Perinatal Adaptation

Question 1

What are the 3 shunts present in the foetal circulation?

Answer 1

Ductus venosus
Foramen ovale
Ductus arteriosus

Question 2

Which vessel carries oxygenated blood from the placenta to the foetus?

Answer 2

Umbilical vein via ductus venosus (liver) and IVC

Question 3

Once oxygenated blood reaches the right atrium, where can it go?

Answer 3

To right ventricle and pulmonary artery

To left atrium via foramen ovale

Question 4

Once oxygenated blood reaches the pulmonary artery, where can it go?

Answer 4

To lungs

To aorta via ductus arteriosus

Question 5

List ways a foetus prepares for birth

Answer 5

Surfactant production
Accumulation of glycogen
Accumulation of brown fat

Question 6

What does the ductus venosus become in circulatory transition?

Answer 6

Ligamentum teres

Question 7

List some causes of failed cardiorespiratory adaptation in a newborn

Answer 7

Cold stress
Prematurity
Meconium aspiration
Hypoxia

Question 8

What is persistent pulmonary hypertension of the newborn?

Answer 8

Resistance to lung blood flow remains high and foramen ovale persists, causing deoxygenated blood to flow to systemic circulation

Question 9

Outline management of persistent pulmonary hypertension of the newborn

Answer 9

Ventilation
Oxygen
Nitric oxide (lung vasodilator)
Sedation
Ionotropes
Extra-corporeal life support (ECLS)

Question 10

How do newborn babies thermoregulate?

Answer 10

Mobilise brown fat stores in response to catecholamines

Peripheral vasoconstriction

Question 11

When is jaundice in a newborn physiological?

Answer 11

When it occurs from 2 days to 2 weeks

Anything before or after this is pathological

Question 12

What is kernicterus?

Answer 12

Encephalopathy caused by unconjugated bilirubin crossing blood-brain barrier

Question 13

What are the parameters for normal birthweight?

Answer 13

2.5-4 kg

Question 14

Which hormones help perinatal adaptation?

Answer 14

Cortisol

Adrenaline

Question 15

Why is vitamin K supplementation important for newborns?

Answer 15

Prevent haemolytic disease

Question 16

Which vaccination is given at birth?

Answer 16

Hepatitis B

Question 17

List important features to examine on the neonatal head

Answer 17

Moulding
Overlapping sutures
Fontanelles (bulging/sunken)
Cephalohaematoma
Ventouse/forceps marks

Question 18

List important features to examine on the neonatal eyes

Answer 18

Red reflex (cataracts)
Size and position
Conjunctival haemorrhage
Squinting

Question 19

List important features to examine on the neonatal mouth

Answer 19

Philtrum
Tongue tie
Sucking/rooting reflexes

Question 20

List important features to examine on the neonatal genital system

Answer 20

Normal passage of urine
Undescended testes
Hypospadius
Normal genitalia