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CIRCULATION
Fetal Circulation
Blood from placenta (80% saturation) returns
to fetus via umbilical vein
Main portion of blood flows through the
ductus venosus directly into IVC
Smaller portion enters the liver sinusoids
(mixes with blood from portal circulation)
Sphincter mechanism in ductus venosus
In IVC mixes blood from lower limbs
Enters right atrium
Guided by the valve of IVC toward foramen
ovale and passes to left atrium
A small portion remains & mixes with blood
from head & upper limbs (SVC)
In left atrium (mixes with blood from lungs) →
left ventricle & ascending aorta
Heart muscle & brain receive well-oxygenated
blood
From SVC into right ventricle → pulmonary
trunk
Resistance in pulmonary vessels is
high, most of the blood passes into
descending aorta via ductus arteriosus
(mixes with blood from proximal aorta)
Descending aorta → umbilical arteries
(oxygen saturation ~ 58%) → placenta
Mixing with desaturated blood may
occur in the following places:
2. liver
3. inferior vena cava
4. right atrium
5. left atrium
6. at the entrance of the ductus
arteriosus into the aorta
Changes At Birth
Changes are caused by cessation of
placental blood flow & beginning of
respiration
As the alveoli expand, constricted pulmonary
vessels open (response to O2) & the Ω of the
pulmonary vasculature drop
Spontaneous constriction of the umbilical
vessels cuts off blood flow from placenta
Create changes in pressure & flow that
cause ductus ateriosus to constrict &
foramen ovale to close
Pressure ↓ in pulmonary trunk → slight
reversal of flow through the ductus
arteriosus
↑ in O2 tension → ductus arteriosus
constrict
Closure of foramen ovale due to
reversal in pressure between the 2 atria
Cessation of umbilical flow & opening of
the pulmonary vasculature → ↓
pressure in right atrium
Sudden ↑ in pulmonary venous return
→ ↑ pressure in left atrium
Septum primum pressed against
septum secundum
First few days, reversible
Fusion in about 1 year
Probe patent foramen ovale – 20% of
individuals
1. Closure of the umbilical arteries
contraction of smooth muscle
thermal & mechanical stimuli & change in
O2 tension
actual obliteration, 2 – 3 months
distal parts → medial umbilcal ligaments
proximal parts → superior vesical arteries
2. Closure of the umbilical vein & ductus
venosus
occurs shortly after that of umbilical
arteries
umbilical vein → ligamentum teres
hepatis
ductus venosus → ligamentum
venosum
3. Closure of ductus arteriosus
contraction of smooth muscle
mediated by bradykinin
complete anatomical closure, 1 – 3
months
→ ligamentum arteriosum