Flashcards in Week 1 Maternal and Fetal Phy 3 of 4 Deck (76)
What structure is responsible for returning deoxygenated blood from fetal internal iliac arteries to placenta?
The umbilical arteries
How many umbilical arteries and veins is their?
2 umbilical arteries and 1 umbilical vein.
What structure is responsible for supplying oxygenated blood from placenta to fetus?
Is the umbilical vein or arteries more saturated with 02?
The umbilical vein is 80% saturated with 02.
Umbilical arteries have LOW 02 saturation.
In relation to fetal circulation what are the three important shunts?
Blood entering the fetus through umbilical vein is conducted via the ? into IVC to bypass the liver.
Most oxygenated blood reaching the heart via the IVC is diverted through ? and pumped out the aorta to head and body.
Deoxygenated blood from the SVC is expelled into the pulmonary artery and ? to the lower body of the fetus .
explain to me the ductus arteriosus shunt?
Deoxygenated blood from the SVC is expelled into the pulmonary artery and ductus arteriosus to the lower body of the fetus.
explain to me the foramen ovale shunt?
shunts blood from the R atrium into the L atrium
explain to me the dectus venosus shunt?
blood is shunted through the dectus venosus to bypass the liver and go to the IVC.
Tell me what happens at birth when the infant takes a deep breath?
decreased resistance in pulmonary vasculature causes increased left atrial pressure vs. right atrial pressure; formen ovale closes (now called fossa ovalis); increase in O2 leads to decrease in prostaglandins, causing closure of ductus atreriosus.
Do prostaglandins help close or keep open the PDA?
prostaglandins help keep PDA open.
Indomethacin does it help close or keep open the PDA?
Indomethacin helps close PDA.
What is the PACO2 of Fetal blood?
PaCO2 = 48 mmHg
What is the PaO2 of Fetal blood?
(and what increment increase if the mother is on 100% 02?)
30 mmHg (+10 increase if mother is on 100% O2)
How long does it take the ductus arteriosus to close?
How long does it take the foramen ovale to close?
In relation to fetal circulation, hypoxia or acidosis in the first few days will ultimately lead to what? (tell me the process for this as well)
Hypoxia or acidosis in first few days leads to PDA or PFO --> left to right --> pulmonary hypertension
(How MO worded it above)
What is the most serious risk factor associated with surgery during pregnancy .
Do pregnant ladies have increased gastric emptying time or delayed? How do you treat?
Delayed gastric emptying time.
prophylaxis with antacids.
What can uterine displacement cause in a pregnant lady? (thus you do not want to place them in supine position)
Do pregnant women have increased or decreased FRC?
decreased FRC, more prone to hypoxia
Do lipid soluble substances diffuse more or less rapidly through the placenta?
During C/S what will you do to prevent Thromboembolism?
prevent DVT with pneumatic compression stockings. (board question)
Most frequent complication of spinal and epidural on pregnant women?
How would you treat hypotension in a pregnant lady who was given a spinal or epidural?
-perform left uterine displacement
What Beta 2 agonist is given to stop premature contractions?
Albuterol ( what mo mentioned in lecture)
Side effects for the mom and for the baby due to Ritodrine?
Mom: hypokalemia, hyperglycemia, tachycardia
Fetus: : hypokalemia, hyperglycemia, tachycardia (+/-)