Physiology Changes in Lactation Part 2 Flashcards
What are the cardiovascular adjustments
Circulatory adjustments during the first few hours of life cause more & more blood flow through the baby’s liver, which lead to have a little blood flow.
How does the blood flow occur in the foetus ?
The blood goes from the placenta to the umbilical cord (artery & vein).
The vein from the umbilical cord enters into the liver of the foetus into the Inferior Vena Cava- it goes to the RA- RV - Pulmonary trunk -Lungs - Pulmonary Vein- LA - LV and it goes out through the aorta
What is the other name for Fetal Circulation called as ?
Parallel circulation
Explain the Fetal Circulation ?
The umbilical vein( oxygenated) go into the liver and it will go to the IVC.
It will go into the RA, it may go to the RV, there’s a foramen ovale & this hole allow the fluid to go from the RA to the LA to the LV, to the aorta.
What does the Umbilical vein carry out?
They carry oxygenated blood & nutrients from the placenta to the fetus
What does the Umbilical artery carry ?
They carry Deoxygenated blood & waste to placenta
What is ductus arteriosus?
connection between aorta and pulmonary trunk
What is ductus Venosus?
vessel in fetal circulation that connects the umbilical vein to the inferior vena cava
Where does the ductus arteriosus closes?
When the air enters the lungs, blood is forced through the pulmonary arteries to the lungs.
Ductus arteriosus closes and becomes the ligamentum arteriosum.
What does the foramen ovale becomes once it closes?
The foramen ovale closes and becomes the fossa ovalis, blood can no longer flow from the Right to the Left atrium
What does the ductus venosus become ?
Ductus venosus degenerate and becomes the Ligamentum venosum
What does the umblical arteries and veins does when they’re cut ?
- Umbilical vein becomes the round ligament of the liver.
- Umbilical arteries degenerate and become the cors of the umbilical arteries.
What are the renal/kidney changes that happen at the Intrauterine stage ?
- Urine is formed in uteri and some excreted into the amniotic fluid
- Excretion of wastes is the function of placenta
What are the changes in Extrauterine stage?
- GFR is Low
- Decrease ability to excrete drugs
- Limited ability to reabsorb Sodium
- Decreased ability to concentrate urine
- Bladder capacity is 6-44ml
- Void within the first 24hrs and shpuld void 6-10 times per day
What are the changes in Hepatic and Liver?
- Iron storage
- Carbohydrate metabolism ( in the form of Glycogen)
- Coagulation and Conjugation of bilirubin
- The function of the liver is Detoxification and produce protein
- If the liver is not mature, there will be a problem with coagulation
- Liver also produces Bile
What is the function of Bile ?
Absorb Fat
How does the iron get stores in the infant?
If the mother’s iron intake is good enough, it’s enough for the baby upto 5 months of age, after the 6th month of age, food that contain iron / iron supplements must be given.
How does carbohydrate metabolism changes occur?
- Glucose is the main source of energy in the first hrs of life.
- If the fetus experiences hypoxia or stress, the glycogen store are used to meet metabolic needs.
What is the Coagulation changes ?
- Coag factors are under th influence of Vit K.
What does vitamin k do?
Help with clotting
Why there is a low level of vitamin K?
Due to the absence of normal flora needed to synthesis vit k result in low level of vit k and creates a transient blood coagulation alteration between the second and fifth day after birth
What is the Hepatic and liver changes that occur ?
The liver is immature in newborn & they undergo changes in the capacity during the early postnatal period.
What is the most important abnormal cause of serious jaundice ?
Erythroblastosis fetalis
rare pregnancy complication that occurs when your immune system attacks
What is the reason of the abnormal cause of the jaundice ?
Destruction of neonatal red blood cells by IgG antibodies
What is the prevention of haemolytic disease in newborn ?
injection of anti D immunoiglobulin
-This prevent the pregnant women from developing Rh positive antibodies
What is the treatment of Haemolytic disease in newborn?
intrauterine blood transfusion to reduce anaemia
Why do mother’s immune cell does not attack the fetus ?
Immune tolerance in pregnancy & the placenta functions as an immunological barrier between the mother and the fetus
The two mechanisms where the mother’s immune cells do not attack on the
What does the Neurokinin B mechanism do ?
What does the placenta acts as ?
It contain phosphocholine molecule which avoid the detection of fetus by the immune cells.
Placenta act like Protection
Why does the small lymphocytes suppress cells in the fetus ?
It inhibit maternal cytotoxic T cells by inhibiting the response to **interlukin **
What does the trophoblasts cells do ?
They don’t express the MCH class 1 isotypes HLA - A and HLA - B
MCH - Major histocompatability complex
What does the brown fat do in the babies ?
Help maintain body temperature.
