Fetal Circulation

Fetal C I R C U L A T I O N

Fetal Circulation
is the circulatory The fetal circulation

system of a human fetus, often encompassing the entire fetoplacental circulation that also includes the umbilical cord and the blood vessels within the placenta that carry fetal blood.

works differently from that of born humans, because the lungs are not in use: the fetus obtains oxygen and nutrients from the mother through the placenta and the umbilical cord.[1]

Placenta
is an organ that

weighs approximately

connects the developing fetus to the uterine wall to allow nutrient uptake, waste elimination, and gas exchange via the mother's blood supply. averages 22 cm (9 inch) in length and 22.5 cm (0.81 inch) in thickness

500 grams (1 lb) has a dark reddish-blue or maroon color. It connects to the fetus by an umbilical cord develops from same sperm and egg cells that form the fetus, and functions as a fetomaternal organ with two components: a. fetal part (Chorion frondosum) b. maternal part (Decidua basali

Placenta Function
Nutrition and immunity

- allows the transfer of nutrients and oxygen from the mother to the fetus and the transfer of waste products and carbon dioxide back from the fetus to the mother. - IgG antibodies pass through the human placenta, providing protection to the fetus in uterus.
Secretes hormones that are important during

pregnancy. a. Human Chorionic Gonadotropin (hCG). - can be found in maternal blood and urine during

 Human Chorionic

hCG is only present

Gonadotropin (hCG). -- the hormone analyzed by pregnancy test; a false-negative result from a pregnancy test may be obtained before or after this period. - Women's blood serum (-) for hCG by 1-2 weeks after birth, is proof that all placental tissue is delivered.

during pregnancy because it is secreted by the placenta, which is present only[8] during pregnancy. hCG ensures that the corpus luteum continues to secrete progesterone and estrogen. Progesterone secretion decreases, the endometrial lining slough off and pregnancy will be lost.

 Progesterone

Estrogen is referred

prevents preterm labor by reducing myometrial contraction. Levels of progesterone are high during pregnancy.

to as the "hormone of women" because it stimulates the development of secondary female sex characteristics. - contributes to the woman's mammary gland development in preparation for lactation and stimulates uterine growth to accommodate

 Human Placental

The placenta also

Lactogen (hPL [Human Chorionic Somatomammotropi n]) - This hormone is

lactogenic and growthpromoting properties. - promotes mammary gland growth in preparation for lactation in the mother. - It regulates maternal glucose, protein, fat levels so that this is always available to the fetus.

provides a reservoir of blood for the fetus, delivering blood to it in case of hypotension and vice versa
Fetal surface

smooth & glistening sholtz Maternal surface red & freshlike duncan Large particles such as bacteria cannot pass through the barrier

 Placental expulsion

Placental expulsion

begins as a physiological separation from the wall of the uterus. The period from just after the fetus is expelled until just after the placenta is expelled is called the third stage of labor. The placenta is expelled within 1530 minutes of the baby being born.

can be managed by giving oxytocin via intramuscular injection followed by cord traction to assist in delivering the placenta. Alternatively, it can be managed by allowing the placenta to be expelled without medical assistance.

The umbilical cord

also called the birth cord or

funiculus umbilicalis is the connecting cord from the developing fetus to the placenta. comes from the same zygote as the fetus and contains two arteries (the umbilical arteries) and one vein (the umbilical vein), buried within Wharton's jelly. The umbilical vein supplies the fetus: oxygenated, nutrient-rich blood from the placenta. the umbilical arteries return the deoxygenated, nutrient-depleted blood.

 joins the placenta,

Wharton's jelly, a

which transfers materials to and from the mother's blood without allowing direct mixing. is about 50 centimeters (20 in) long and about 2 centimeters (0.75 in) in diameter.

gelatinous substance made contains one vein, which carries oxygenated, nutrientrich blood to the foetus, and two arteries that carry deoxygenated, nutrient-depleted blood away.

 Associated Problems:

too short - mechanical abruptio - uterine inversion

Associated Problems: too long cord coil cord compression cord prolapsed

Amniotic sac
is the sac in which the

fetus develops in amniotes. a tough but thin transparent pair of membranes, which hold a developing embryo until birth. The inner membrane, the amnion, contains the amniotic fluid and the fetus.

 The outer membrane,

the Chorion, contains the amnion and is part of the placenta. It encloses the amniotic cavity and the embryo. The amniotic cavity contains the amniotic fluid. On the outer side, the amniotic sac is connected to the yolk sac, to the allantois and, through the

Amniotic Fluid
Also known as liquor

amnii is the nourishing and protecting liquid contained by the amniotic sac of a pregnant woman. The amniotic sac grows and begins to fill with water, proteins, carbohydrates, lipids and phospholipids,

Purposes
Protects fetus against Amniocentesis

blows or pressure on mothers abdomen Protects the fetus against the sudden changes in temp. since liquid changes temp. more slowly than air Protects the fetus from infection Provides free movement for the

removal of amniotic fluid to diagnosed chromosomal abnormalities Meconium stained amniotic fluid in non breech presentation is a sign of fetal distress

 During weeks 811,

the fetus begins to swallow and urinate, which is why the amniotic fluid contains fetal urine. The volume of amniotic fluid increases as the fetus grows approximately 800 ml. The amount of fluid declines when the baby is born.

 The fore waters are

released when the amnion ruptures. This is commonly known as the time when a woman's "water breaks (BOW). When this occurs during labour at term, it is known as "spontaneous rupture of membranes" (SROM). If the rupture precedes labour at term, however, it is referred to as "premature rupture of membranes" (PROM).

The majority of the

hind waters remain inside the womb until the baby is born. Artificial rupture of membrane (ARM), a manual rupture of the amniotic sac, can also be performed to release the fluid if the amnion has not spontaneously ruptured.

 Oligo scanty

Polyhydramni

amount of Amniotic fluid less than 500cc which may result to fetal distress because no enough fluid to equalize the pressure

os excessive amount of excessive Amniotic fluid > 15002000cc w/c may result to preterm labor or uterine

Foramen Ovale
also called ostium

secundum of Born or falx septi allows blood to enter the left atrium from the right atrium. one of two fetal cardiac shunts closes at birth and lungs becomes functional It later forms the fossa ovalis - an embryonic remnant of the foramen

Ductus Venosus
shunts approximately

half of the blood flow of the umbilical vein directly to the inferior vena cava. allows oxygenated blood from the placenta to bypass the liver closes during the first week of life in full-term neonates; may take much longer to close in pre-term neonates.

 After it closes, the

remnant is known as ligamentum venosum. If the ductus venosus fails to occlude after birth, the individual is said to have an intrahepatic portosystemic shunt (PSS).

Fetal circulation. The ductus venosus (red) connects the umbilical vein to the inferior vena cava

Ductus Arteriosus
is a temporary fetal

blood vessel that connects the aorta and the pulmonary artery before birth. the ductus arteriosus acts as a "short cut" that allows blood to bypass the deflated lungs and go straight out to the body.

 After birth, when the

lungs are needed to add oxygen to the blood, the ductus arteriosus normally closes. Closure of the ductus arteriosus usually occurs at birth as levels of certain chemicals, called prostagladins, change, and the lungs fill with air. If the ductus arteriosus closes correctly, the blood pumped from the heart goes to the lungs, back into the heart, and

The blood returning

from the lungs and moving out of the aorta carries oxygen to the cells of the body.
In some infants, the

ductus arteriosus remains open (or patent), and the resulting heart defect is known as patent ductus arteriosus.

The Flow
Oxygenated blood

enters the umbilical vein from the placenta oxygenated blood bypass the liver via ductus venosus and combines with deoxygenated blood in the inferior & superior vena cava Enters the right atrium Enters the foramen

 Some blood enters the

right ventricle but most Enters pulmonary artery with some blood going to the lungs to supply oxygen and nourishment Flows to ductus arteriosus Enters descending aorta ( blood going to the lower extremities) Goes back to the placenta via umbilical arteries

 The core concept

The branch of the

behind fetal circulation is that fetal hemoglobin has a higher affinity for oxygen than does adult hemoglobin, which allows a diffusion of oxygen from the mother's circulatory system to the fetus.

umbilical vein that supplies the right lobe of the liver first joins with the portal vein

Summary
Structure Placenta Umbilical Arteries Umbilical Vein Foramen Ovale Location
Attached to the uterus 2 arteries in the cord 1 vein in the cord Opening in the interatrial septum (bet. the R & L atrium)

Function
Gas exchange during fetal life Carry unoxygenated blood from the fetus Carry oxygenated blood from the fetus To shunt blood from the R atrium to the L atrium so that blood can be supplied to brain, heart & kidney To supply blood to the liver

Ductus Venosus

Accessory vein connecting umbilical vein into fetal liver & inferior vena cava Connection bet. fetal lungs & the aorta

Ductus Arteriosus

Shunting of the larger portion of the blood away from the lungs & directly to the aorta