The Fetal Circulation

Download as ppt, pdf, or txt
Download as ppt, pdf, or txt
You are on page 1of 13

The Fetal circulation

Helen Wolde
 In the fetal circulation ,the right and
left ventricle exist in a parallel circuit
,as opposed to the series circuit of a
newborn or adult
• Ductus venosus
• Foramen ovale
• Ductus arteriosus
Circulatory adaptation
at birth there is an increase in the
conductance of the pulmonary vessels due to;
•Expansion of collapsible pulmonary capillaries as
well as those vessels that are anotomically
‘tethered’ to the pulmonary parenchyma
•As blood gas composition is changed by an
increase in Po2 and a decrease in Pco2 ,further
increase in vascular conductance is achieved
The output from the right ventricle flows
entirely into the pulmonary circulation and the
shunt through DA reverses
 The peripheral vascular resistance
increases due to ;
• Increasing of the oxygenation of the
blood
• Loss of umblical circulation
• Cold shock of birth
 The left ventricle is now coupled to
the high resistance circulation. There
is a 200% increase in output
 This marked increase in left
ventricular performance is achieved
through a combination of hormonal
and metabolic signals
 This is the ‘transitional’ phase of the
perinatal circulation
 The removal of the placenta from the
circulation results in closure of DV
which becomes ligamentum venosus
 The increased volume of pulmonary
blood flow returning to the left
atrium increases the left atrial
volume and pressure sufficiently to
close the foramen ovale functionally
 The ductus arteriosus remains open
for some hours
 DA constricts under the influence of
prostaglandin interacting with rising
oxygen tension in the blood
 This involutional process normally
begins at about 4-24hr postnatally
and is completed by 24hrs
 The umbilical arteries constrict
vigorously under the influence of
increased oxygen tension and in
response to stretch of the umbilical
cord
 The umbilical arteries close earlier
than the vein resulting in an average
transfer of 15-20ml /Kg of blood to
the fetus
 Persistent pulmonary HTN of the
newborn occurs in term and post-
term infants
 There is excessively high pulmonary
vascular resistance and the infant
becomes ill in the delivery room or
within the first 24 hrs of life
 The patency of this fetal pathways
may either provide a life saving route
for blood to bypass a congenital
defect(PDA ,foramen ovale) or
present an additional stress to the
circulation (PDA)
 Therapeutic agents may either
maintain these fetal pathways or
hasten their closure
Summary
1. There is rise and subsequent fall in
systemic resistance
2. A vast decrease in pulmonary
resistance
3. Increase in left ventricular volume
and pressure workload
4. Decrease in right ventricular
workload
5. Closure of DA ,FO ,DA

You might also like