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Normal Physiology of a Neonate The Neonate is a very small child. During the first six weeks after birth, he is born with several physical changes. His body is in the process of becoming fully developed, and this can be seen in his weight and physiology. In this article, we will review the normal physiology of a neonate, as well as the signs of injury and base line weights. In addition, we will discuss the presence of meconium in the amniotic fluid.Normal physiology of a neonateThe normal physiology of a newborn differs from the physiology of an older infant, child, or adult. The newborn is a tiny being whose physiological state changes rapidly, in hours, rather than days or years. Most body systems in a newborn will change rapidly and are unpredictably, and the physiology of a newborn is not a complete guide to how they work. This article will discuss the essential elements of a newborn's respiratory system.In neonates, the tubular heart begins beating approximately 28 days after LMP. After 4 weeks, circulation to the fetus begins. By six to eight weeks, the atrium begins to divide and the chambers become defined. By eight weeks, the fetal heart is fully formed. At birth, the newborn's initial cardiac rate is 110 to 180 beats per minute. This may be slightly higher than the adult level because of crying effort, but it will fall to approximately 70 beats per minute by 6 months. The pulmonary artery walls have a thick layer of smooth muscle, which plays a major role in reducing blood pressure. This layer of muscle also thins over the first six to eight weeks of life.Signs of an injury in a neonateNeonates may show symptoms of spinal cord injury during birth. The typical signs include decreased movement, hoarse voice, and respiratory depression. An MRI or CT scan of the head may be required to determine the extent of the bleeding. In rare cases, there may be no obvious symptoms or a delayed response to therapy. Nonetheless, any neonatal spinal cord injury should be suspected if symptoms persist or worsen after a few days.In addition to signs of cerebral damage, a newborn may exhibit other symptoms that are indicative of an injury. For instance, a baby may experience breathing difficulties if the phrenic nerve is injured. However, this injury can result in permanent damage to the brain. Depending on the length of time the injured nerves were left without oxygen, the baby may not fully recover. In addition, newborns with this condition may have abnormal sensitivity to light.Baseline weights for a neonateNeonatal weights at various ages are important for determining the risk for developing chronic lung diseases. Although the earliest age of neonatal obesity is still unclear, it is possible that a child's birth weight is the most important predictor of their adult weight. This study uses routinely collected weights to develop a severity index. Based on clinician panel assessment of severity, this index is intended to provide an objective measure of a neonate's risk for chronic lung disease.Fluid and electrolyte imbalances are common amongst unwell neonates. Their fluid needs are unique because their extracellular fluid decreases over the first few days of life, and their weight falls. Additionally, the insensible water loss increases with decreases in body weight. In order to determine the correct fluid and electrolyte management, it is important to consider the corrected gestational age of the neonate and its disease pathophysiology.Meconium in the amniotic fluidAlthough meconium in the amniotic fluid is relatively rare, it can be dangerous for the neonate if it is inhaled. This is rare for healthy babies but it can still result in complications. If your baby has meconium in its amniotic fluid, discuss your options with your care provider to minimize any discomfort. Ideally, you will want to avoid any traumatic methods such as suctioning.One of the reasons meconium may appear in the amniotic fluid is because the fetus has already passed meconium during pregnancy. While meconium-stained amniotic fluid is relatively uncommon before 37 weeks gestation, it increases as the fetus approaches full term. Although it can be a painful experience for a mother, meconium in the amniotic fluid is a natural part of the birth process.Meconium aspirationThere are several complications associated with meconium aspiration in neonates. The severity of the disease varies, depending on the gestational age and birth weight of the infant. If obstetric intervention is performed immediately, the outcome is usually better than when the neonate is transferred to a nursery for further management. Despite the risks associated with meconium aspiration, the disease can be avoided with appropriate care.In a recent study, researchers compared the outcomes of meconium aspiration in two groups. The group that underwent meconium aspiration was at risk for pulmonary complications, including bleeding diathesis and hypoxic ischemic encephalopathy. Both groups had similar mortality rates, but in the group with more severe complications, meconium aspiration was found to be a contributing factor to the neonatal deaths.Transporting a neonateWhether it is by ambulance or helicopter, there are several steps to take when transporting a neonate. The transport team consists of a medical director and a transport coordinator. Equipment used during transport includes self-contained incubators, continuous positive airway pressure, and a nebulizer with blended oxygen. All supplies needed for the transport team are readily available. Using life support equipment is a vital part of neonate care.An incubator designed for the transport of a neonate is essential. A passive neonatal transport incubator is designed to maintain a constant predetermined temperature, while allowing the child to remain semi or fully upright. The incubator's perforations function as air outlet ports for the neonate to breathe. A passive thermo-regulating incubator can also be used for imaging. Regardless of the type of incubator used, it is important to consider the location of the MRI when transporting a neonate.
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