1. MCB 135E Discussion October 11-15

2. Mid-Term I Average 87 (+/- 9) Key available in hallway near 102 Donner

3. Topics Labor and Delivery Cardio-respiratory Changes After Birth The Normal Newborn

4. Labor and Delivery Parturition Hormones Delivery Phase

5. 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

6. Hormones Fetal Hormones Estrogen Progesterone Oxytocin Prostoglandins Relaxin

8. Delivery Phases Dilation and Effacement Descent and Expulsion Expulsion of the Placenta

13. Cardio-Respiratory Changes Heart Development Cardiac Outflow Anomalies Normal Fetal Circulation Fetal Cardiac Function Transitional Physiology

15. 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

16. 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

17. The Normal Newborn Respiration Assessment of Transition What to Expect

18. 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

19. Transition Apgar Scoring The first hours of life Primary vs Secondary Apnea

20. 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