15. Physiology of the newborn. Immediate newborn care
Covers how the newborn adapts at birth: the switch to breathing, the changes in circulation as the foetal shunts close, heat loss and glucose, and when jaundice and weight loss count as normal. It then sets out the Apgar score as a table of five signs scored 0 to 2, with the interpretive bands, and lists the immediate care of a healthy baby, including vitamin K, eye prophylaxis, early breastfeeding, and screening and vaccination.
Topic 15 of 61 in the MU Sofia syllabus for Obstetrics and Gynecology (Medicine, Year 5). The free AceMed note covers it in 4 sections, about 282 words (2 min of reading), with 16 flashcards.
In this note
Introduction
Adaptation at birth
Apgar score (at 1 and 5 minutes)
Immediate care of the healthy newborn
Introduction
At birth the newborn must switch from placental to independent life within minutes: start breathing, change the circulation and keep warm.
Adaptation at birth
Breathing: lung fluid is absorbed; cold, touch and a rise in CO₂ trigger the first breath; surfactant keeps the alveoli open.
Circulation: pulmonary resistance falls and systemic resistance rises when the cord is clamped. The foramen ovale closes functionally within hours, the ductus arteriosus within 1–3 days, and the ductus venosus also closes.
Temperature: newborns lose heat fast (large surface, wet skin) and make heat from brown fat.
Glucose: falls in the first hours; feeding early prevents hypoglycaemia.
Physiological jaundice appears after 24 hours, peaks on days 3–5. Jaundice in the first 24 hours is always pathological.
Weight loss of up to 7–10% in the first days is normal; birth weight is regained by 10–14 days.
Apgar score (at 1 and 5 minutes)
7–10 is normal, 4–6 moderately depressed, 0–3 severely depressed. Resuscitation is never delayed while waiting for the 1-minute score.
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