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Specialist of the Ministry of Health Aygun Rustamkhanli: Natural childbirth is very important for the newborn to go through the adaptation period without complications
2021-08-13

Specialist of the Ministry of Health Aygun Rustamkhanli: Natural childbirth is very important for the newborn to go through the adaptation period without complications

Aygun Rustamkhanli, Head of the Neonatology Department of the Teaching Surgery Clinic of the Azerbaijan Medical University, informed about the initial adaptation period of newborns.
 
What is the initial adaptation period?
 
The intrauterine period is the period when all the needs of the fetus are met by the mother. Dynamic time begins with birth. All the organs and systems of the newborn undergo significant changes to ensure postpartum adaptation. Failure to complete the adaptation in any organ or system can be a life-threatening cause for the newborn. Awareness of possible pathological changes and normal physiology provides the basis for timely diagnosis and, if necessary, treatment.
 
What processes begin in the body with birth?
 
With the onset of labor, ie with pain, the level of some hormones (epinephrine, norepinephrine, catecholamine) in the body rises and falls to normal levels 4 hours after birth. The hormones that increase with this pain cause an increase in blood flow to the heart, the development of the lungs (surfactant synthesis), and a decrease and absorption of fluid in the fetal lungs. At the same time there is an increase in metabolism (glycogenolysis, lipolysin) and thyroid hormones after birth. With these, it is clear how important natural childbirth is for a newborn to go through the adaptation period without complications.
 
What happens during the postpartum adaptation period?
 
In the mother's womb, the fetus is partially deprived of oxygen. This is because the rate of blood flow to the fetal lungs is low, and oxygenated and non-oxygenated blood circulate in the same vein. All this is replaced by a different physiology in the body during the postpartum period of adaptation. With the closure of the newborn's umbilical cord, the rate of blood flow to the lungs increases. Adaptation begins with the first crying, that is, breathing. Intra-abdominal oxygen-free environment is eliminated. Absence of some of the substances provided by the couple (prostaglandins) after birth also causes significant changes in the blood circulation of the heart. The arterial flow closes, and in the mother's womb, this flow connects the aorta and pulmonary artery, one of the vital vessels, to mix the blood. Functional closure occurs no later than 96 hours, and anatomical closure within 1-3 months.
 
Wet lung syndrome is sometimes seen in newborns. Please inform about it.
 
For the adaptation of the respiratory system, it is important to absorb fetal lung fluid, start rhythmic ventilation, reduce the pressure and increase the speed of pulmonary blood vessels, and have a sufficient amount of surfactant synthesis. Inside the womb, the lungs are filled with amniotic fluid and amniotic fluid, which is rich in chlorine synthesized from the lungs. The amount of lung fluid that is continuously synthesized in a premature baby is about 20ml / kg. The presence of this fluid in the abdomen is important for the development of the lungs. However, air should replace this fluid for postpartum ventilation. During childbirth, part of the lung fluid is expelled by squeezing the chest cavity. The rest of the fluid is excreted through the pulmonary circulation and lymphatic drainage. If this does not happen, the discharge of lung fluid is delayed. As a result, the clinical manifestations are manifested as "Transient Taxipnoea of ​​the Newborn" or "Wet Lung Syndrome" with shortness of breath, wheezing and retraction.
 
How important is it to be aware of the adaptation of individual organs and systems in the newborn?
 
As can be seen, the activity of the circulatory and respiratory organs is closely linked during the adaptation period. The presence of disease-related pathological processes in any organ or system of the newborn can lead to changes in the adaptation of other organs and systems. This also applies to metabolic, hematological, gastrointestinal, renal, immune and neurological system adaptations.
Ideally, the newborn should be handed over to his or her family in good health after following the changes that will take place during the adaptation period and, if necessary, after appropriate interventions. In addition to newborns requiring severe resuscitation and treatment, the adaptation period of normal, healthy infants in the first days after birth should be closely monitored and monitored.

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