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    Fetal Circulation

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    veegeer
    This document describes fetal circulation and the changes that occur after birth. In fetal circulation, the placenta functions as the lungs and oxygenated blood passes to the left umbilical vein into the liver. The ductus venosus and foramen ovale allow blood to bypass the lungs. After birth, closure of the ductus arteriosus, foramen ovale, and ductus venosus establishes independent pulmonary and systemic circulation as the lungs begin functioning. The umbilical arteries and vein become ligaments.

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    Fetal Circulation

    Uploaded by

    veegeer
    2K views15 pages
    This document describes fetal circulation and the changes that occur after birth. In fetal circulation, the placenta functions as the lungs and oxygenated blood passes to the left umbilical vein into the liver. The ductus venosus and foramen ovale allow blood to bypass the lungs. After birth, closure of the ductus arteriosus, foramen ovale, and ductus venosus establishes independent pulmonary and systemic circulation as the lungs begin functioning. The umbilical arteries and vein become ligaments.

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    This document describes fetal circulation and the changes that occur after birth. In fetal circulation, the placenta functions as the lungs and oxygenated blood passes to the left umbilical vein into the liver. The ductus venosus and foramen ovale allow blood to bypass the lungs. After birth, closure of the ductus arteriosus, foramen ovale, and ductus venosus establishes independent pulmonary and systemic circulation as the lungs begin functioning. The umbilical arteries and vein become ligaments.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    2K views15 pages

    Fetal Circulation

    Uploaded by

    veegeer
    This document describes fetal circulation and the changes that occur after birth. In fetal circulation, the placenta functions as the lungs and oxygenated blood passes to the left umbilical vein into the liver. The ductus venosus and foramen ovale allow blood to bypass the lungs. After birth, closure of the ductus arteriosus, foramen ovale, and ductus venosus establishes independent pulmonary and systemic circulation as the lungs begin functioning. The umbilical arteries and vein become ligaments.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 15

    Fetal circulation

    Neonatal circulation
    Placenta and umbilical vessels

    • Placenta functions as fetal


    lungs and the oxygenated
    blood passes into left
    umbilical vein which
    enters the liver.
    • The umbilical
    arteries(right and left)
    carry deoxygenated blood
    from the fetus to the
    placenta
    Problems of fetal circulation
    • The lungs do not function in fetal life.
    • Hence the left heart and the systemic
    circulation are maintained by number of by-
    pass mechanisms namely;
    • Foramen ovale
    • Ductus arteriosus
    • Ductus venosus
    The left umbilical vein
    • Highly
    oxygenated,nutrient
    rich blood comes from
    the left umbilical vein.
    • Much of this blood is
    diverted into ductus
    venosus, which
    connects the left
    umbilical vein to IVC
    in the liver
    left umbilical vein
    Sphincter mechanism in the liver
    • This regulates the flow of remaining blood
    from umbilical vein into IVC through
    hepatic veins.
    • It is generally agreed that a physiological
    sphincter exists and prevents overloading of
    heart when the venous flow in the
    left.umb.vein is high(eg.during uterine
    contractions)
    Foramen ovale
    • After a short course in
    IVC the blood enters
    the right atrium and
    much of it passes into
    the left atrium through
    foramen ovale(a gap in
    the interatrial septum)
    Ductus arteriosus
    • Low oxygenated blood
    from SVC and some
    amount of blood from IVC
    pass into right ventricle
    and thence into pulmonary
    artery(trunk).
    • 90% of this blood is by-
    passed into the aorta by a
    channel ductus arteriosus
    Ductus arteriosus
    • Connects the left
    branch of the
    pulmonary trunk to
    arch of aorta(beyond
    the origin of left
    subclavian artery)
    • It protects the lungs
    from circulatory
    overloading.
    Pulmonary vascular resistance
    • is high in fetal life and pulmonary blood
    flow is low as the lungs do not need much
    blood for their survival but developing brain
    does.
    Umbilical arteries
    • About 65%of blood in the descending aorta
    • Passes into umbilical arteries(right and left)
    • Which are direct branches of fetal internal
    iliac arteries(hypo gastric arteries)
    • Remaining 35% of blood supplies the lower
    half of the body and viscera
    Postnatal changes
    • Once the child takes the
    first respiration,pulmonary
    circulation begins and the
    right and left hearts
    become completely
    independent of each other.
    • All the by-pass channels
    having served their
    purpose,obliterate.
    • Foramen ovale is closed
    and becomes fossa ovalis
    in the right atrium
    Ligamentum arteriosum
    • The ductus arteriosus
    becomes a fibrous band
    called ligamentum
    arteriosum(which has left
    recurrent laryngeal nerve
    hooking around)
    • (By 96 hours after birth
    100% closure occurs)
    • Many factors contribute to
    this process of obliteration
    called involution(mainly
    oxygen,and transforming
    growth factor)
    Ligamentum venosum
    • Ductus venosus
    becomes a fibrous
    band called
    ligamentum venosum
    which is seen in
    continuation with
    ligamentum
    teres(obliterated left
    umbilical vein)
    Other changes and clinical aspects
    • The umbilical arteries become umbilical ligaments
    attached to the internal iliac arteries upto superior
    vesical arteries.
    • Any failure of all these closures lead to
    • Patent foramen ovale,ASD,VSD,PDA and
    coarctation of aorta.
    • The left umbilical vein remains patent for
    considerable time and can be used for exchanging
    transfusions.

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