Newborn and Neonatal Care Part 1

Vocabulary flashcards covering key terms related to perinatal care, fetal circulation, labor and delivery, perinatology, neonatology, fetal assessment, maternal-fetal conditions, and diagnostic procedures.

Perinatal Period

The time from the 28th week of pregnancy through the 7th postpartum day.

Neonatal Period

The first 28 days of life, subdivided into early (0–7 days) and late (8–28 days) neonate.

Early Neonatal

The first 7 days of life.

Late Neonatal

Days 8 through 28 of life.

Newborn

The first few hours of life.

Neonate

A baby in the first 28 days of life.

Foramen Ovale

A fetal shunt between the right and left atria that normally closes after birth (functional closure early, anatomical closure later).

Ductus Arteriosus

Fetal vessel between the pulmonary artery and the aorta that constricts and closes after birth as oxygen rises.

Ductus Venosus

Fetal channel that bypasses the liver; closes after birth.

First Breath

The newborn’s initial inhale that expands alveoli, reduces pulmonary resistance, and initiates circulatory transition.

Surfactant

A substance produced by type II alveolar cells that reduces alveolar surface tension, enabling collapse-free expansion; begins ~25 weeks and matures by term.

Functional Closure

Temporary, immediate closure of fetal shunts after birth (e.g., foramen ovale) due to hemodynamic changes.

Anatomical Closure

Permanent, structural closure of fetal shunts, occurring over weeks (e.g., foramen ovale).

Umbilical Cord Clamping

Clamping of the cord increases systemic blood pressure and influences circulatory transition at birth.

Pulmonary Vascular Resistance

High resistance in utero that decreases after birth as the lungs aerate.

First Breath Stimuli

Mechanical and chemical cues from birth (e.g., chest compression, fluid clearance, oxygen exposure) triggering respiration.

Functional Residual Capacity (FRC)

Volume of air remaining in the lungs after a normal exhalation; established with sustained lung expansion after birth.

Fetal Circulation

Circulation before birth where placental gas exchange occurs and shunts direct blood away from the lungs.

PVR Decrease

Decrease in pulmonary vascular resistance after birth allowing better pulmonary blood flow.

Neonatology

Pediatric subspecialty caring for the newborn from birth to about 28 days.

Perinatology

OB subspecialty focused on fetal and maternal care from early pregnancy to postpartum.

Fetal Medicine

Branch focusing on assessment of fetal growth, well-being, and fetal disease.

Ultrasonography

Imaging tool used to assess fetal growth, amniotic fluid, placenta, fetal anatomy, and gestational age.

Crown-Rump Length

A first-trimester ultrasound measure used for dating pregnancy (most effective at 6–8 weeks).

Biometric Measures

Second-trimester ultrasound measures (BPD, HC, abdominal circumference, femur length) for gestational dating and growth.

Gestational Age by US

Estimation of fetal age using ultrasound measurements; 18–20 weeks is optimal for GA and anatomy assessment.

Fetal Distress

Insufficient oxygen or nutrients to the fetus, often indicated by abnormal fetal heart rate patterns.

Antepartum Fetal Surveillance

Monitoring to identify risk of fetal death in high-risk pregnancies.

Nonstress Test (NST)

FHR monitoring to detect accelerations with fetal movement; reactive NST shows 2 accelerations of ≥15 bpm for ≥15 seconds in 20 minutes.

Reactive NST

Two FHR accelerations of ≥15 bpm above baseline for ≥15 seconds within 20 minutes.

Nonreactive NST

NST without adequate accelerations, prompting further assessment (e.g., BPP).

Biophysical Profile (BPP)

Composite fetal well-being score including breathing, movement, tone, NST, and amniotic fluid; 8–10 reassuring.

Doppler Ultrasonography

Ultrasound assessment of blood flow; reduced/absent/reversed end-diastolic velocity may indicate compromise.

Fetal Heart Rate Baseline

Normal baseline 110–160 bpm; reflects autonomic balance throughout pregnancy.

Tachycardia

Fetal heart rate > 160 bpm, can indicate hypoxia, infection, or maternal factors.

Bradycardia

Fetal heart rate < 110 bpm, may indicate fetal hypoxia or other conditions.

Variability

Fluctuation in FHR amplitude; categories: absent, minimal (≤5), moderate (6–25), marked (>25) bpm.

Accelerations

Abrupt increases in FHR by ≥15 bpm for ≥15 seconds, suggesting adequate placental function.

Early Decelerations

FHR decelerations related to fetal head compression and contractions.

Late Decelerations

FHR decelerations occurring after contractions, often due to uteroplacental insufficiency.

Variable Decelerations

FHR decelerations not related to contractions; often due to cord compression; V/U-shaped.

Category I/II/III FHR

Classification of fetal heart rate tracing: I normal, II not predictive, III abnormal and predictive of acidemia.

CMV (Cytomegalovirus)

Common congenital infection; can cause sensorineural hearing loss.

Maternal Diabetes

Increases risk of neonatal hypoglycemia, hypocalcemia, RDS, macrosomia, IUGR, and other complications.

Preeclampsia/Eclampsia

Maternal hypertensive disorders that can cause IUGR, prematurity, and fetal death via uteroplacental insufficiency.

Hypothyroidism/Hyperthyroidism (Pregnancy)

Thyroid dysfunction affecting fertility and fetal development; can cause adverse outcomes.

Maternal Immunologic Disease

Autoimmune conditions (e.g., ITP, SLE) that can cross placenta and affect newborn.

Radiation Exposure

Fetal exposure risk; dose-related risks depend on gestational age (early exposure higher risk for malformations and cognitive effects at specific doses).

Medication and Teratogen Exposure

FDA pregnancy risk categories (A, B, C, D, X) indicating relative risk during pregnancy.

Amniocentesis

Transabdominal withdrawal of amniotic fluid for infection/genetic testing, typically 15–20 weeks.

Cordocentesis / PUBS

Percutaneous umbilical blood sampling for fetal hematologic disorders, infections, or acidosis.

Aneuploidy Screening

First-trimester or mid-gestation screening for risk of common chromosomal abnormalities.

Rh(D) Immunoglobulin Prophylaxis

Rh-negative mothers receive RhIg to prevent Rh incompatibility and hemolytic disease.

Antenatal Corticosteroids

Steroids given to the mother to accelerate fetal lung maturation and surfactant production.

Folic Acid Supplementation

Preconception and early pregnancy measure to prevent neural tube defects.

Perinatal Period / Early Neonatal Period

A patient is in their 29th week of pregnancy. If their baby is born today, the baby would be considered to be within which classification period for the first 7 days of life?

Ductus Arteriosus; it could lead to persistent pulmonary hypertension or a patent ductus arteriosus, affecting oxygenation after birth.

During fetal development, a crucial vessel shunts blood from the pulmonary artery directly to the aorta. If this vessel fails to close properly after birth as oxygen levels rise, what is its name and what immediate issue might arise in the newborn's circulation?

Surfactant

A 28-week premature infant is born and has significant respiratory distress. What naturally produced substance, often deficient in preterm babies, is crucial for reducing alveolar surface tension and preventing lung collapse?

Reactive NST

A pregnant patient at 38 weeks undergoes a Nonstress Test (NST). The monitor shows two fetal heart rate accelerations of 16 bpm above the baseline, each lasting 17 seconds, within a 20-minute period. How would this NST be interpreted?

The score would be less than 8/10, suggesting potential fetal compromise; the absent breathing and inconsistent movements would warrant further assessment.

A Biophysical Profile (BPP) is performed on a fetus, and the results show good fetal tone, presence of amniotic fluid, and a reactive NST, but absent fetal breathing movements and inconsistent fetal body movements. What would be the total score, and what do these specific findings suggest the need for?

Tachycardia (>160 bpm); possible causes include fetal hypoxia, maternal infection, or maternal fever.

During labor, the fetal heart rate (FHR) monitor continuously shows a baseline FHR of 170 bpm. What is this FHR pattern called, and what concerning factors might be contributing to it?

Variable Decelerations; often caused by umbilical cord compression.

A laboring patient's FHR tracing consistently shows abrupt, V or U-shaped drops in FHR, which occur seemingly unrelated to uterine contractions. What type of deceleration is this, and what is its most common cause?

Intrauterine Growth Restriction (IUGR) and prematurity

A newborn delivered by a mother with preeclampsia is noted to be smaller than expected for gestational age. What specific fetal complication is frequently associated with maternal hypertensive disorders like preeclampsia due to uteroplacental insufficiency?

Antenatal corticosteroids accelerate fetal lung maturation and promote surfactant production, reducing the risk and severity of neonatal respiratory distress syndrome.

A pregnant patient at 30 weeks gestation is admitted with preterm labor. The obstetrician decides to administer a course of antenatal corticosteroids (e.g., betamethasone). What is the primary benefit of this medication for the fetus?