ANATOMY

Dr. Dakubu
 FOETAL CIRCULATION
• During pregnancy, the fetal circulatory system
works differently than after birth:

• The fetus is connected by the umbilical cord to

the placenta, the organ that develops and
implants in the mother's uterus during
pregnancy.
• Through the blood vessels in the umbilical
cord, the fetus receives all the necessary
nutrition, oxygen, and life support from the
mother through the placenta.
• Waste products and carbon dioxide from the
fetus are sent back through the umbilical cord
and placenta to the mother's circulation to be
eliminated.
• Blood from the mother enters the placenta
and comes in close proximity to the fetal
blood that has returned from the fetus to the
placenta through the umbilical arteries.
• Once the two circulations are in close
proximity in the placenta, the oxygen (O2) and
nutrients, like sugar, protein and fat molecules
can move from maternal to fetal blood, and
carbon dioxide (CO2) and waste products can
move from fetal to maternal blood.
• The maternal blood returns from the placenta
to the mother's veins for her systems to take
care of the waste
• The new well nourished fetal blood returns to
the baby through the umbilical vein.
• The umbilical vein goes to the liver and splits in
to three branches, one of which connects to the
inferior vena cava, a major vein connected to
the heart.
• In this way the well nourished blood reaches
the fetal heart to be sent to the rest of the
body.
 Inside the foetal heart:
• Blood enters the right atrium, the chamber on
the upper right side of the heart.
• Most of the blood flows to the left side
through a special fetal opening between the
left and right atria, called the foramen ovale.
• Blood then passes into the left ventricle (lower
chamber of the heart) and then to the aorta,
(the large artery coming from the heart).
• From the aorta, blood is sent to the head and
upper extremities.
• After circulating there, the blood returns to the
right atrium of the heart through the superior
vena cava.
• About one-third of the blood entering the right
atrium does not flow through the foramen ovale,
but, instead, stays in the right side of the heart,
eventually flowing into the pulmonary artery.
• Because the placenta does the work of exchanging oxygen
(O2) and carbon dioxide (CO2) through the mother's
circulation, the fetal lungs are not used for breathing.
• Instead of blood flowing to the lungs to pick up oxygen
and then flowing to the rest of the body, the fetal
circulation shunts (bypasses) most of the blood away from
the lungs.
• In the fetus, blood is shunted from the pulmonary artery
to the aorta through a connecting blood vessel called the
ductus arteriosus.
• With clamping of the cord, the detachment from the
placenta and the first breaths of air the baby takes at
birth, the fetal circulation changes.
• By removing the placenta reservoir, the baby's venous
resistance/blood pressure goes up.
• By filling the lungs with air, the blood pressure in the
lung arteries goes down.
• This eventually leads to the closing of the two areas
for shunting, the patent foramen ovale (PFO) and the
patent ductus arteriosus (PDA).
• Because the ductus arteriosus (the normal
connection between the aorta and the
pulmonary artery) is no longer needed, it
begins to constrict and close off.
• The circulation in the lungs increases and more
blood flows into the left atrium of the heart.
This increased pressure causes the foramen
ovale to close and blood circulates normally.