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  • Fetal Cir

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    Diana Da Silva
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    In fetal circulation, there are shunts that allow blood to bypass the lungs, including the ductus venosus, foramen ovale, and ductus arteriosus. These shunts redirect most blood away from the non-functional lungs to the placenta. After birth, removal of the placenta and expansion of the lungs causes structural and physiological changes that close the shunts as blood flow is redirected to the lungs. Premature infants have difficulty closing the ductus arteriosus due to immature responses to oxygen and other stimuli that normally cause closure.

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    In fetal circulation, there are shunts that allow blood to bypass the lungs, including the ductus venosus, foramen ovale, and ductus arteriosus. These shunts redirect most blood away from the non-functional lungs to the placenta. After birth, removal of the placenta and expansion of the lungs causes structural and physiological changes that close the shunts as blood flow is redirected to the lungs. Premature infants have difficulty closing the ductus arteriosus due to immature responses to oxygen and other stimuli that normally cause closure.

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    4 views16 pages

    Fetal Cir

    Uploaded by

    Diana Da Silva
    In fetal circulation, there are shunts that allow blood to bypass the lungs, including the ductus venosus, foramen ovale, and ductus arteriosus. These shunts redirect most blood away from the non-functional lungs to the placenta. After birth, removal of the placenta and expansion of the lungs causes structural and physiological changes that close the shunts as blood flow is redirected to the lungs. Premature infants have difficulty closing the ductus arteriosus due to immature responses to oxygen and other stimuli that normally cause closure.

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    Fetal Circulation

    Burhan Iskandar Pediatric Cardiology Division Pediatric Department,Medical Faculty Hasanuddin University Makassar

    Fetal circulation
    Fetal circulation Infant and children

    Gases e change

    Placenta

    Lung

    In !etal circulation, there " shunts # Placenta Ductus venosus Foramen ovale Ductus arteriosus

    Fetal cardiac output

    Cardiac output in adult, i! heart rate decreased stroke volume In !etal cardiac output, i! heart rate decreased stroke volume is una$le to increase so is easy develop !etal distress

    Changes in circulation after birth

    %emoval placenta &ung e pansion

    SVR

    Ductus venosus closure

    PVR
    Foramen ovale closure PDA closure

    RA pressure

    LA pressure PBF Venous return to LA

    SO2

    Closure of the ductus


    Fungsional closure '()'* h +natomic closure ,)- .k

    Oxygen, Protaglandin E2, Maturity


    Brady inin Acet!ylc!loline

    O"ygen # t!e ductus


    /0, systemic circulation is the strongest stimulus !or ductal closure Premature in!ant less responsiveness to o ygen than !ull)term in!ant Decreased responsiveness o! immature ductus may also due to persistently high level o! PG1,

    PGE2 ~ the ductus


    PG1, level a!t $irth ductal constriction
    Removal o$ t!e placenta Removal P%&2 $rom circulating due to PBF

    Constricting effect of Indo!ethacine and dilator effect of PGE2 are greater in i!!atur fetus than ter! fetus

    Prolonged patency of PDA

    Closed sini$icant PDA

    Synt!etic iv Synt!eticP%&() P%&()iv

    'ndomet!acine

    Pre!ature "e#born
    2he ductus arteriosus is more likely to remain open a!ter $irth due to # Ductal smooth muscle doesn3t have !ully developed contrictor response to o ygen Persistent high level o! PG1, P$% !ore rapid fall in pre!ature infant and this is lead to early & % shunt and C'F

    Pre!ature "e#born
    2he ductus arteriosus is more likely to remain open a!ter $irth due to # Ductal smooth muscle doesn3t have !ully developed contrictor response to o ygen Persistent high level o! PG1, P$% !ore rapid fall in pre!ature infant

    %espone P( and )( to *arious sti!uli


    Hypo ia and acidosis
    Symp!atetic stimulation

    DA DA

    rela"es

    constricts

    PA

    0 ygen

    DA

    constricts

    rela"es

    PA

    $agal sti!ulation +,adrenergic bloc.rady-inin

    Dilated P+

    Thanks and see u next time

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