Adaption of Baby at Birth

Question 1

How may vessels in uterus?

Answer 1

3
-One vein carries oxygenated blood to baby
2 arteries which carries deoxygenated blood back to placenta

Question 2

3 shunts?

Answer 2

Ductus venosus
Foramen ovale
Ductus arteriosus

Question 3

Changes in lungs and circulation when baby is born?

Answer 3

• Switch from placental gas exchange to air breathing

- Circulatory transition, lung aeration, pink colour appears

Question 4

What is involved in circulatory transition?

Answer 4

Pulmonary vascular resistance drops 
Systemic vascular resistance rises 
Oxygen tension rises 
Circulating prostaglandins drop 
Duct constricts 
Foramen ovale close

Question 5

What is persistent pulmonary HT of newborn?

Answer 5

o When the circulation fails to transition effectively normally because the pulmonary resistance doesn’t drop
o Baby is cyanosed – usually very unwell babies
o Because deoxygenated blood is joining aorta at ductus arteriosus body parts supplied by aorta before the duct (right arm and head and neck) have higher sats than post ductal
o One sats probe on right hand and one on a foot helps diagnose (10-20% difference usually)

Question 6

Managemnet of PPHN?

Answer 6

	Ventilation
	Oxygen
	Nitric oxide
	Sedation
	Inotropes
	ECLS

Question 7

Rfs for adaptation problems?

Answer 7

• Hypoxia / asphyxia during delivery
• Particularly small or large babies
• Premature babies – a whole other lecture
• Some maternal illnesses and medications
• Ill babies – sepsis, congenital anomalies