A brief description about the fetal circulation for BSc Nursing students. This PPT includes the slides aboute fetal circulation from the basic Anatomy and Physiology of Heart and Circulatory system till the Applied aspects of it.

2. LEARNING OBJECTIVES
1. Introduction
2. Anatomy And Physiology Cardio-vascular System
3. Definition Of Foetal Circulation
4. Shunting
5. Flow Of Blood In Foetal Life
6. Changes After Birth
7. Applied Aspect

3. INTRODUCTION
The Circulation of Blood in A Growing Foetus or during
foetal life is different from that of adults circulation,
because of immaturity of lungs or physiologically lungs
are not functioning to Oxygenate the blood, hence the
foetal blood will get Oxygenated blood from maternal
blood through the placental membrane.

4. ANATOMY AND PHYSIOLOGY
The heart is a hallow muscular organ in our body, which maintains the circulation of blood in
a closed circuit known as the circulatory system, heart pumps the blood to all the organs in
our body even to the heart itself, where the exchange of gases, nutrients and other essential
elements takes place through the various transport mechanisms like diffusion, osmosis, etc.
Measurements of heart
• Anteroposterior Diameter - 6cm
• Transvers Diameter - 8 To 9cm
• Length From Apex To Base - 12cm
• Weight In Male - 300-350g
• Weight In Female - 250-300g
Fig:1.1

5. Anatomical Position Of Heart
Heart lies in the middle mediastinum in such a fashion that apex of the heart faces
down, tilted towards left at 4th intercoastal space midclavicular line. base of the heart lies
upward and backward on right side extending to right 3rd coastal cartilage.
RELATIONS OF HEART
Superiorly – The Aorta, Superior Vena Cava, Pulmonary Artery and Pulmonary Veins.
Inferiorly - Apex Rests on the Central Tendon of the Diaphragm.
Anteriorly – The Ribs, Intercoastal Muscles and Sternum.
Posteriorly – Esophagus, Trachea, Left & Right Bronchus, Descending Aorta, Inferior Vena
Cava, And Thoracic Vertebrae.
Laterally – The Lungs.
LAYERS OF HEART
1. Endocardium (Inner Layer)
2. Myocardium (Middle Layer) And
3. Pericardium (Outer Layer)

6. HEART CHAMBERS
The Human Heart has four chambers i.e Right and Left Atrium , And
two Ventricles below the atrium, both the atrium are separated by a
septum called as Atrial Septum and respectively ventricles are by the
Ventricular Septum.
Heart Valves
1. Atrio-ventricular Valves
• Tricuspid Valve (Right Side) And
• Bicuspid Valve (Left Side)
2. Semilunar Valves
• Pulmonary Valve (B/T Rt Ventricle And Pulmonary Artery)
• Aortic Valve (B/T Lt Ventricle And Aorta)
Fig:1.2

7. PHYSIOLOGY OF HEART
Heart as a vital and involuntary function of pumping the bool to all
the organs of our body to nourish all tissue and maintains the controlled
flow of blood in a closed circuit, whole physiology of heart is explained
under the following headings. all the cardio-vascular activities are
controlled by autonomous nervous system (center is located in medulla).
• conductive system of heart (transmission of electrical impulses to maintain the
normal rhythm of the heart)
• cardiac cycle (cyclic changes or events taking place in the heart to
pump the blood)
• circulatory system (circulation of blood throughout the body when heart pumps)
• cardiac out put and (amount of blood ejected from heart in one minute)
• blood pressure (the pressure exerted by the blood on the wall of the blood vessel
during contraction and relaxation of left ventricle)

8. • CONTI….
Fig:1.4

9. • CONT……
CIRCULATORY SYSTEM
Fig:1.5

10. Definition Of Foetal Circulation
Foetal circulation is the circulation of oxygenated and deoxygenated
blood from and to the placenta during the foetal life.

11. SHUNTING
Shunting is the connection between two blood vessels without the
capillaries, shunting can between two arteries, two veins, or between the
arteries and veins. there are three shunting in the fetal circulation,
1. Ductus Venosus (DV) : It is the vein to vein
connection where umbilical vein
connected to the inferior vena cava.
2. Foramen Ovule (FO) : It is the communication
between the atria’s.
3. Ductus Arteriosus (DA) : It is the artery to artery
connection between
pulmonary artery and aorta.

12. Foetal Circulation
Fetal circulation is the circulation of oxygenated and deoxygenated
blood from and to the placenta during the fetal life. It starts from the
placenta, through umbilical vein (which carries oxygenated blood) and
ends to the entry of deoxygenated blood to the placenta through
umbilical arteries.
Placenta
Placenta is the main sours of oxygen and other essential nutrients
for the foetal growth and survival, from placenta one umbilical vein arises,
which carry the oxygenated blood and venous blood is returned to it
through two umbilical Arteries.

13. Umbilical Vein And Ductus Venosus :
One umbilical vein arises from the placenta, which carries the pure
oxygenated blood and other essential nutrients to foetus. foetal liver is
supplied by the pure oxygenated blood and after, the umbilical vein
communicate with the inferior vena cava where the mixing of oxygenated
and deoxygenated blood takes place since inferior vena cava carries
deoxygenated blood and that point of vein to vein connection is known
as ductus venosus (fig: 1.6) . Finally the mixed blood enters the right
atrium through inferior vena cava.

14. Foramen Ovule :
Foramen ovule is the communicating hole in the atrial septum
(between right and left atrium), which allows the blood flow from right
atrium to the left atrium (fig:1.7). This foramen ovule is normal during
foetal life and it closes physiologically soon after the birth and it closes
anatomically permanently at 6th month, and finally foramen ovule
becomes fossa ovule after birth.
Fig:1.7Fig:1.6

15. DUCTUS ARTERIOSUS :
It is the connection or communication between the pulmonary
artery and aorta. Due to high pulmonary pressure in the lungs as the
lungs are filled with fluid during foetal life, the blood moves directly from
pulmonary artery to aorta through the ductus arteriosus (fig:1.8). Only a
little amount of blood goes to the lung for its maturation.
Fig:1.8

16. Fig:1.9

17. Changes After Child Birth
• Lungs Starts With Its Basic Functioning Following First Cry Of
Baby.
• Foreman Ovule - Fossa Ovule
• Ductus Venosus - Ligamentum Venosus
• Ductus Arteriosus - Ligamentum Arteriosus

18. Fig:2.0

19. Applied Aspect (If there is any abnormalities during division of cells in
the heart may leads to congenital heart defects),
A CYANOTIC CONGENITAL HEART DEFECTS
 Septal Wall Defects
• Atrial Septal Defect And
• Ventricular Septal Defect
 Patent Ductus Arteriosus(PDA)
CYANOTIC CONGENITAL HEART DEFECTS
Tetralogy Of Fallot (TOF)
 Transposition Of Great Vessels Fig:2.1