Perinatal adaptation Flashcards
what are the 3 shunts in foetal circulation
ductus venosus (liver - portal vein) foramen ovale (IVC - RA) ductus arteriosus (pulmonary vein - aortic arch)
what substance is produced in foetal lungs in 3rd trimester
pulmonary surfactant
what substance is accumulated in liver, muscle and heart prior to birth
glycogen
what increases in baby with onset of labour
catecholamines
cortisol
what causes transition of foetal circulation to neonatal circulation
pulmonary vascular resistance drops and systemic vascular resistance increases
increased PO2, decreased prostaglandins
what does ductus arteriosus become
ligamentum arteriosus (or persistent ductus arteriosus)
what does ductus venosus become
ligamentum teres
what happens if foramen ovale doesn’t shut
persistent pulmonary hypertension of newborn
management of PPHN
ventilation
oxygen
nitric oxide sedation
inotropes
what is important in first few hours of life
thermoregulation
glucose homeostasis
nutrition
what is main source of heat production on newborn
breakdown of stored adipose tissue in response to catecholamines (this is not efficient in first 12 hours)
risk factors for hypothermia in new born
pre-term/small for dates babies:
low stores of brown/subcutaneous fat
larger surface area:volume
management of hypothermia of new born
dry hat skin-skin blanket/clothes heated mattress incubator
new borns have large/little intake of milk in first hours
little
insulin increases/decreases in first few hours
decreases (increased glycogen)
