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Fetal hemoglobin, or foetal haemoglobin (also hemoglobin F, HbF, or α 2 γ 2) is the main oxygen carrier protein in the human fetus.Hemoglobin F is found in fetal red blood cells, and is involved in transporting oxygen from the mother's bloodstream to organs and tissues in the fetus.
Fetal hemoglobin enhances the fetus' ability to draw oxygen from the placenta. This is facilitated by the hemoglobin molecule that made up of two alpha and two gamma chains (2α2γ). Its oxygen-hemoglobin dissociation curve is shifted to the left, meaning that it is able to absorb oxygen at lower concentrations than adult hemoglobin. This ...
Research by Ola Didrik Saugstad and others led to new international guidelines on newborn resuscitation in 2010, recommending the use of normal air instead of 100% oxygen. [31] [32] Increasing the oxygen concentration to the mother has shown little effect on the fetus as hyperoxygenated blood does not perfuse the placental exchange site well. [33]
When the baby is born, the lungs are needed for oxygen transfer and need high blood flow which is encouraged by low PVR. The failure of the circulatory system of the newborn to adapt to these changes by lowering PVR leads to persistent fetal circulation. [2] The newborn is therefore born with elevated PVR, which leads to pulmonary hypertension.
It has been demonstrated that high concentrations of oxygen lead to generation of oxygen free radicals, which have a role in reperfusion injury after asphyxia. [4] Research by Ola Didrik Saugstad and others led to new international guidelines on newborn resuscitation in 2010, recommending the use of normal air instead of 100% oxygen. [5] [6]
The use of fetal scalp blood testing originated in Germany in 1961 and required 0.25 mL of blood drawn from the fetus. [1] As one of the first methods of monitoring fetal wellbeing during labor, there were many disadvantages including the need for at least 3 cm dilation of the mother and extreme precision from the physician performing the procedure. [9]
Transient tachypnea of the newborn occurs in approximately 1 in 100 preterm infants and 3.6–5.7 per 1000 term infants. It is most common in infants born by caesarian section without a trial of labor after 35 weeks of gestation. Male infants and infants with an umbilical cord prolapse or perinatal asphyxia are at higher risk.
An algorithm is used to treat/resuscitate babies in need of respiratory support post-birth. The algorithm steps include: clearing the airways and warming, stimulating, and drying the baby, positive-pressure ventilation (PPV), supplementary oxygen, intubation, chest compressions, and pharmacological therapy. The order of these interventions is ...