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11- Reproduction > Perinatal Adaptation and Breast Feeding > Flashcards

Perinatal Adaptation and Breast Feeding Flashcards

1
Q

what are the three shunts in foetal circulation?

A

ductus venosus

foramen ovale

ductus arteriosus

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2
Q

what are the embryological remnants of the three foetal cardiac shunts?

A

ductus venosus → ligamentum teres

foramen ovale → closes

ductus arterioses → ligamentum arteriosus

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3
Q

if foramen ovale persists this is known as?

A

PFO- patent foramen ovale

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4
Q

if the ductus arteriosus persists this is known as?

A

ductus arteriosus

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5
Q

what happens to the foetal lungs during third trimester?

A

surfactant produced

accumulation of glycogen in liver, muscle, heart

accumulation of brown/subcut fat

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6
Q

what happens to the foetal lungs during labour and delivery?

A

inc catecholamies / cortisol

synthesis of lung fluid stops

vaginal delivery squeezes the lungs

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7
Q

what is seen during the first seconds of life following delivery?

A

baby is blue

start to breathe

cries

turns pink

cord is cut

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8
Q

what happens to pulmonary vascular resistnace and systemic vascular resistance following birth?

A

pulmonary vascular resistance drops

systemic vascular resistance rises

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9
Q

why does pulmonary vascular resistance drop following birth?

A

to allow more blood flow into lungs and oxygen exchange to occur

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10
Q

what circulatory transition changes occur following birth?

A

circulating prostaglandins drop

duct constricts

formamen ovale closes

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11
Q

failure of foramen ovale and ductus arteriosus to close can result in what?

A

Persistent Pulmonary Hypertension of the Newborn

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12
Q

what are the four methods heat loss occurs when baby is born?

A

convection

conduction

radiation

evaporation

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13
Q

how does baby produce heat?

A

breakdown of stored brown fat in response to catecholamines

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14
Q

when are babies at most risk of developing hypothermia?

A

first 12 hours as breakdown of brown fat not sufficient enough at maintaining temperature

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15
Q

which babies have the highest risk of developing hypothermia?

A

small for dates/ preterms

(have lower fat stores and larger surface area:vol)

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16
Q

how can you keep baby warm to prevent hypothermia?

A

keep baby dry

skin to skin

blankets/hat/clothes

incubator

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17
Q

hypothermia will lead to what other complications?

A

hypoglycaemia and hypoxia

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18
Q

what babies are at risk of developign hypoglycaemia?

A

inc in energy demands if unwell/hypothermic

small/premy as lower glycogen stores

innapropriate insulin/glucagon ratio due to maternal diabetes or some drugs

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19
Q

how are the anterior and posterior pituitary involved in breast feeding?

A

ant pituitary → prolactin → milk production

post pituitary → oxytocin → milk ejection

20
Q

how does the composition of breast milk change?

A

colustum to foremilk to hindmilk

21
Q

what is colustrum?

A

yellowish milk produced in first few days after baby is born

contains antibodies and white blood cells

22
Q

what is foremilk and hindmilk?

A

foremlik is the milk at the beginning of a feeding

hindmilk follows it

23
Q

which is richer in fat and higher in calories, foremilk or hindmilk?

A

hindmilk

24
Q

why does foetal haemoglobin become disadvantageous following birth?

A

2,3,DPG shifts curve to the right

haemopoesis move to bone marrow

25
Q

why do newborn babies experience physiological jaundice?

A

due to rapid breakdown of foetal haemoglobin

(liver enzyme pathways present but immature)

26
Q

when does physiological jaundice present?

A

2-3 days following birth

usually resolves around 2 weeks

27
Q

what would be pathological jaundice?

A

early or prolonged jaundice

28
Q

what is prolonged jaundice?

A

jaundice lasting:

>2 weeks in neonates

>3 weeks in preterm neonates

29
Q

how is jaundice treated in neonates?

A

phototherapy (fibre optic blanket) if serum bilirubin >50

30
Q

what are the two main reasons for babies becoming ill?

A

prematurity

congenital malformity

31
Q

how are dilated bowels diagnosed?

A

diameter of bowel is bigger than the diameter of the vertebral column

32
Q

what is pneuoperitoneum?

A

free air in the abdomen

33
Q

what is NEC (baby sick gut)?

A

necrotising enterocolitis

inflammation and necrosis (death) of inestines

34
Q

what can cause bowel obstruction in the newborn?

A

something inside the lumen

somethign pressing on the outside of the lumen

something within the lumen wall

35
Q

what is seen on X-ray in bowel obstruction?

A

laddering

36
Q

what is meconium?

A

baby’s first poo- really dark, almost black

37
Q

what is meconium ileus?

A

obstruction means baby cannot pass meconium

will present w no meconium passed in forst couple days and vomiting

38
Q

meconium ileus is strongly assoc w what condition?

A

cystic fibrosis

39
Q

what is atresia?

A

obstruction due to narrowing of bowel

baby will feed well initially then vomit

40
Q

how is atresia managed?

A

surgical reconstruction to anastomose bowel

(disregard really extended bowel as will not regain tone to join further down)

41
Q

what serious condition presents with green vomiting?

A

malrotation

42
Q

what imaging can be done for malrotation?

A

water soluble contrast

43
Q

why is it important to infrom radiologists that you are investigating malrotation when performing water soluble contrast?

A

will only look as far as stomach: we are interested in duodenum and jejunum

44
Q

when would pyloric stenosis present?

A

>6 weeks

45
Q

what is the neonatal period?

A

birth to 4 weeks

46
Q

what is the treatment for mastitis?

A

flucloxacillin

(can continue to breast feed)

47
Q

what is Sheehans Syndrome?

A

complication of severe PPH → pituitary gland undergoes necrosis leading to inadequate production of prolactin (can prevent milk production)

11- Reproduction (19 decks)

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