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Post 1:
Michelle Wynn
6/22/24, 4:02 PM
NEW
Hello Class,
A baby’s first breath inflates their lungs to its capacity and decreases lung pressure. The first breath is considered the more difficult one due to the transition from being in a fluid-filled environment in the womb to air filled surroundings after birth. This requires the baby to generate enough force to expand their lungs and replace fluid with air. Therefore, both the circulatory and respiratory systems are both impacted by a baby’s first breath.
APGAR is a test performed on a baby 1 minute after birth, which determines how well the baby tolerated the birthing process. Then again at 5 minutes the score tells the health care provider how well the baby is adjusting to being outside of the womb. APGAR stands for – appearance, pulse, grimace, activity, and respiration. The baby’s breathing effort, heart rate, muscle tone, reflexes, and skin color are examined. This test will determine if a newborn needs help breathing or is having heart trouble. The good thing about this is it does not predict the future health of the child.
References:
Hooper, S., te Pas, A., Lang, J. et al. Cardiovascular transition at birth: a physiological sequence. Pediatr Res 77, 608–614 (2015). https://doi.org/10.1038/pr.2015.21
https://www.nature.com
Arulkumaran S. Fetal surveillance in labor. In: Arulkumaran SS, Robson MS, eds. Munro Kerr’s Operative Obstetrics. 13th ed. Philadelphia, PA: Elsevier; 2020:chap 9.
Post 2:
Nichapha Tansawangkul
6/22/24, 7:02 PM
NEW
When newborns take their first breath impacts the circulatory system. Why do you think this might be?
When newborns take their first breath, it significantly impacts the circulatory system because it triggers the inflation of the lungs, which were previously filled with amniotic fluid. This inflation drastically reduces the resistance in the pulmonary vessels, allowing blood to flow more freely through the lungs for oxygenation. Additionally, the first breath initiates the closure of the fetal shunts—ductus arteriosus, foramen ovale, and ductus venosus—that previously bypassed the lungs and liver. These closures redirect blood flow through the lungs for oxygenation and through the liver for detoxification and metabolism. Consequently, the pressures in the heart chambers shift, supporting a normal circulatory pattern suitable for life outside the womb.
What other systems might be impacted by this first independent breath?
The first independent breath of a newborn impacts several other physiological systems beyond the circulatory system. Primarily, the respiratory system undergoes profound changes as the newborn transitions from a fluid-filled environment to breathing air. This initiation of breathing stimulates the expansion of the lungs and activates the exchange of oxygen and carbon dioxide, crucial for oxygenating blood and removing metabolic wastes. Concurrently, the nervous system responds by coordinating respiratory muscle contractions, ensuring effective ventilation. In conjunction with these changes, the endocrine system adjusts to the new oxygen-rich environment, triggering the release of surfactant to maintain alveolar stability and enhance lung compliance. Additionally, the act of breathing generates heat through metabolic processes, supporting the newborn’s thermoregulatory system as it adapts to maintaining body temperature independently. Moreover, the first breath marks the beginning of gastrointestinal function, influencing digestion and absorption processes essential for nutrient utilization and growth. Lastly, exposure to ambient air kickstarts the colonization of gut microbiota, contributing to the development of the immune system and overall health. Thus, the first breath orchestrates a cascade of physiological adjustments across multiple systems, crucial for the newborn’s adaptation to extrauterine life and ongoing development.
How does obtaining an Apgar score provide quick information to medical professionals about the functioning body systems of the newborn?
Obtaining an Apgar score provides rapid and critical information to medical professionals about the newborn’s health and functioning body systems immediately after birth. The score assesses five physiological parameters:
Heart Rate: Reflects cardiovascular function.
Respiratory Effort: Indicates the adequacy of breathing and lung function.
Muscle Tone: Assesses the neuromuscular system.
Reflex Irritability (Grimace Response): Evaluates the central nervous system’s responsiveness.
Color (Skin): Indicates oxygenation and circulation.
The score is typically assigned at 1 minute and 5 minutes after birth, with higher scores (out of 10) indicating better overall health. Here’s how the Apgar score provides quick insight into the newborn’s condition:
Heart Rate and Respiratory Effort: These parameters immediately assess the cardiovascular and respiratory systems’ ability to function independently outside the womb (American Academy of Pediatrics, 2015).
Muscle Tone and Reflexes: They indicate the neuromuscular maturity and the central nervous system’s ability to coordinate responses (American College of Obstetricians and Gynecologists, 2020).
Skin Color: Provides a quick assessment of oxygenation and blood perfusion throughout the body (Royal College of Obstetricians and Gynaecologists, 2015).
By quickly evaluating these five parameters, the Apgar score allows medical professionals to promptly identify any immediate needs for intervention, such as resuscitation or further evaluation. It serves as a standardized tool for communicating the newborn’s health status among healthcare providers, facilitating timely and appropriate care.
References:
American Academy of Pediatrics and American Heart Association. (2015). Textbook of Neonatal Resuscitation (NRP). 7th ed. Elk Grove Village, IL: American Academy of Pediatrics.
American College of Obstetricians and Gynecologists. (2020). ACOG Committee Opinion No. 764: Medically Indicated Late-Preterm and Early-Term Deliveries. Obstetrics & Gynecology, 135(3), e153-e156.
Royal College of Obstetricians and Gynaecologists. (2015). Intrapartum Care: Care of Healthy Women and Their Babies During Childbirth. Clinical Guideline CG190. London: RCOG Press.