Predisposing factors

Pregnant women <35 years of age

Paternal age <55 years of age
Previous child with down syndrome
A parent carrier
Smoking
Use of oral contraceptive

Precipitating Factors
Aneurysm (paternal)
Mother: 47y.o

Maternal Egg cells

Arrest state of posphase 1

Small Head

Formed in the female embryo

Flattened Forehead
Short neck with
loose folds

Shed in Ovulation
Long suspension state (menopausal stage)

Epicanthal eye
folds

Accumulation of errors in the chromosomes

White spots in eye

iris

Nondisjunction

Flat nose
Sperm/Egg with abnormal number of chromosomes merges with a normal
mate
Small, low set ears
Fertilized egg will have am abnormal number of chromosomes
Congenital cataracts

Protruding tongue

One cell has two 21st chromosomes instead of one

Single transverse
crease
Hearing loss
Flat facial profile

Short broad hands

Trisomy 21 (Down Syndrome)

Wide space
between first and
second toes

Ductus fails to close

Persistent patency of ductus arteriosus Hypotonia

Small nose with a
nasal bridge
Fetal Shunting
Flattened Occiput

Pulmonary vascular resistance falls

Blood begins to shunt, left to right, from aorta to

PA mouth
Small
Increased hemodynamic effect

Congenital Heart
Defect
Increased pulmonary venous return to the LA and LV
Increased pulmonary workload of left side of the heart
Increased pulmonary vascular pressure
Poor feeding and
Weight gain
Sweating with
exertion

Patent Ductus Arteriosus

Tachypnea

Labored Breathing
Pulmonary ingestion, Increased respiratory effort,
Dyspnea
and higher oxygen use
Heart Murmurs

Unable to produce adequate amount of surfactants

Decreased Compliance
Inspiratory pressure increases
Collapsed Alveoli
Impaired immune defenses, no exchange of oxygen and carbon dioxide
Hypoxia
Inefficient pulmonary blood flow
Depression of the preterm newborns available energy
Acquisition of organisms and pathogens
Goes to the lower airways
Sudden Chills
Pleuritic Chest Pain
Orthopnea

Inflammation

Tachypnea

Colonization of bacteria Dyspnea

Pneumonia

Rapid and bounding pulse

Bradycardia

Crackles

Headaches

Lips and nail beds central

cyanosis

Flushed Cheeks

Fever