FETAL CIRCULATION
Dr.Santosh
Reddy
DEFINITION
The circulation of oxygenated blood, de-oxygenated
blood, nutritive material etc. in the fetus is termed as
fetal circulation.
Placental Role in Fetal Circulation:
• The circulatory system of the mother is not directly connected to that of the
fetus, so the placenta functions as the respiratory center for the fetus as well
as a site of filtration for plasma nutrients and wastes.
Fetal Lungs:
• Pulmonary vascular resistance is the resistance offered to blood through lungs. The
resistance is very high in fetus because of the non-functioning of fetal lungs. Because
of this high pressure, the blood is diverted from pulmonary artery into aorta.
The blood vessels responsible for fetal circulation are:
1 Umbilical Vein : It carries the oxygenated blood from the placenta to the
growing fetus.
2 Umbilical Arteries : Supplies de-oxygenated blood from the fetus to the
placenta.
SHUNTS INVOLVED IN FETAL CIRCULATION:
1. Ductus Venosus.
2. Ductus Arteriosus.
3. Foramen Ovale.
DUCTUS VENOSUS
The Ductus Venosus shunts the portion of left umbilical
vein blood flow directly to the inferior vena cava.
Allows oxygenated blood from the placenta to bypass the
liver.
DUCTUS ARTERIOSUS
Also called Ductus Botalli.
Connects the pulmonary artery to the proximal descending
aorta.
It allows most of the blood from the right-ventricle to
bypass the fetus fluid-filled non-functioning lungs.
FORAMEN OVALE
It is an opening in the intra-atrial septum.
It allows the blood to enter the left atrium from the right
atrium
It is also called False Septi.
FETAL RESPIRATION AND
CIRCULATION
• Before birth, the fetal lungs do not participate in gas exchange. All of the
oxygen used by the fetus is supplied from the mother by diffusion across
the placenta. CO2 produced during fetal metabolism is transported
across the placenta and removed by the mother’s lungs.
• The fetal lungs are expanded in utero, but the potential air sacs (alveoli)
are filled with fluid instead of air. The pulmonary vessels that will carry
blood to the alveoli after birth are tightly constricted and very little
blood flows into them.
TRANSITIONAL CIRCULATION
A series of physiologic changes occur after birth that culminates in a
successful transition from fetal to neonatal circulation.
Three important physiologic changes that occur during this transition.
When the baby breathes and the umbilical cord is clamped, the
newborn uses the lungs for gas exchange. Fluid is absorbed quickly
from the alveoli and the lungs fill with air. The previously constricted
pulmonary blood vessels begin to dilate so that blood can reach the
alveoli where oxygen will be absorbed and CO2 will be removed
• Although the initial steps in a normal transition occur within a
few minutes of birth, the entire process may not be completed
for hours or even several days.
• For example, studies have shown it may take up to 10 minutes
for a normal term newborn to achieve oxygen saturation
greater than 90%. It may take several hours for alveolar fluid to
be completely absorbed. Functional closure of the ductus
arteriosus may not occur for 24 to 48 hours after birth, and
complete relaxation of the pulmonary blood vessels does not
occur for several months.
HOW DOES A NEWBORN RESPOND TO AN INTERRUPTION IN
NORMAL TRANSITION?
• If there is an interruption in either placental function or neonatal
respiration, gas exchange within tissues is decreased and the arterioles in
the intestines, kidneys, muscles, and skin may constrict. A survival
reflex maintains or increases blood flow to the heart and brain. This
redistribution of blood flow helps to preserve function of these vital
organs. If inadequate gas exchange continues, the heart begins to fail
and blood flow to all organs decreases. The lack of adequate blood
perfusion and tissue oxygenation interferes with cellular function and
may lead to organ damage.
