the first few seconds after birth?
Foramen ovale closes
Ductus arteriosus becomes ligamentum arteriosis
Ductus venosus becomes ligamentum teres
What is PPHN?
Persistent Pulmonary Hypertension of the Newborn
failure of normal circulatory transition after birth - causes hypoxaemia due to right-to-left shunting of blood
How is PPHN treated?
Ventilate + nitric oxide +inotropes
How does a neonate thermoregulate in the first few hours?
Breakdown of brown fat in response to catecholamine
How are glucose levels regulated in the first few hours by a neonate?
Decreased insulin Increased glycogen (used for gluconeogenesis)
Where does haematopoesis move from and to in the newborn?
From liver, spleen & lymph nodes to bone marrow
What shifts the oxygen dissociation curve to the right after birth?
Increase in 2,3 DPG
When is newborn jaundice pathological?
In the first 24 hours
Causes of jaundice in the first 24 hours after birth
Rhesus haemolytic disease
ABO haemolytic disease
Hereditary spherocytosis
Glucose-6-phosphodehydrogenase
When is newborn jaundice usually physiological?
2-14 days
If newborn jaundice is prolonged and conjugated bilirubin is raised what is this suggestive of?
Biliary atresia (surgery needed)
What are causes of prolonged jaundice in the newborn?
Biliary atresia Hypothyroidism Galactosaemia UTI Breast milk jaundice Congenital infections
