The fetal circulation allows the developing fetus to exchange materials with its mother through structures like the umbilical cord and placenta. There are three major shunts in the fetal circulatory system - the ductus venosus, ductus arteriosus, and foramen ovale - that direct highly-oxygenated blood from the placenta away from the lungs and toward vital organs like the brain and heart. At birth, the loss of placental blood flow and beginning of breathing cause pressure changes and closure of the shunts, redirecting blood flow to the lungs for oxygenation and establishing the postnatal circulatory pattern.
The female reproductive system contains two main parts: the uterus, which hosts the developing fetus, produces vaginal and uterine secretions, and passes the anatomically male sperm through to the fallopian tubes; and the ovaries, which produce the anatomically female egg cells.
TAPVC defines the anomaly in which the pulmonary veins have no connection with the left atrium. Rather, the pulmonary veins connect directly to one of the systemic veins (TAPVC) or drain in to right atrium.
A PFO or ASD is present essentially in those who survive after birth
When pulmonary veins drain anomalously into the right atrium either because of complete absence of the interatrial septum or malattachment of the septum primum , then it is known as total anomalous pulmonary venous drainage.
When some or all of the pulmonary veins drain anomalously in to RA or its tributaries without being abnormally connected, the terms partially anomalous pulmonary venous drainage (PAPVD) or totally anomalous pulmonary venous drainage (TAPVD) with normal pulmonary venous connections are used.
Describe the normal fetal circulation and mention the changes that occur in it is placental stage and after birth. Fetal circulation is composed of placenta, umbilical cord, heart and systemic blood vessels.
A major difference between the fetal circulation and postnatal circulation is that the lungs are not used during the fetal stage resulting in the presence of shunts to move oxygenated blood and nutrients from the placenta to the fetal tissue.
At birth, the start of breathing and the severance of the umbilical cord prompt various changes that quickly transform fetal circulation into postnatal circulation.
When the embryo develops into the fetus, it creates a functional cardiovascular system that cooperates with the mother's system.
During birth, there are functional physiological changes that transform the shared system into an individual one for the fetus.
In the fetus main filtration site for plasma nutrients and wastes in the placenta, which is outside of the body cavity.
In adults, the circulation occurs entirely inside the body.
The blood that flow to through the fetus is actually more complicated than after the baby is born (normal heart).
This is because the mother (the placenta) is doing the work that the baby's lungs will do after birth.
The placenta accepts the blood without oxygen from the fetus through blood vessels that leave the fetus through the umbilical cord (Umbilical arteries , there are two of them).
When blood goes through the placenta it pick up oxygwn.
The oxygen rich blood then returns to the fetus via the third vessels in the umbilical cord (Umbilical vein).
The oxygen rich blood that enters the fetus passes through the fetal liver and enters the right side of the heart.
The oxygen rich blood goes through one of the two extra connections in the fetal heart that will close after the baby is born.
The hole between the top two heart chmbers (right and left atrium) is called "Patent Foramen Ovale (PFO).
This hole allows the oxygen rich blood to go form the right atrium to left atrium and then to the left ventricle and out the aorta.
As a result the blood with the most oxygen gets to the brain.
Blood coming back from the fetus's body also enters the right atrium, but the fetus is able to send this oxygen poor blood from the right atrium to the right ventricle (the chamber that normally pumps blood to the lungs).
most of the blood that leaves the right ventricle in the fetus bypass the lungs through the second of the extra fetal connections known as the ductus arteriosus.
The ductus arteriosus sends the oxygen poor blood to the organs in the lower half of the fetal body. This also allows for the oxygen poor blood to leave the fetus through the umbilical arteries and get back to the placenta to pick up oxygen.
Since the patent foramen ovale and ductus arteriosus are normal findings in the fetus, it is impossible to predict whether or not these connections will close normally after birth in a normal fetal heart.
The female reproductive system contains two main parts: the uterus, which hosts the developing fetus, produces vaginal and uterine secretions, and passes the anatomically male sperm through to the fallopian tubes; and the ovaries, which produce the anatomically female egg cells.
TAPVC defines the anomaly in which the pulmonary veins have no connection with the left atrium. Rather, the pulmonary veins connect directly to one of the systemic veins (TAPVC) or drain in to right atrium.
A PFO or ASD is present essentially in those who survive after birth
When pulmonary veins drain anomalously into the right atrium either because of complete absence of the interatrial septum or malattachment of the septum primum , then it is known as total anomalous pulmonary venous drainage.
When some or all of the pulmonary veins drain anomalously in to RA or its tributaries without being abnormally connected, the terms partially anomalous pulmonary venous drainage (PAPVD) or totally anomalous pulmonary venous drainage (TAPVD) with normal pulmonary venous connections are used.
Describe the normal fetal circulation and mention the changes that occur in it is placental stage and after birth. Fetal circulation is composed of placenta, umbilical cord, heart and systemic blood vessels.
A major difference between the fetal circulation and postnatal circulation is that the lungs are not used during the fetal stage resulting in the presence of shunts to move oxygenated blood and nutrients from the placenta to the fetal tissue.
At birth, the start of breathing and the severance of the umbilical cord prompt various changes that quickly transform fetal circulation into postnatal circulation.
When the embryo develops into the fetus, it creates a functional cardiovascular system that cooperates with the mother's system.
During birth, there are functional physiological changes that transform the shared system into an individual one for the fetus.
In the fetus main filtration site for plasma nutrients and wastes in the placenta, which is outside of the body cavity.
In adults, the circulation occurs entirely inside the body.
The blood that flow to through the fetus is actually more complicated than after the baby is born (normal heart).
This is because the mother (the placenta) is doing the work that the baby's lungs will do after birth.
The placenta accepts the blood without oxygen from the fetus through blood vessels that leave the fetus through the umbilical cord (Umbilical arteries , there are two of them).
When blood goes through the placenta it pick up oxygwn.
The oxygen rich blood then returns to the fetus via the third vessels in the umbilical cord (Umbilical vein).
The oxygen rich blood that enters the fetus passes through the fetal liver and enters the right side of the heart.
The oxygen rich blood goes through one of the two extra connections in the fetal heart that will close after the baby is born.
The hole between the top two heart chmbers (right and left atrium) is called "Patent Foramen Ovale (PFO).
This hole allows the oxygen rich blood to go form the right atrium to left atrium and then to the left ventricle and out the aorta.
As a result the blood with the most oxygen gets to the brain.
Blood coming back from the fetus's body also enters the right atrium, but the fetus is able to send this oxygen poor blood from the right atrium to the right ventricle (the chamber that normally pumps blood to the lungs).
most of the blood that leaves the right ventricle in the fetus bypass the lungs through the second of the extra fetal connections known as the ductus arteriosus.
The ductus arteriosus sends the oxygen poor blood to the organs in the lower half of the fetal body. This also allows for the oxygen poor blood to leave the fetus through the umbilical arteries and get back to the placenta to pick up oxygen.
Since the patent foramen ovale and ductus arteriosus are normal findings in the fetus, it is impossible to predict whether or not these connections will close normally after birth in a normal fetal heart.
Fetal Circulation by Barkha Devi,Lecturer,Sikkim Manipal College of NursingBarkha Devi
This PowerPoint will provide you a short a sweet lecture about fetal circulation. Please give me your feed back .
-Discuss anatomy and physiology of fetal circulation
-Compare and contrast fetal circulation to infant circulation
-Define specialized structures of fetal circulation
Blood from the placenta is carried to the fetus by the umbilical vein. In humans, less than a third of this enters the fetal ductus venosus and is carried to the inferior vena cava, while the rest enters the liver proper from the inferior border of the liver. The branch of the umbilical vein that supplies the right lobe of the liver first joins with the portal vein. The blood then moves to the right atrium of the heart. In the fetus, there is an opening between the right and left atrium (the foramen ovale), and most of the blood flows through this hole directly into the left atrium from the right atrium, thus bypassing pulmonary circulation. The continuation of this blood flow is into the left ventricle, and from there it is pumped through the aorta into the body. Some of the blood moves from the aorta through the internal iliac arteries to the umbilical arteries, and re-enters the placenta, where carbon dioxide and other waste products from the fetus are taken up and enter the maternal circulation.
This is a presentation I had made for giving a seminar on Fetal Circulation in the first year of my MBBS course in Maharashtra.
Please share it with your juniors and colleagues.Thank You
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2. MEANING
• The circulatory system of fetus, called the fetal
circulation, exists only in the fetus & contains
special structure that allows the developing fetus
to exchange material with its mother.
• Umbilical cord:
• 2 umbilical arteries(carries non-o2 blood from
fetus to placenta).
• 1 umbilical vein arteries(carries o2 blood from
placenta to fetus).
3. COMPARISION
REVIEW OF ADULT BLOOD
CIRCULATION
3 shunts in fetal circulation
• Ductus venosus: connects
umbilical vein to inferior
venacava.
• Ductus arteriosus:
connects pulmonary artery
to aorta.
• Foramen ovale: opening
between right and left
aterium.
4.
5.
6.
7. FETAL CIRCULATION
• Before birth, blood from the placenta, about
80% saturated with oxygen, returns to the
fetus by way of the umbilical vein.
• On approaching the liver, most of this blood
flows through the ductus venosus directly
into the inferior vena cava, bypassing the
liver.
• After a short course in the inferior vena
cava, where placental blood mixes with
deoxygenated blood returning from the
lower limbs, it enters the right atrium.
8. FETAL CIRCULATION
• Here it is guided toward the oval foramen by
the valve of the inferior vena cava, and most
of the blood passes directly into the left
atrium.
• From the left atrium, where it mixes with a
small amount of desaturated blood
returning from the lungs, blood enters the
left ventricle and ascending aorta.
• Since the coronary and carotid arteries are
the first branches of the ascending aorta,
the heart musculature and the brain are
supplied with well-oxygenated blood.
9. FETAL CIRCULATION
• A small amount from the IVC is prevented
from entering the left atrium and remains in
the right atrium.
• It mixes with desaturated blood returning
from the head and arms by way of the
superior vena cava.
• Desaturated blood from the superior vena
cava flows by way of the right ventricle into
the pulmonary trunk.
10. FETAL CIRCULATION
• During fetal life, resistance in the pulmonary
vessels is high, such that most of this blood
passes directly through the ductus
arteriosus into the descending aorta, where
it mixes with blood from the proximal aorta.
• After coursing through the descending
aorta, blood flows toward the placenta by
way of the two umbilical arteries.
• The oxygen saturation in the umbilical
arteries is approximately 52-58%.
11. FETAL CIRCULATION
• Theoretically, mixing may occur in the following
places :
1)In the liver by mixture with a small amount of
blood returning from the portal system.
2)In the inferior vena cava which carries
deoxygenated blood returning from the lower
extremities, pelvis, and kidneys.
3)In the right atrium by mixture with blood returning
from the head and limbs.
4)In the left atrium by mixture with blood returning
from the lungs.
5)At the entrance of the ductus arteriosus into the
descending aorta.
12. CIRCULATORY CHANGES AT BIRTH
• Changes in the vascular system at birth are
caused by cessation of placental blood flow and
the beginning of respiration.
• Since the ductus arteriosus closes by muscular
contraction of its wall, the amount of blood
flowing through the lung vessels increases
rapidly.
• This, in turn, raises pressure in the left atrium.
• Simultaneously, pressure in the right atrium
decreases as a result of interruption of placental
blood flow.
• The septum primum is then apposed to the
septum secundum and functionally the oval
13. Foramen ovale Closes shortly after birth,
fuses completely in first year.
Ductus arteriousus Closes soon after birth,
becomes ligamentum
arteriousum in about 3
months.
Ductus venosus Ligamentum venosum
Umbilical arteries Medial umbilical ligaments
Umbilical vein Ligamentum teres
14.
15. Loss of placenta also leads to:
1. First breath
2. Lungs expand and fluid
is expelled
3. Decreased pulmonary
resistance
4. Increased pressure in
left atrium
5. Closure of foramen
ovale
• Increased systemic
resistance
• Pressure in right atrium
decreased
• Change from right to left
shunting to left to right
blood flow
• Increased O2 levels in
pulmonary circulation
• Closure of the ductus
arteriosus
15
