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The fetal circulation is composed of the placenta, umbilical blood vessels encapsulated by the umbilical cord, heart and systemic blood vessels. A major difference between the fetal circulation and postnatal circulation is that the lungs are not used during the fetal stage resulting in the presence of shunts to move oxygenated blood and ...
Persistent fetal circulation is a condition caused by a failure in the systemic circulation and pulmonary circulation to convert from the antenatal circulation pattern to the "normal" pattern. Infants experience a high mean arterial pulmonary artery pressure and a high afterload at the right ventricle.
The pathway of fetal umbilical venous flow is umbilical vein left portal vein ductus venosus inferior vena cava eventually right atrium.. This anatomic course is important to recall when assessing the success of neonatal umbilical venous catheterization, as failure to cannulate through the ductus venosus results in malpositioned hepatic catheterization via the left or right portal veins.
A study of 32 normal pregnancies showed that fetal heart motion was visible at a mean human chorionic gonadotropin (hCG) level of 10,000 UI/L (range 8650–12,200). [19] Obstetric ultrasonography can also use Doppler technique on key vessels such as the umbilical artery to detect abnormal flow. Doppler fetal monitor
The unpaired umbilical vein carries oxygen and nutrient rich blood derived from fetal-maternal blood exchange at the chorionic villi.More than two-thirds of fetal hepatic circulation is via the main portal vein, while the remainder is shunted from the left portal vein via the ductus venosus to the inferior vena cava, eventually being delivered to the fetal right atrium.
In prenatal development, the eustachian valve helps direct the flow of oxygen-rich blood through the right atrium into the left atrium and away from the right ventricle. . Before birth, the fetal circulation directs oxygen-rich blood returning from the placenta to mix with blood from the hepatic veins in the inferior vena
All of these cardiovascular system changes result in the adaptation from fetal circulation patterns to an adult circulation pattern. During this transition, some types of congenital heart disease that were not symptomatic in utero during fetal circulation will present with cyanosis or respiratory signs.
Umbilical cord compression can result from, for example, entanglement of the cord, [16] a knot in the cord, [16] or a nuchal cord, [16] (which is the wrapping of the umbilical cord around the fetal neck) [17] but these conditions do not always cause obstruction of fetal circulation. Velamentous cord insertion; Single umbilical artery; Umbilical ...