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As the umbilical vessels are obliterated and the infant starts breathing at birth, the source of oxygen changes from the placenta to the lungs. This major trigger will facilitate the transformation from fetal to postnatal circulation in many ways. First, the ductus venosus was previously kept open by the blood flow from the umbilical vein.
A catheter may be inserted into one of the umbilical arteries of critically ill babies for drawing blood for testing. [6] This is a common procedure in neonatal intensive care, and can often be performed until 2 weeks after birth (when the arteries start to decay too much). [7]
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 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.
Fetal hemoglobin, or foetal haemoglobin (also hemoglobin F, HbF, or α 2 γ 2) is the main oxygen carrier protein in the human fetus.Hemoglobin F is found in fetal red blood cells, and is involved in transporting oxygen from the mother's bloodstream to organs and tissues in the fetus.
During vaginal birth, the newborn's chest is compressed by the birth canal. Upon delivery, negative pressure allows air into the lungs. The first cries of the infant allow for alveoli expansion and absorption of fetal lung fluid. Temperature changes and other sensory stimulation contributes to respiratory function as well.
Ductus arteriosus evolved with the lung in the ancestors of the lungfish as a connection between the pulmonary arteries and dorsal aorta. During embryonic development, reptiles, birds, and mammals all have either one or two paired ductus arteriosi that provide a fetal shunt of blood away from the lungs.
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.