Abstract
During the intrauterine life, fetus is totally reliant on the mother for nutrition, growth and development, for gas exchange (Oxygenation and Carbon Dioxide removal), and for clearing of waste products, and placenta is the link. Maintenance of Maternal-placental-fetal physiology and metabolism, and Regulation of Placental Circulation, plays an important role in this aspect. At birth, this equation changes and the newborn baby must adapt to the new situation and fend for itself. Fetal growth and nutrition in the intrauterine period will have a great impact in the newborn baby at birth.
This is a complex process, and several factors interplay to make this transition a success. Problems at this stage can affect the wellbeing of the newborn with increase in morbidity and mortality.
Anesthesiologists need to understand and have complete knowledge of the transition process (from intrauterine to extrauterine life - what initiates, normal adaptation, abnormality in adaptation process), placenta and Feto-Placental circulation, adult circulation, systems involved (cardiovascular, various shunts, systemic and pulmonary vascular resistances, fetal lungs and airway, and liver), interplay of various mechanisms, fetal asphyxia, fetal distress, birth asphyxia, respiratory distress syndrome (RDS) in the newborn, role of Surfactant and Prostaglandins, and factors that can have adverse effects.
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Saha, U. (2023). Changes in the Newborn at Birth: Fetal-to-Newborn Transition. In: Saha, U. (eds) Clinical Anesthesia for the Newborn and the Neonate. Springer, Singapore. https://doi.org/10.1007/978-981-19-5458-0_3
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DOI: https://doi.org/10.1007/978-981-19-5458-0_3
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