FETAL
CIRCULATION
Before going through fetal circulation ,we
should understands the several temporary
structure that enable the fetal circulation.
which became change after delivery. these
are
The umbilical veins:-the umbilical veins
leads from the umbilical cord to the
underside of the liver and carries blood rich
in O2 and nutrient. it has a branch which
joint the portal vein and supplies the livers
CONTINUE
The ductus venous(from vein to vein):
it connect the umbilical vein to the inferior
[Link] this point the blood mixes with
deoxygenated blood returning from the lower
parts of the body.
CONTINUE
The foramen ovale:-
it is a temporary opening between the atria
which allows a majority of blood entering
from inferior venacava to pass across into
the left [Link] reason for this diversion
is that the blood does not need to pass
through the lungs ,it is already oxygenated.
CONTINUE
The ductus arteriosus(from an artery to
artery):-it lead from the bifurcation(divide
into two separate part) of the pulmonary
artery to descending aorta.
The hypo gastric arteries: these are branch
off from the internal iliac arteries and became
the umbilical arteries when they enter the
umbilical cards. they return to placenta.
PROCESS OF FETAL CIRCULATION
The umbilical vein carrying the oxygenated blood
(80% saturated) from the placenta enters the fetus at
the umbilicus and runs along the free margin of liver.
In the liver, it gives off branches to the left lobe of
the liver and about half of the blood passes into it
and receives the deoxygenated blood from the portal
vein to drain in inferior venacava.
In liver, the greater portion of oxygenated
blood is mixed with portal venous blood.
The other half of the blood enters a vessel
called the ductus venous, which bypass the
liver.
The ductus venosus connects the inferior
[Link] oxygenated blood from
dectus venosus and deoxygenated blood
from inferior venacava mixed.
As the blood from the inferior venacava
enters the right atrium, most of the blood
flow(75%) of it is shunted directly into the
left atrium through the foramen ovale.
The more highly oxygenated blood of left
atrium is mixed with a small amount of
deoxygenated blood returning from the
lungs through the pulmonary veins.
The left arterial blood is passed on through
the mitral opening to the left ventricles
The left ventricular blood (65% saturated
oxygen) is pumped into the ascending and
arch of aorta and distributed by their
branches to heart, head, neck, brain and
arms.
The rest of the fetal blood 25% remain in the
right atrium. Blood low in oxygen returning
from the head via the superior venacava also
enters the right atrium.
Mostly blood pass from right atrium to the
right ventricle through the tricuspid valve
then to pulmonary artery.
Only small volume of blood enters the
pulmonary artery to supply oxygen and
nutrients for both lungs
Remaining all the pulmonary arterial blood
flow through a special artery present in the
fetus that connects the pulmonary artery
with the aorta called the ductus arteriosus.
The right ventricular blood with low oxygen
content is discharged into the pulmonary
trunk,
The major portion of blood is passed
directly through the ductus arteriosus into
the descending aorta.
The mixed blood of descending aorta is
distributed in whole body and most impure
blood leaves the body by way of two
umbilical arteries to reach the placenta for
recycle.
CHANGE OF THE FETAL CIRCULATION AT
BIRTH
The fetal circulation changes soon after
birth due to
Cessation of the placental blood flow
Initiation of respiration
THE FOLLOWING CHANGES OCCUR
IN THE VASCULAR SYSTEM.
1)Closure of the umbilical arteries:- actual
obliteration takes about 2-3 month. the distal parts
form the lateral umbilical ligaments and the
proximal parts remain open as superior vasical
arteries.
2)Closure of the umbilical vein:-the ductus venosus
collapse and the venous pressure of the inferior
vanacava falls and also in right atria. after
obliteration ,the umbilical forms the ligamenum
trees and ductus venosus becomes ligament
venosum
CONTINUE
3)Closure of the ductus arteriosus:-functional
closure of the ductus may occur soon after the
establishment of pulmonary circulation, the
anatomical obliteration take about 1-3 months and
becomes ligamentum arteriosum.
4)Closure of the foramen ovale: functional closure
occurs soon after birth but anatomical closures in
about 1 years time. during the few days, the closure
may be reversible, this is evidenced by the cyanotic
look of the baby during crying.
DIFFERENCES BETWEEN ADULT AND FETAL
CIRCULATION
Criteria Adult Circulation Fetal circulation
Artery Carries oxygenated Carries Non-
blood away from the oxygenated blood
heart away from the fetal
heart
veins Carries non- Carries oxygenated
oxygenated blood blood back to the heart
towards the heart
Exchange of gases Takes places in the Takes place in the
lungs placenta
pressure Increase pressure on the Increase pressure on the
left side of the heart right side of the heart
CONTINUE
criteria Adult circulation Fetal circulation
Mixed of blood The venous and The arterial and venous blood
arterial blood is not is mixed .
mixed .
Function of
aorta The aorta carries only The aorta carries mixed (O2
oxygenated blood for and CO2 )blood. for
distribution. distribution.
Temporary In adult circulation
there is no temporary In fetal circulation there is
structure
structure. five temporary structure.
which is change different parts
after delivery
SEQUENCE
Non-oxygenated blood enters the right atrium
via the inferior and superior vena cava.
Increase level of blood in the right atrium causes
the tricuspid valve to open and drain the blood
to the right ventricle.
Pressure of blood in the right ventricle causes the
pulmonic valve to open and non-oxygenated
blood is directed to the pulmonary artery then
to the lungs.
CONTINUE
Exchange of gases occurs in the lungs.
Highly oxygenated blood is returned to the
heart via the pulmonary vein to the left atrium.
From the left atrium the pressure of the
oxygenated blood causes the mitral valve to
open and drain the oxygenated blood to the left
ventricle.
CONTINUE
Left ventricle then pumps the
oxygenated blood that opens the
aortic valve. Blood is then directed to
the ascending and descending aorta to
be distributed in the systemic
circulation
FETAL CIRCULATION SEQUENCE
Exchange of gases occurs in the placenta.
Oxygenated blood is carried by the umbilical
vein towards the fetal heart.
The ductus venosus directs part of the blood
flow from the umbilical vein away from the
fetal liver (filtration of the blood by the liver
is unnecessary during the fetal life) and
directly to the inferior vena cava.
CONTINUE
Blood from the ductus venosus enters to
the inferior vena cava. Increase levels of
oxygenated blood flows into the right
atrium
in fetal circulation most of the blood in the
right atrium is directed by the foramen
ovale (opening between the two atria) to
the left atrium.
CONTINUE
The blood then flows to the left atrium to the
left ventricle going to the aorta. Majority of
the blood in the ascending aorta goes to the
brain, heart, head and upper body.
The portion of the blood that drained into the
right ventricle passes to the pulmonary artery
CONTINUE
As blood enters the pulmonary artery (carries
blood to the lungs), an opening called ductus
arteriosus connects the pulmonary artery and
the descending aorta.
Hence, most of the blood will bypass the non-
functioning fetal lungs and will be distributed
to the different parts of the body.
CONTINUE
A small portion of the oxygenated blood that
enters the lungs remains there for fetal lung
maturity.
The umbilical arteries then carry the non-
oxygenated blood away from the heart to the
placenta for oxygenation.
