Repro Flashcards
What is the definition (age) of neonate
2-4 weeks (S&H says 2; MDR says 4)
What are the three fetal shunts? Which are intracardiac?
Foramen ovale (intracardiac)
Ductus arteriosus (extracardiac)
Ductus venosus (extracardiac)
What does the ductus venosus connect?
Umbilical vein to CVC
What hormone plays a role in keeping the ductus arteriosus patent?
PGE2
Where does most of the blood leaving the RV go in the fetus? Why
Shunted across ductus arteriosus because of high pulmonary pressures and low systemic resistance
What hormones maintain collapsed lungs and pulmonary vasoconstriction?
Endothelin
Arachidonic acid metabolites
Hypoxia (obvi not a hormone)
Which vessel involved in fetal circulation has the greatest oxygen content?
Umbilical vein (oxygenated blood from placenta)
Three key differences in renal physiology in the neonate
Decreased GFR
Altered tubular function
Decreased concentrating ability
Normal neonate body temp
95-98 F
Definition of pediatric (age)
2 weeks to 6 months
What side of the thorax is the thymus on
Left
Why is LRS the preferred fluid type in neonates?
Because lactate is the preferred metabolic fuel in the neonate with hypoglycemia
Do neonates have immature parasympathetic or sympathetic nerve fibers in the myocardium?
Sympathetic
When does the shivering reflex develop?
6 days
Puppies should gain how much weight within the first 10 days of birth?
Double their weight
What is the normal mean blood pressure in a 1 month old dog
49 mm Hg
When can puppies concentrate their urine normally (age)?
10 weeks
The oral route of fluid and drug administration should be avoided during the first 72 hours because why?
Higher absorption due to increased GI permeability
What is the safest class of antimicrobials?
Beta lactams
Common bacterial isolates for neonatal sepsis
Staph
Strep
E coli
Klebsiella
Enterobacter
Clostridium
Salmonella
When giving SQ serum to augment immunity, what is the dose?
2-4 ml/100g body weight
What is the major side effect of oxygen toxicity in neonates?
Permanent blindness due to retrolental fibroplasia
Average neonatal mortality (%)?
15-25%
Main causes of neonatal mortality (sentinel article)?
Respiratory distress after dystocia
Bacterial infection
What are the five parameters of the modified Apgar score
Heart rate
Respiratory effort
Reflex irritability
Motility
Mucus color
What does an Apgar score of 0-3 identify?
Severe distress
What does an Apgar score of 4-6 identify?
Moderate distress
What does an Apgar score of 8-10 identify?
No distress
Apgar Score Theriogenology 2009 Veronesi et al
True/False: The type of delivery affected the rate of puppies born dead
False
Apgar Score Theriogenology 2009 Veronesi et al
What puppy factors also correlated with poor Apgar scores?
Puppies that did not search for mammary glands
Puppies that did not have suckling and swallowing reflexes
Two primary causes of fetal depression post dystocia/c-section
Hypoxia
Anesthetic agents
What are the first 4 steps in neonatal resuscitation
Warming
Suction nose
Rub neonate
Reverse opioids if appropriate
What are the sequential steps if the neonate is not breathing well/apneic?
First - tight fitting oxygen mask
If no change - intubate
If HR low - compressions and epi
If HR ok but breathing bad - consider acupuncture point and doxapram
What is an appropriate environmental temp during neonatal resuscitation
90 F
What is the name of the acupuncture point used to stimulate breathing in neonates
JenChung GV 26 or Renzhong
What is the most likely cause of bradycardia during neonatal resuscitation?
Myocardial hypoxia (not vagal)
Is naloxone recommended during neonatal resuscitation no matter what?
No. Only give if dam got opioids or else could decrease function of endogenous opioids in neonate
Should you give atropine to neonates with bradycardia? Why or why not?
No (not if less than 14 days). Neonates do not have fully functioning sympathetic nervous system
What parameter at birth is associated with higher neonatal mortality?
Low birth weight
Describe the 3 stages of labor
1 - inapparent uterine contractions, dilation of cervix, nesting behavior, restless; 6-12 hours
2 - contractions, fetal expulsion; first puppy within 4 hr, subsequent puppies every 2 hr
3 - fetal membranes expelled; 10-15 min
When is medical management of dystocia contraindicated?
Secondary uterine inertia (obstruction)
List examples of maternal factors of dystocia
Small pelvic size
Primary or secondary uterine inertia
Malnutrition
Infection
List examples of fetal causes of dystocia
Fetal monsters
Oversized fetus
Malposition/malposture
Fetal death
What is secondary uterine inertia in layman’s terms?
Uterine fatigue
What is the difference between primary and secondary uterine inertia?
Primary is defined as no signs of labor
Secondary is fatigue due to birth canal obstruction
What are causes of primary uterine inertia
Small litters (inadequate stimulation)
Large litters (overstretched myometrium)
Hypocalcemia
Obesity
Infection
Uterine torsion
Trauma
What two types of vulvar discharge are concerning for dystocia?
Green to black discharge prior to first fetus
Bloody discharge at any time
Fetal heart rates below what # indicate that immediate help is meeded
140
What factors indicate that medical treatment for dystocia is appropriate
Dam in good health
Cervix dilated
Fetal size appropriate
No fetal distress
No protracted labor
How does oxytocin works?
Increases sodium permeability of uterine myofibrils causing myometrium to produce sustained contraction
Surgical intervention is required in what % of dystocia cases?
60-80%
True or False: OHE at the time of C-section decreases milk production
False
Can gas inhalants cross the placenta?
Yes
When is en bloc csection ideal?
Dam is spayed
Infection
Litter is dead
Dam is critical
