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My Child Health > Perinatal Adaptation > Flashcards

Perinatal Adaptation Flashcards

1
Q

Purpose of ductus venosus

A

Allows oxygenated blood to bypass the liver into IVC

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2
Q

Purpose of foramen ovale

A

Allows blood to pass from the right to left atrium to bypass lungs

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3
Q

Purpose of ductus arteriosus

A

Connects pulmonary artery to aorta to allow blood to flow back into the placenta after perfusing foetal organs

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4
Q

What is surfactant

A

Produced by type II pneumocytes to reduce surface tension of the lungs

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5
Q

Explain the circulatory transition at birth

A

Lungs fill with oxygen, pulmonary vascular resistance decreases below SVR due to cord clamping, blood flow through shunts decreases and decrease prostaglandin circulation from the placenta and oxygen acting as a vasoconstrictor closes the ductus arteriosus

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6
Q

What do the ductus arteriosus and ductus venosus become after birth

A

Ductus arteriosus= ligamentum arteriosus

Ductus venosus= ligamentum teres

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7
Q

What is PPHN

A

Persistent pulmonary hypertension, PVR does not decrease below SVR causing mixing of oxygenated and deoxygenated blood via the foramen oval and ductus arteriosus

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8
Q

Causes of PPHN

A

Sepsis, Hypoxic/ischaemic insult, meconium aspiration

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9
Q

Diagnosis of PPHN

A

Pre/postductal sats (right arm + left leg) > 3%= PPHN

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10
Q

Treatment of PPHN

A

Ventilation, oxygen, nitric oxide (vasodilator)

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11
Q

What is transient tachypnoea

A

Failure of lung fluid to be absorbed, diagnosis of exclusion

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12
Q

What babies are affected by transient tachypnoea

A

Babies born by C-section

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13
Q

Pathogenesis of transient tachypnoea

A

No squeezing of the lungs during birth, the babies take longer to absorb the lung fluid

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14
Q

Symptoms of transient tachypnoea

A

Difficulty breathing/grunting

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15
Q

Treatment of transient tachypnoea

A

Self-limiting, can require respiratory support

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16
Q

In what ways is heat lost in newborns

A

Radiation, evaporation, conduction, convection

17
Q

How is heat produced in newborns

A

Non-shivering thermogenesis

18
Q

Explain glucose homeostasis in newborns

A

Glucose supply from placenta is lost and mother’s milk supply takes time so physiological drop in insulin

19
Q

What illnesses can precede hypoglycaemia in newborns and why

A

Septic, hypoxic, acidotic babies, due to high metabolic states putting increased energy demands on their glucose store

20
Q

Explain glucose problems in premature babies

A

They haven’t got a large enough glycogen supply and I immature hepatic enzymes for glycogenolysis and gluconeogenesis

21
Q

Explain the differences between foetal haemoglobin and adult haemoglobin

A

Foetal haemoglobin has a higher affinity for oxygen allowing it to be removed from the mother’s bloodstream and transported to the organs + tissues of the foetus.

22
Q

Describe the changes in haemoglobin after birth

A

Adult haemoglobin releases oxygen far better than foetal haemoglobin, it is produced in the bone marrow and increased 2,3-BPG increases post-nasally which shifts the curve to the right helping the development of adult haemoglobin

23
Q

Explain physiological anaemia in newborns

A

The breakdown of foetal haemoglobin occurs at a rate faster than adult haemoglobin being produced

24
Q

Explain physiological jaundice

A

The large breakdown of foetal haemoglobin producing bilirubin and the conjugating pathway is still immature, occurs between 3rd and 8th days of life

25
Q

Explain Pathological jaundice

A

Jaundice in first 24 hours, jaundice lasting >24 hours, persistent high levels of unconjugated bilirubin, can cross the BBB and settle in basal ganglia causing neurological consequences e.g. cerebral palsy

26
Q

Treatment of jaundice

A

Blue light therapy (phototherapy or blanket + light cables)

27
Q

What babies are at increased risk of jaundice

A

HIE, large/small babies, premature babies, maternal illness, medications, sepsis

28
Q

Explain APGAR scoring

A 
A= Appearance
P= Pulse
G=Grimace
A=Activity
R=Respiration 
Taken in first 1,5, 10 minutes after birth, normal >8, score of 10 is rare as most babies are born with some degree of acrocyanosis
29
Q

What is hydrops foetalis

A

Fluid build up in baby’s tissues due to heart failure from baby’s heart having to pump a larger blood volume t achieve the same level of oxygenation, caused by anaemia from rhesus disease or chromosomal problems

My Child Health (10 decks)

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