Perinatal adaptation Flashcards Preview

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Flashcards in Perinatal adaptation Deck (24)
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1
Q

What changes happen in the baby in the 3rd trimester to prepare for birth?

A

Surfactant production
Accumulation of glycogen (liver, muscle, heart)
Accumulation of brown fat(between scapulae & around internal organs)
Accumulation of sub cut fat
Swallowing amniotic fluid

2
Q

What change brings on the onset of labour?

A

Increased catecholamines/cortisol

3
Q

What happens in the first few seconds of life?

A

PVR drops
Oxygen tension rises
Circulating prostaglandins drop

4
Q

What are the 3 embryological remnant that change in the first few seconds after birth?

A

Foramen ovale closes
Ductus arteriosus becomes ligamentum arteriosis
Ductus venosus becomes ligamentum teres

5
Q

What is PPHN?

A

Persistent Pulmonary Hypertension of the Newborn

failure of normal circulatory transition after birth - causes hypoxaemia due to right-to-left shunting of blood

6
Q

How is PPHN treated?

A

Ventilate + nitric oxide +inotropes

7
Q

How does a neonate thermoregulate in the first few hours?

A

Breakdown of brown fat in response to catecholamine

8
Q

How are glucose levels regulated in the first few hours by a neonate?

A
Decreased insulin 
Increased glycogen (used for gluconeogenesis)
9
Q

Where does haematopoesis move from and to in the newborn?

A

From liver, spleen & lymph nodes to bone marrow

10
Q

What shifts the oxygen dissociation curve to the right after birth?

A

Increase in 2,3 DPG

11
Q

When is newborn jaundice pathological?

A

In the first 24 hours

12
Q

Causes of jaundice in the first 24 hours after birth

A

Rhesus haemolytic disease
ABO haemolytic disease
Hereditary spherocytosis
Glucose-6-phosphodehydrogenase

13
Q

When is newborn jaundice usually physiological?

A

2-14 days

14
Q

If newborn jaundice is prolonged and conjugated bilirubin is raised what is this suggestive of?

A

Biliary atresia (surgery needed)

15
Q

What are causes of prolonged jaundice in the newborn?

A
Biliary atresia 
Hypothyroidism 
Galactosaemia
UTI 
Breast milk jaundice 
Congenital infections
16
Q

How is puerperal pyrexia defined?

A

Temp of <38 in thefirst 14 days following delivery

17
Q

What are the causes of puerperalpyrexia

A
Endometritis
UTI 
Wound infections 
Mastitis 
VTE
18
Q

How is puerperal pyrexia caused by endometritis treated?

A

IV antibiotics (clindamycin + gentamicin)

19
Q

When does newborn NEC tend to present?

A

Afer recovering from RDS

20
Q

What is newborn NEC?

A

Necrosis of gut tissue

21
Q

How does newborn NEC present?

A
Feeding intolerance 
Abdo distension 
Bloody stools 
(May progress rapidly to abdo discolouration, peritonitis &amp; hypotension)
22
Q

What condition should be considered in a newborn that presents with a meconium ileus?

A

CF (insert temporary stoma)

23
Q

What condition presents with green vomiting in the newborn?

A

Malrotation 7 volvulus

24
Q

Which artery can be pinched in a volvulus?

A

Superior mesenteric artery (midgut)