The Foetal Circulation and Congenital Problem Flashcards
Is the placenta included in the foetal circulation?
Yes
What state are the lungs in in a foetus?
Fluid filled and unexpanded
The foetal heart pumps blood to the placenta via what?
Umbilical arteries
Blood from the placenta returns to the foetus via what?
Umbilical vein
Where does oxygenated blood in the foetus return to?
The right side of the heart
What are the 3 cardiac shunts, specific to foetal life?
Ductus venosus, foramen ovale, ductus arteriosus
What does the ductus venosus connect?
The umbilical vein to the IVC
What does the foramen ovale connect?
Right atrium to left atrium
What does the ductus arteriosus connect?
Connects pulmonary bifurcation to the descending aorta
Does blood from the placenta go into the portal circulation?
No
The membrane flap of the foramen ovale is on which side?
Left atrium
What maintains patency of the ductus arteriosus?
Prostaglandin E2
Where is prostaglandin E2 produced?
Placenta
What happens to the resistance of the pulmonary and systemic circulations after birth?
Pulmonary resistance decreases and systemic resistance increases
As resistance of circulations is changed after birth, what happens to the relative pressures of the atria?
Left atrial pressure exceeds right atrial pressure
What does the anatomical closure of the ductus arteriosus form?
Ligamentum arteriosum
What are treatment options for patent ductus arteriosus?
wait and watch, NSAIDs, surgery
What can be used to keep the ductus arteriosus open until further treatment is available?
Prostaglandin E2
What is the basis of persistent pulmonary hypertension of the newborn?
Lung vascular resistance fails to drop
What are some clinical signs of persistent pulmonary hypertension of the newborn?
Blue baby, large difference between finger and foot O2 saturations
What counts as major congenital heart disease?
Requires surgery within the first year of life
Congenital heart defects can present up to about?
8 weeks
Can murmurs be normal in newborn babies?
Yes
What causes cyanosis in a newborn baby?
Any condition which causes deoxygenated blood to bypass the lungs and enter the systemic circulation
What congenital disease causes a collapse at the time of the duct closure?
Transposition of the great vessels
Will babies with transposition of the great vessels be acidotic or alkalotic?
Acidotic
What is the treatment for transposition of the great vessels?
ABC, prostaglandin E2, multi-system supportive treatment
What causes a presentation with heart failure?
Usually moderate to large left to right shunts
When does a left to right shunt tend to present?
After a few weeks when pulmonary pressure drops
When does a murmur of a VSD occur?
In the first few weeks as pulmonary pressure drops
What are the components of tetralogy of fallot?
VSD, pulmonary stenosis, right ventricular hypertrophy, overriding aorta
