Fetal Circulation

Dr. Shofa N.F.

Divisi fisiologi FK Unswagati
 Anatomy and Physiology
Fetal Circulation
• Umbilical cord
• 2 umbilical arteries: return non-oxygenated
blood, fecal waste, CO2 to placenta
• 1umbilical vein: brings oxygenated blood
and nutrients to the fetus
 Anatomy and Physiology
• Fetus depends on placenta to meet O2
needs while organs continue formation
• Oxygenated blood flows from the
placenta
• To the fetus via the umbilical vein
• After reaching fetus the blood flows
through the inferior vena cava
 A/P Fetal Circulation
• Blood continues to travel from the
inferior vena cava to the ductus
venosis
• Ductus Venosis
• Small amount of blood routed to growing
liver
• Increased blood flow leads to large liver in
newborns
 A/P Fetal Circulation
• Blood continues to travel up the inferior
vena cava
• Empties into the right atrium of the
heart
• The blood then passes to the left
atrium through the foramen ovale
 A/P Fetal Circulation
• Foramen ovale
• Small opening in the septum of the heart
• Completely bypasses the non-functioning lungs

• Blood continues journey to the left ventricle

blood is then pumped into the aorta
• Blood is circulated to the upper extremities
• Blood then returns to the right atrium
 A/P Fetal Circulation
• From the right atrium, the blood goes
to the right ventricle then to the
pulmonary arteries
• Pulmonary arteries
• Small amount goes to the maturing lungs
• Rest of blood is shunted away from
lungs by ductous ateriosus back to
aorta
 A/P Fetal Circulation
• Blood travels back from aorta to the
two umbilical arteries to the
placenta
• The placenta will re-supply the blood
with oxygen
• Fetal circulation is a low-pressure
system
 A/P Fetal Circulation
• Low pressure system
• Lungs are closed
• Most oxygenated blood flows between the
atria of the heart through the foramen
ovale
• This oxygen rich blood flows to the brain
through the ductus arteriosus
 Conversion of Fetal to Infant
Circulation
• At birth
• Clamping the cord shuts down low-
pressure system
• Increased atmospheric pressure(increased
systemic vascular resistance) causes lungs
to inflate with oxygen
• Lungs now become a low-pressure system
• Pressure from increased blood flow
Conversion: Fetal to Infant
Circulation
• In the left side of the heart causes the
foramen ovale to close
• More heavily oxygenated blood passing by
the ductus arteriosus causes it constrict
• Functional closure of the foramen ovale
and ductus arteriosus occurs soon after
birth
• Overall anatomic changes are not complete
for weeks
 Conversion (cont)
• What happens to these special
structures after birth?
• Umbilical arteries atrophy
• Umbilical vein becomes part of the fibrous
support ligament for the liver
• The foramen ovale, ductus arteriosus,
ductus venosus atrophy and become
fibrous ligaments
 Overview of Conversion
• Umbilical cord is clamped
• Loose placenta
• Closure of ductus venosus
• Blood is transported to liver and portal
system
• Loss of placenta also leads to
 Overview of Conversion
• First breath
• Lungs expand and fluid is expelled
• Decreased pulmonary resistance
• Increased pressure in left atrium
• Closure of foramen ovale
 Overview of Conversion
• Loss of placenta
• Increased systemic resistance
• Pressure in right atrium decreased
• Change from right to left shunting to
left to right blood flow
• Increased O2 levels in pulmonary
circulation
• Closure of the ductus arteriosus
 Fetal vs. Infant Circulation
• Fetal • Infant
• Low pressure system • High pressure system
• Right to left shunting • Left to right blood flow
• Lungs non-functional • Lungs functional
• Increased pulmonary • Decreased pulmonary
resistance resistance
• Decreased systemic • Increased systemic
resistance resistance
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