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Perinatal Period: Questions With Complete Solutions
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Perinatal Period: Questions With Complete Solutions
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Perinatal Period: Questions With Complete SolutionsPerinatal Period Right Ans - -Pertaining to the period immediately before
and after birth
-Commences at 22 weeks gestation
-Ends 7 completed days after birth
-Perinatal and maternal health are closely linked
Pulmonary Adaptation Right Ans - -In fetal circulation/oxygenation, the
normal cord is 3 vessels (1 vein and 2 arteries)
-Umbilical arteries are paired and carry deoxygenated blood from fetus to
placenta
Umbilical *vein* carries _________ blood from ________ to ________ Right Ans - -
Oxygenated
-Placenta
-Fetus
Pulmonary Adaptation: SUA Right Ans - -An isolated single umbilical artery
(SUA) occurs in up to 2% of all live-born infants
-Can be detected prenatally or on PE of newborn after birth
-Believed to result from either aplasia or atrophy of 2nd umbilical artery
-Associated structural or chromosomal anomalies are found in 27% of infants
with SUA, with renal malformations MC
-Seen more frequently in monoamniotic twins, and intrauterine growth
restriction is observed 18% of time
-A newborn found to have a SUA should by thoroughly examined for
dysmorphic features, abdominal masses, and presence of heart disease
-Considered high risk pregnancy
-Needs higher resolution, increased serial ultrasounds and possible earlier
delivery (36-37 wks)
Respiratory Distress Syndrome - preterm Right Ans - -One of the MC
symptom complexes of the newborn
-Primarily a disease of preterm infants within first 24hours of life
-Can affect term babies, specifically infants of diabetic moms
-Approx. 50% of infants born between 26 and 28 weeks gestation develop
RDS, drops to 20-30% at 30-32 weeks
, -Introduction of prenatal steroids and exogenous surfactant have improved
outcomes in patients with RDS
RDS - preterm - Pathophysiological mechanism Right Ans - -Involves
noncompliant, stiff lungs that are structurally immature that contain
insufficient surfactant
-This status leads to atelectasis at end of expiration
-Get ventilation-perfusion mismatch
-Promotes hypoxemia, hypercarbia and then persistent pulmonary htn
RDS - preterm - Noncardiopulmonary causes include: Right Ans - -
Hyperthermia, hypothermia
-Hypoglycemia
-Drug intoxications
-Central nervous system insults
-Polycythemia
-Metabolic acidosis
RDS - preterm - Cardiopulmonary causes include: Right Ans - -Hypoplastic
left heart
-Aortic stenosis
-Coarction of aorta
-Upper airway obstruction
-Meconium aspiration
-Pneumonia
-Pneumothorax
RDS - preterm - Tx Right Ans - -Multidisciplinary approach
-Basic principles of neonatal care: thermoregulation, cardio and nutritional
support, early infection care
-Nasal CPAP
-Surfactant replacement
RDS - preterm - Prevention Right Ans - -Prevention of prematurity,
asphyxia, avoidance of maternal fluid overload
-Prenatal administration of a single course of steroids to women in preterm
labor between 24-34 weeks gestation
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