Transition to Bein' a Baby Flashcards
Respiration as fetus
lungs-100 mL amniotic fluid
catecholamines decrease lung fluid during labor
ductus arteriosus opens
Resp during birth
fetal thorax compressed during vaginal delivery-1/3 fluid expelled
remaining 2/3 expelled/resorbed in 24 hrs
Resp after birth
remaining fluid resorbed/replaced with air
decrease in pulm vasc pressure, ductus arteriosis closes
by 5th breath- baby breathes ~ adult
Reasons baby takes a breath
physical stimulation cold air compression of thorax during delivery resp center stimulation hypoxia change in BP from cord cutting
Normal fetal circulation
to R atrium
oxygenated blood from placenta through umbilical vein…
through ductus venosus to IVC…
to R atrium
Normal fetal circ
R atrium to umbilica a
through foramen ovale to L atrium to aorta
aorta to arteries of upper body
remaining blood through R ventricle through ductus arteriosus to pulmonary a
less oxygenated blood carried into descending aorta to iliac arteries into hypogastric arteries…
=> umbilical arteries
Normal newborn circ changes
Lungs expand, pulm vessels fill = reduction in Resistance to blood flow to lungs
P falls on R side of heart–> foramen ovale closes!
Rise in O2 tension in blood –> PGs released to contract SM of ductus arteriosus
Thermal Regulation
in utero: baby is 1/2 degree warmer than mom
BROWN FAT: in mediastinum, shoulder blade, behind neck, around kidneys
metabolized in the cell itself, directed by ANS
“non shivering thermogenesis”
GI of neonate
Meconium is present from week 16 on - mucus, bile acids, fatty acids and epithelial cells, etc
Meconium should be passed in first 24 hours
Bowel sounds should be present
Gastrocolic reflex - Colon empties with full stomach
GU of neonate
Baby pees into amniotic fluid for last 41/2 months of pregnancy
Baby should pee w/in 24 hours of delivery
91% urinate by 9-16 hrs
99% by 24hrs
Secondary causes of persistent fetal circulation
▪ Meconium ▪ Premature ductal closure ▪ Maternal ingestion of antiprostaglandins ▪ Infection - B strep, E coli, sepsis ▪ Hypoxia
Hypotension Risk factors
acidemia, infextion/sepsis, blood loss during delivery
Hypoglycemia sxs
▪ tremors /"jitteriness" ▪ cyanosis ▪ convulsions / seizures ▪ apnea or irregular respirations ▪ apathy / lethargy
GBS Risk factors
▪ Previous GBS infant – 5.5% incidence
▪ Intrapartum fever – 5.36%
▪ Maternal age <20 y – 2.2%
GBS infected infant sxs
▪ Apnea ▪ Tachypnea ▪ Chest retractions ▪ Grunting ▪ Bradycardia ▪ Hypotension
