FETAL & ADULT

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

4. Closure of foramen ovale