Transcript MCB 135E Discussion October 11-15

MCB 135E
Discussion
October 11-15
Mid-Term I
• Average 87 (+/- 9)
• Key available in hallway near 102 Donner
Topics
• Labor and Delivery
• Cardio-respiratory Changes After Birth
• The Normal Newborn
Labor and Delivery
• Parturition
• Hormones
• Delivery Phase
Parturition
• Birth Process
– 38 Weeks after fertilization
– 40 Weeks after last menstrual period
• Onset of Labor
– Process that is not completely understood, but
involves a combination of mechanical and
hormonal factors
Hormones
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Fetal Hormones
Estrogen
Progesterone
Oxytocin
Prostoglandins
Relaxin
Delivery Phases
• Dilation and Effacement
• Descent and Expulsion
• Expulsion of the Placenta
Cardio-Respiratory Changes
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Heart Development
Cardiac Outflow Anomalies
Normal Fetal Circulation
Fetal Cardiac Function
Transitional Physiology
Fetal Cardiac Function
• In adult:
– Hypothalamic control of cardiac output
• Increase Heart Rate
• Increase Contractile force of myocardium
• In fetus
– Contractile force is at a maximum
– Control cardiac output only through increased
heart rate
Transitional Physiology
• Changes in fetal circulation at birth:
– Loss of placenta
– Opening of pulmonary arteries
– Functionality of the lungs
• Blood is allowed to flow to lungs due to less
pressure (the path of least resistance)
– Apoptosis of fetal modifications
The Normal Newborn
• Respiration
• Assessment of Transition
• What to Expect
Respiration
• First breath
– Responsible for opening of lungs
– 30-100mmHg in newborn vs. 5-10 mmHg
normal
• Close ductus arteriosus
– First functional, later anatomical
• Removal of lung fluid
Transition
• Apgar Scoring
• The first hours of life
• Primary vs Secondary Apnea
What to Expect…
• The first week of life:
– Vitamin K
• control blood clotting and is essential for synthesizing the
liver protein that controls the clotting (thrombin)
– Antibiotic Eye Drops
– Hepatitis B Vaccine
– Feeding
• Increase intake until 1 fluid ounce per hour of milk is
consumed
– Jaundice
• Indicator of postbirth adaptations
• Caused by an incomplete metabolism of bilirubin
– Bilirubin is a waste product of hemoglobin breakdown